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2018 Workers' Compensation Part B Fee Schedule

35606-36578

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CPT/HCPC Code Modifier Medicare Location Global Surgery Indicator Multiple Surgery Indicator Prevailing Charge Amount Fee Schedule Amount Site of Service Amount
35606   1 90 2 0 3,720.57 0
35606   2 90 2 0 3,654.49 0
35606   3 90 2 0 3,489.87 0
35606   4 90 2 0 3,064.72 0
35612   1 90 2 0 3,343.08 0
35612   2 90 2 0 3,006.32 0
35612   3 90 2 0 2,774.13 0
35612   4 90 2 0 3,145.76 0
35616   1 90 2 0 3,081.29 0
35616   2 90 2 0 3,023.88 0
35616   3 90 2 0 3,102.80 0
35616   4 90 2 0 2,753.74 0
35621   1 90 2 0 3,994.52 0
35621   2 90 2 0 3,920.30 0
35621   3 90 2 0 3,797.45 0
35621   4 90 2 0 3,828.02 0
35623   1 90 2 0 2,229.70 0
35623   2 90 2 0 2,195.68 0
35623   3 90 2 0 2,055.93 0
35623   4 90 2 0 2,033.61 0
35626   1 90 2 0 4,147.69 0
35626   2 90 2 0 4,076.19 0
35626   3 90 2 0 3,781.00 0
35626   4 90 2 0 3,736.93 0
35631   1 90 2 0 3,933.86 0
35631   2 90 2 0 3,869.50 0
35631   3 90 2 0 3,604.35 0
35631   4 90 2 0 3,563.14 0
35632   1 90 2 0 2,938.92 0
35632   2 90 2 0 2,665.66 0
35632   3 90 2 0 2,665.66 0
35632   4 90 2 0 2,665.66 0
35633   1 90 2 0 3,173.91 0
35633   2 90 2 0 2,879.22 0
35633   3 90 2 0 2,879.22 0
35633   4 90 2 0 2,879.22 0
35634   1 90 2 0 2,876.26 0
35634   2 90 2 0 2,608.66 0
35634   3 90 2 0 2,608.66 0
35634   4 90 2 0 2,608.66 0
35636   1 90 2 0 3,249.47 0
35636   2 90 2 0 3,201.26 0
35636   3 90 2 0 3,002.94 0
35636   4 90 2 0 2,969.00 0
35637   1 90 2 0 2,578.94 0
35637   2 90 2 0 2,287.37 0
35637   3 90 2 0 2,287.37 0
35637   4 90 2 0 2,287.37 0
35638   1 90 2 0 2,619.72 0
35638   2 90 2 0 2,323.53 0
35638   3 90 2 0 2,323.53 0
35638   4 90 2 0 2,323.53 0
35642   1 90 2 0 2,571.07 0
35642   2 90 2 0 2,530.93 0
35642   3 90 2 0 2,366.13 0
35642   4 90 2 0 2,339.75 0
35645   1 90 2 0 4,044.56 0
35645   2 90 2 0 4,028.01 0
35645   3 90 2 0 2,376.40 0
35645   4 90 2 0 2,349.37 0
35646   1 90 2 0 4,654.31 0
35646   2 90 2 0 4,572.37 0
35646   3 90 2 0 4,234.11 0
35646   4 90 2 0 4,057.40 0
35647   1 90 2 0 2,910.06 0
35647   2 90 2 0 2,605.47 0
35647   3 90 2 0 2,605.47 0
35647   4 90 2 0 2,605.47 0
35650   1 90 2 0 4,394.37 0
35650   2 90 2 0 4,341.36 0
35650   3 90 2 0 4,212.10 0
35650   4 90 2 0 2,650.37 0
35654   1 90 2 0 4,222.62 0
