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2020 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   4 90 2 X 3,232.40 X
35606   3 90 2 X 3,680.81 X
35606   2 90 2 X 3,854.43 X
35606   1 90 2 X 3,924.13 X
35612   3 90 2 X 2,925.91 X
35612   2 90 2 X 3,170.81 X
35612   4 90 2 X 3,317.87 X
35612   1 90 2 X 3,525.99 X
35616   4 90 2 X 2,904.41 X
35616   2 90 2 X 3,189.33 X
35616   1 90 2 X 3,249.88 X
35616   3 90 2 X 3,272.56 X
35621   3 90 2 X 4,005.22 X
35621   4 90 2 X 4,037.46 X
35621   2 90 2 X 4,134.79 X
35621   1 90 2 X 4,213.07 X
35623   4 90 2 X 2,144.87 X
35623   3 90 2 X 2,168.42 X
35623   2 90 2 X 2,315.81 X
35623   1 90 2 X 2,351.69 X
35626   4 90 2 X 3,941.39 X
35626   3 90 2 X 3,987.87 X
35626   2 90 2 X 4,299.21 X
35626   1 90 2 X 4,374.63 X
35631   4 90 2 X 3,758.09 X
35631   3 90 2 X 3,801.55 X
35631   2 90 2 X 4,081.21 X
35631   1 90 2 X 4,149.09 X
35632   2 90 2 X 2,811.51 X
35632   3 90 2 X 2,811.51 X
35632   4 90 2 X 2,811.51 X
35632   1 90 2 X 3,099.72 X
35633   2 90 2 X 3,036.75 X
35633   3 90 2 X 3,036.75 X
35633   4 90 2 X 3,036.75 X
35633   1 90 2 X 3,347.56 X
35634   2 90 2 X 2,751.39 X
35634   3 90 2 X 2,751.39 X
35634   4 90 2 X 2,751.39 X
35634   1 90 2 X 3,033.62 X
35636   4 90 2 X 3,131.45 X
35636   3 90 2 X 3,167.24 X
35636   2 90 2 X 3,376.41 X
35636   1 90 2 X 3,427.26 X
35637   2 90 2 X 2,412.52 X
35637   3 90 2 X 2,412.52 X
35637   4 90 2 X 2,412.52 X
35637   1 90 2 X 2,720.05 X
35638   2 90 2 X 2,450.66 X
35638   3 90 2 X 2,450.66 X
35638   4 90 2 X 2,450.66 X
35638   1 90 2 X 2,763.05 X
35642   4 90 2 X 2,467.76 X
35642   3 90 2 X 2,495.59 X
35642   2 90 2 X 2,669.40 X
35642   1 90 2 X 2,711.74 X
35645   4 90 2 X 2,477.92 X
35645   3 90 2 X 2,506.42 X
35645   2 90 2 X 4,248.39 X
35645   1 90 2 X 4,265.84 X
35646   4 90 2 X 4,279.39 X
35646   3 90 2 X 4,465.77 X
35646   2 90 2 X 4,822.53 X
35646   1 90 2 X 4,908.96 X
35647   2 90 2 X 2,748.03 X
35647   3 90 2 X 2,748.03 X
35647   4 90 2 X 2,748.03 X
35647   1 90 2 X 3,069.28 X
35650   4 90 2 X 2,795.38 X
35650   3 90 2 X 4,442.56 X
35650   2 90 2 X 4,578.89 X
35650   1 90 2 X 4,634.80 X
35654   3 90 2 X 4,255.65 X
35654   4 90 2 X 4,420.54 X
35654   1 90 2 X 4,453.65 X
35654   2 90 2 X 4,499.88 X
35656   2 90 2 X 3,529.70 X
35656   4 90 2 X 3,552.53 X
35656   3 90 2 X 3,564.89 X
35656   1 90 2 X 3,703.83 X
35661   3 90 2 X 2,959.79 X
35661   4 90 2 X 3,046.54 X
35661   2 90 2 X 3,124.97 X
35661   1 90 2 X 3,205.97 X
35663   4 90 2 X 2,810.98 X
35663   1 90 2 X 3,170.57 X
35663   2 90 2 X 3,342.15 X
35663   3 90 2 X 3,466.72 X
35665   3 90 2 X 3,319.20 X
35665   4 90 2 X 3,335.56 X
35665   2 90 2 X 3,480.89 X
35665   1 90 2 X 3,566.48 X
35666   4 90 2 X 3,356.80 X
35666   2 90 2 X 3,689.87 X
35666   3 90 2 X 3,827.36 X
35666   1 90 2 X 4,356.00 X
35671   4 90 2 X 4,791.71 X
35671   3 90 2 X 4,807.11 X
35671   2 90 2 X 4,955.10 X
35671   1 90 2 X 4,962.68 X
35681   4 ZZZ 0 X 2,234.90 X
35681   3 ZZZ 0 X 2,262.57 X
35681   2 ZZZ 0 X 2,494.91 X
35681   1 ZZZ 0 X 2,551.22 X
35682   2 ZZZ 0 X 829.35 824.60
35682   3 ZZZ 0 X 829.35 824.60
35682   4 ZZZ 0 X 829.35 824.60
35682   1 ZZZ 0 X 992.72 987.21
35683   2 ZZZ 0 X 956.42 949.69
35683   3 ZZZ 0 X 956.42 949.69
35683   4 ZZZ 0 X 956.42 949.69
35683   1 ZZZ 0 X 