35654   2 90 2 0 4,266.45 0
35654   3 90 2 0 4,034.89 0
35654   4 90 2 0 4,191.22 0
35656   1 90 2 0 3,511.69 0
35656   2 90 2 0 3,346.60 0
35656   3 90 2 0 3,379.96 0
35656   4 90 2 0 3,368.24 0
35661   1 90 2 0 3,039.66 0
35661   2 90 2 0 2,962.86 0
35661   3 90 2 0 2,806.26 0
35661   4 90 2 0 2,888.50 0
35663   1 90 2 0 3,006.10 0
35663   2 90 2 0 3,168.78 0
35663   3 90 2 0 3,286.88 0
35663   4 90 2 0 2,665.16 0
35665   1 90 2 0 3,381.47 0
35665   2 90 2 0 3,300.32 0
35665   3 90 2 0 3,147.02 0
35665   4 90 2 0 3,162.53 0
35666   1 90 2 0 4,130.03 0
35666   2 90 2 0 3,498.46 0
35666   3 90 2 0 3,628.82 0
35666   4 90 2 0 3,182.67 0
35671   1 90 2 0 4,705.24 0
35671   2 90 2 0 4,698.05 0
35671   3 90 2 0 4,557.74 0
35671   4 90 2 0 4,543.14 0
35681   1 ZZZ 0 0 2,418.88 0
35681   2 ZZZ 0 0 2,365.48 0
35681   3 ZZZ 0 0 2,145.20 0
35681   4 ZZZ 0 0 2,118.96 0
35682   1 ZZZ 0 0 941.22 936.00
35682   2 ZZZ 0 0 786.32 781.83
35682   3 ZZZ 0 0 786.32 781.83
35682   4 ZZZ 0 0 786.32 781.83
35683   1 ZZZ 0 0 1,070.36 1062.91
35683   2 ZZZ 0 0 906.80 900.42
35683   3 ZZZ 0 0 906.80 900.42
35683   4 ZZZ 0 0 906.80 900.42
35685   1 ZZZ 0 0 403.02 0
35685   2 ZZZ 0 0 362.23 0
35685   3 ZZZ 0 0 362.23 0
35685   4 ZZZ 0 0 362.23 0
35686   1 ZZZ 0 0 333.38 0
35686   2 ZZZ 0 0 299.62 0
35686   3 ZZZ 0 0 299.62 0
35686   4 ZZZ 0 0 299.62 0
35691   1 90 2 0 3,566.33 0
35691   2 90 2 0 4,511.20 0
35691   3 90 2 0 3,231.74 0
35691   4 90 2 0 3,192.96 0
35693   1 90 2 0 2,227.66 0
35693   2 90 2 0 2,192.62 0
35693   3 90 2 0 2,048.35 0
35693   4 90 2 0 2,025.28 0
35694   1 90 2 0 2,576.38 0
35694   2 90 2 0 2,537.10 0
35694   3 90 2 0 2,375.89 0
35694   4 90 2 0 2,350.03 0
35695   1 90 2 0 2,576.38 0
35695   2 90 2 0 2,537.10 0
35695   3 90 2 0 2,375.89 0
35695   4 90 2 0 2,350.03 0
35697   1 ZZZ 0 0 298.92 0
35697   2 ZZZ 0 0 268.39 0
35697   3 ZZZ 0 0 268.39 0
35697   4 ZZZ 0 0 268.39 0
35700   1 ZZZ 0 0 445.28 0
35700   2 ZZZ 0 0 438.49 0
35700   3 ZZZ 0 0 410.57 0
35700   4 ZZZ 0 0 406.06 0
35701   1 90 2 0 1,252.92 0
35701   2 90 2 0 1,244.21 0
35701   3 90 2 0 1,208.08 0
35701   4 90 2 0 954.76 0
35721   1 90 2 0 1,065.12 0
35721   2 90 2 0 1,054.98 0
35721   3 90 2 0 1,012.82 0
35721   4 90 2 0 1,020.40 0
35741   1 90 2 0 1,073.39 0
35741   2 90 2 0 1,065.32 0
35741   3 90 2 0 1,031.95 0
35741   4 90 2 0 907.52 0
35761   1 90 2 0 1,022.45 0
35761   2 90 2 0 1,003.26 0
35761   3 90 2 0 924.03 0
35761   4 90 2 0 912.78 0
35800   1 90 2 0 1,083.54 0
35800   2 90 2 0 1,065.74 0
35800   3 90 2 0 992.25 0
35800   4 90 2 0 980.67 0
35820   1 90 2 0 2,020.53 0
35820   2 90 2 0 2,028.32 0
35820   3 90 2 0 1,980.23 0
35820   4 90 2 0 1,972.16 0
35840   1 90 2 0 1,975.51 0
35840   2 90 2 0 1,946.71 0
35840   3 90 2 0 1,940.23 0
35840   4 90 2 0 1,889.25 0
35860   1 90 2 0 1,317.00 0
35860   2 90 2 0 1,301.97 0
35860   3 90 2 0 1,275.47 0
35860   4 90 2 0 1,267.74 0
35870   1 90 2 0 7,125.87 0
35870   2 90 2 0 7,125.87 0
35870   3 90 2 0 7,125.87 0
35870   4 90 2 0 7,125.87 0
35875   1 90 2 0 1,958.59 0
35875   2 90 2 0 1,941.54 0
35875   3 90 2 0 1,896.99 0
35875   4 90 2 0 1,890.93 0
35876   1 90 2 0 2,065.69 0
35876   2 90 2 0 2,048.01 0
35876   3 90 2 0 2,000.92 0
35876   4 90 2 0 1,993.93 0
35879   1 90 2 0 1,940.81 0
35879   2 90 2 0 1,731.28 0
35879   3 90 2 0 1,731.28 0
35879   4 90 2 0 1,731.28 0
35881   1 90 2 0 2,126.39 0
35881   2 90 2 0 1,899.18 0
35881   3 90 2 0 1,899.18 0
35881   4 90 2 0 1,899.18 0
35883   1 90 2 0 1,890.38 0
35883   2 90 2 0 1,669.50 0
35883   3 90 2 0 1,669.50 0
35883   4 90 2 0 1,669.50 0
35884   1 90 2 0 2,007.57 0
35884   2 90 2 0 1,773.21 0
35884   3 90 2 0 1,773.21 0
35884   4 90 2 0 1,773.21 0
35901   1 90 2 0 1,370.49 0
35901   2 90 2 0 1,355.25 0
35901   3 90 2 0 1,295.05 0
35901   4 90 2 0 1,285.93 0
35903   1 90 2 0 1,409.17 0
35903   2 90 2 0 1,393.70 0
35903   3 90 2 0 1,332.58 0
35903   4 90 2 0 1,323.14 0
35905   1 90 2 0 1,639.73 0
35905   2 90 2 0 1,622.84 0
35905   3 90 2 0 1,556.29 0
35905   4 90 2 0 1,544.81 0
35907   1 90 2 0 1,661.83 0
35907   2 90 2 0 1,644.81 0
35907   3 90 2 0 1,577.77 0
35907   4 90 2 0 1,566.06 0
36000   1 XXX 2 0 77.47 0
36000   2 XXX 2 0 72.75 0
36000   3 XXX 2 0 104.99 0
36000   4 XXX 2 0 118.72 0
36002   1 0 2 0 338.36 205.46
36002   2 0 2 0 300.40 187.37
36002   3 0 2 0 300.40 187.37
36002   4 0 2 0 300.40 187.37
36005   1 0 2 0 109.88 0
36005   2 0 2 0 104.99 0
36005   3 0 2 0 136.36 0
36005   4 0 2 0 149.76 0
36010   1 XXX 2 0 479.11 0
36010   2 XXX 2 0 470.16 0
36010   3 XXX 2 0 448.96 0
36010   4 XXX 2 0 439.91 0
36011   1 XXX 2 0 424.97 0
36011   2 XXX 2 0 419.68 0
36011   3 XXX 2 0 397.79 0
36011   4 XXX 2 0 393.22 0
36012   1 XXX 2 0 528.57 0
36012   2 XXX 2 0 521.40 0
36012   3 XXX 2 0 491.97 0
36012   4 XXX 2 0 486.14 0
36013   1 XXX 2 0 484.15 0
36013   2 XXX 2 0 475.05 0
36013   3 XXX 2 0 453.48 0
36013   4 XXX 2 0 444.40 0
36014   1 XXX 2 0 452.11 0
36014   2 XXX 2 0 446.03 0
36014   3 XXX 2 0 420.88 0
36014   4 XXX 2 0 415.97 0
36015   1 XXX 2 0 528.57 0
36015   2 XXX 2 0 521.40 0
36015   3 XXX 2 0 491.97 0
36015   4 XXX 2 0 486.14 0
36100   1 XXX 2 0 482.42 0
36100   2 XXX 2 0 475.55 0
36100   3 XXX 2 0 447.38 0
36100   4 XXX 2 0 458.88 0
36140   1 XXX 2 0 392.43 0
36140   2 XXX 2 0 378.38 0
36140   3 XXX 2 0 353.16 0
36140   4 XXX 2 0 360.94 0
36160   1 XXX 2 0 454.85 0
36160   2 XXX 2 0 447.80 0
36160   3 XXX 2 0 418.80 0
36160   4 XXX 2 0 413.80 0
36200   1 XXX 2 0 488.54 0
36200   2 XXX 2 0 481.90 0
36200   3 XXX 2 0 454.53 0
36200   4 XXX 2 0 449.02 0
36215   1 XXX 2 0 601.55 0
36215   2 XXX 2 0 594.68 0
36215   3 XXX 2 0 566.04 0
36215   4 XXX 2 0 559.44 0
36216   1 XXX 2 0 711.30 0
36216   2 XXX 2 0 703.18 0
36216   3 XXX 2 0 669.40 0
36216   4 XXX 2 0 661.55 0
36217   1 XXX 2 0 847.27 0
36217   2 XXX 2 0 837.58 0
36217   3 XXX 2 0 797.47 0
36217   4 XXX 2 0 788.14 0
36218   1 XXX 0 0 135.21 0
36218   2 XXX 0 0 133.65 0
36218   3 XXX 0 0 127.27 0
36218   4 XXX 0 0 125.82 0
36221   1 0 2 0 1,570.66 302.69
36221   2 0 2 0 1,366.76 273.62
36221   3 0 2 0 1,366.76 273.62
36221   4 0 2 0 1,366.76 273.62
36222   1 0 2 0 1,943.23 406.04
36222   2 0 2 0 1,693.54 368.29
36222   3 0 2 0 1,693.54 368.29
36222   4 0 2 0 1,693.54 368.29
36223   1 0 2 0 2,125.73 438.89
36223   2 0 2 0 1,852.47 398.18
36223   3 0 2 0 1,852.47 398.18
36223   4 0 2 0 1,852.47 398.18
36224   1 0 2 0 2,307.65 476.65
36224   2 0 2 0 2,011.54 432.97
36224   3 0 2 0 2,011.54 432.97
36224   4 0 2 0 2,011.54 432.97
36225   1 0 2 0 2,110.02 436.84
36225   2 0 2 0 1,839.04 396.54
36225   3 0 2 0 1,839.04 396.54
36225   4 0 2 0 1,839.04 396.54
36226   1 0 2 0 2,352.22 477.56
36226   2 0 2 0 2,049.96 433.74
36226   3 0 2 0 2,049.96 433.74
36226   4 0 2 0 2,049.96 433.74
36227   1 ZZZ 0 0 340.52 150.41
36227   2 ZZZ 0 0 300.92 137.03
36227   3 ZZZ 0 0 300.92 137.03
36227   4 ZZZ 0 0 300.92 137.03
36228   1 ZZZ 0 0 1,613.00 306.37
36228   2 ZZZ 0 0 1,405.62 279.14
36228   3 ZZZ 0 0 1,405.62 279.14
36228   4 ZZZ 0 0 1,405.62 279.14
36245   1 XXX 2 0 682.68 0
36245   2 XXX 2 0 674.89 0
36245   3 XXX 2 0 642.47 0
36245   4 XXX 2 0 634.93 0
36246   1 XXX 2 0 711.30 0
36246   2 XXX 2 0 703.18 0
36246   3 XXX 2 0 669.40 0
36246   4 XXX 2 0 661.55 0
36247   1 XXX 2 0 847.27 0
36247   2 XXX 2 0 837.58 0
36247   3 XXX 2 0 797.47 0
36247   4 XXX 2 0 788.14 0
36248   1 XXX 0 0 135.21 0
36248   2 XXX 0 0 133.65 0
36248   3 XXX 0 0 127.27 0
36248   4 XXX 0 0 125.82 0
36251   1 0 2 0 2,044.82 404.49
36251   2 0 2 0 1,780.47 366.30
36251   3 0 2 0 1,780.47 366.30
36251   4 0 2 0 1,780.47 366.30
36252   1 0 2 0 2,247.39 526.70
36252   2 0 2 0 1,960.59 477.14
36252   3 0 2 0 1,960.59 477.14
36252   4 0 2 0 1,960.59 477.14
36253   1 0 2 0 3,126.52 563.12
36253   2 0 2 0 2,720.31 510.30
36253   3 0 2 0 2,720.31 510.30
36253   4 0 2 0 2,720.31 510.30
36254   1 0 2 0 3,253.58 607.45
36254   2 0 2 0 2,831.84 550.51
36254   3 0 2 0 2,831.84 550.51
36254   4 0 2 0 2,831.84 550.51
36260   1 90 2 0 1,537.76 0
36260   2 90 2 0 1,512.62 0
36260   3 90 2 0 1,408.95 0
36260   4 90 2 0 1,392.99 0
36261   1 90 2 0 668.76 0
36261   2 90 2 0 869.61 0
36261   3 90 2 0 623.74 0
36261   4 90 2 0 616.96 0
36262   1 90 2 0 527.33 0
36262   2 90 2 0 519.68 0
36262   3 90 2 0 513.24 0
36262   4 90 2 0 482.94 0
36299     YYY 2 0 * 0
36400   1 XXX 2 0 22.33 18.79
36400   2 XXX 2 0 22.12 18.63
36400   3 XXX 2 0 20.96 17.74
36400   4 XXX 2 0 20.81 17.52
36405   1 XXX 2 0 52.90 0
36405   2 XXX 2 0 52.16 0
36405   3 XXX 2 0 48.79 0
36405   4 XXX 2 0 48.12 0
36406   1 XXX 2 0 29.73 0
36406   2 XXX 2 0 29.36 0
36406   3 XXX 2 0 27.90 0
36406   4 XXX 2 0 27.54 0
36410   1 XXX 2 0 33.73 0
36410   2 XXX 2 0 33.21 0
36410   3 XXX 2 0 31.26 0
36410   4 XXX 2 0 30.86 0
36415     XXX 9 0 7.97 0
36416     XXX 9 0 * 0
36420   1 XXX 2 0 126.57 0
36420   2 XXX 2 0 125.19 0
36420   3 XXX 2 0 100.57 0
36420   4 XXX 2 0 148.03 0
36425   1 XXX 2 0 128.60 122.87
36425   2 XXX 2 0 107.27 102.56
36425   3 XXX 2 0 126.53 121.14
36425   4 XXX 2 0 107.44 102.61
36430   1 XXX 0 0 79.62 0
36430   2 XXX 0 0 70.14 0
36430   3 XXX 0 0 67.63 0
36430   4 XXX 0 0 74.95 0
36440   1 XXX 2 0 175.48 0
36440   2 XXX 2 0 173.28 0
36440   3 XXX 2 0 164.23 0
36440   4 XXX 2 0 162.19 0
36450   1 XXX 2 0 594.20 0
36450   2 XXX 2 0 677.02 0
36450   3 XXX 2 0 323.35 0
36450   4 XXX 2 0 319.46 0
36455   1 XXX 2 0 399.17 0
36455   2 XXX 2 0 393.77 0
36455   3 XXX 2 0 371.53 0
36455   4 XXX 2 0 366.98 0
36456   1 XXX 2 0 137.22 0
36456   2 XXX 2 0 126.85 0
36456   3 XXX 2 0 126.85 0
36456   4 XXX 2 0 126.85 0
36460   1 XXX 2 0 1,477.96 0
36460   2 XXX 2 0 1,477.96 0
36460   3 XXX 2 0 1,477.96 0
36460   4 XXX 2 0 1,477.96 0
36465   1 0 2 0 1,972.27 152.15
36465   2 0 2 0 1,726.01 139.76
36465   3 0 2 0 1,726.01 139.76
36465   4 0 2 0 1,726.01 139.76
36466   1 0 2 0 2,060.63 193.33
36466   2 0 2 0 1,805.08 177.72
36466   3 0 2 0 1,805.08 177.72
36466   4 0 2 0 1,805.08 177.72
36468     XXX 2 0 * 0
36470   1 10 2 0 96.73 87.23
36470   2 10 2 0 94.92 85.80
36470   3 10 2 0 94.48 85.31
36470   4 10 2 0 86.75 78.52
36471   1 10 2 0 165.40 149.07
36471   2 10 2 0 163.76 147.70
36471   3 10 2 0 157.09 141.87
36471   4 10 2 0 155.45 140.46
36473   1 0 2 0 1,912.46 223.23
36473   2 0 2 0 1,664.80 206.84
36473   3 0 2 0 1,664.80 206.84
36473   4 0 2 0 1,664.80 206.84
36474   1 ZZZ 0 0 349.36 111.84
36474   2 ZZZ 0 0 308.61 103.62
36474   3 ZZZ 0 0 308.61 103.62
36474   4 ZZZ 0 0 308.61 103.62
36475   1 0 2 0 3,910.95 621.97
36475   2 0 2 0 3,316.16 572.34
36475   3 0 2 0 3,316.16 572.34
36475   4 0 2 0 3,316.16 572.34
36476   1 ZZZ 0 0 757.10 303.38
36476   2 ZZZ 0 0 658.63 280.15
36476   3 ZZZ 0 0 658.63 280.15
36476   4 ZZZ 0 0 658.63 280.15
36478   1 0 2 0 3,599.96 621.97
36478   2 0 2 0 3,056.72 572.34
36478   3 0 2 0 3,056.72 572.34
36478   4 0 2 0 3,056.72 572.34
36479   1 ZZZ 0 0 764.51 303.38
36479   2 ZZZ 0 0 664.81 280.15
36479   3 ZZZ 0 0 664.81 280.15
36479   4 ZZZ 0 0 664.81 280.15
36481   1 0 2 0 1,119.43 0
36481   2 0 2 0 1,104.49 0
36481   3 0 2 0 1,042.46 0
36481   4 0 2 0 1,030.10 0
36482   1 0 2 0 2,625.30 225.41
36482   2 0 2 0 2,298.73 207.21
36482   3 0 2 0 2,298.73 207.21
36482   4 0 2 0 2,298.73 207.21
36483   1 ZZZ 0 0 178.77 112.37
36483   2 ZZZ 0 0 161.25 103.37
36483   3 ZZZ 0 0 161.25 103.37
36483   4 ZZZ 0 0 161.25 103.37
36500   1 0 2 0 169.96 168.44
36500   2 0 2 0 170.61 168.84
36500   3 0 2 0 170.24 168.82
36500   4 0 2 0 164.92 163.07
36510   1 0 2 0 115.12 0
36510   2 0 2 0 114.11 0
36510   3 0 2 0 109.90 0
36510   4 0 2 0 108.78 0
36511   1 0 2 0 165.97 0
36511   2 0 2 0 152.63 0
36511   3 0 2 0 152.63 0
36511   4 0 2 0 152.63 0
36512   1 0 2 0 165.97 0
36512   2 0 2 0 152.63 0
36512   3 0 2 0 152.63 0
36512   4 0 2 0 152.63 0
36513   1 0 2 0 165.97 0
36513   2 0 2 0 152.63 0
36513   3 0 2 0 152.63 0
36513   4 0 2 0 152.63 0
36514   1 0 2 0 165.97 0
36514   2 0 2 0 152.63 0
36514   3 0 2 0 152.63 0
36514   4 0 2 0 152.63 0
36516   1 0 2 0 165.97 0
36516   2 0 2 0 152.63 0
36516   3 0 2 0 152.63 0
36516   4 0 2 0 152.63 0
36522   1 0 2 0 1,188.13 0
36522   2 0 2 0 530.64 0
36522   3 0 2 0 494.06 0
36522   4 0 2 0 487.29 0
36555   1 0 0 0 601.13 246.46
36555   2 0 0 0 527.90 226.18
36555   3 0 0 0 527.90 226.18
36555   4 0 0 0 527.90 226.18
36556   1 0 0 0 569.64 219.80
36556   2 0 0 0 502.43 204.78
36556   3 0 0 0 502.43 204.78
36556   4 0 0 0 502.43 204.78
36557   1 10 2 0 1,306.61 554.89
36557   2 10 2 0 1,138.12 498.62
36557   3 10 2 0 1,138.12 498.62
36557   4 10 2 0 1,138.12 498.62
36558   1 10 2 0 1,279.85 528.12
36558   2 10 2 0 1,112.93 473.40
36558   3 10 2 0 1,112.93 473.40
36558   4 10 2 0 1,112.93 473.40
36560   1 10 2 0 2,450.45 654.66
36560   2 10 2 0 2,120.62 592.84
36560   3 10 2 0 2,120.62 592.84
36560   4 10 2 0 2,120.62 592.84
36561   1 10 2 0 2,428.96 632.44
36561   2 10 2 0 2,100.27 571.93
36561   3 10 2 0 2,100.27 571.93
36561   4 10 2 0 2,100.27 571.93
36563   1 10 2 0 3,064.50 660.71
36563   2 10 2 0 2,640.29 595.33
36563   3 10 2 0 2,640.29 595.33
36563   4 10 2 0 2,640.29 595.33
36565   1 10 2 0 1,952.48 632.44
36565   2 10 2 0 1,694.90 571.93
36565   3 10 2 0 1,694.90 571.93
36565   4 10 2 0 1,694.90 571.93
36566   1 10 2 0 2,039.28 676.18
36566   2 10 2 0 1,772.84 613.18
36566   3 10 2 0 1,772.84 613.18
36566   4 10 2 0 1,772.84 613.18
36568   1 0 0 0 702.28 181.96
36568   2 0 0 0 607.77 165.13
36568   3 0 0 0 607.77 165.13
36568   4 0 0 0 607.77 165.13
36569   1 0 0 0 636.70 169.81
36569   2 0 0 0 552.46 155.22
36569   3 0 0 0 552.46 155.22
36569   4 0 0 0 552.46 155.22
36570   1 10 2 0 3,149.41 573.11
36570   2 10 2 0 2,707.62 515.89
36570   3 10 2 0 2,707.62 515.89
36570   4 10 2 0 2,707.62 515.89
36571   1 10 2 0 2,831.11 571.16
36571   2 10 2 0 2,436.72 514.06
36571   3 10 2 0 2,436.72 514.06
36571   4 10 2 0 2,436.72 514.06
36575   1 0 2 0 324.12 112.55
36575   2 0 2 0 266.38 86.38
36575   3 0 2 0 266.38 86.38
36575   4 0 2 0 266.38 86.38
36576   1 10 2 0 784.24 376.91
36576   2 10 2 0 678.30 331.71
36576   3 10 2 0 678.30 331.71
36576   4 10 2 0 678.30 331.71
36578   1 10 2 0 997.24 426.26
36578   2 10 2 0 861.95 376.17
36578   3 10 2 0 861.95 376.17
36578   4 10 2 0 861.95 376.17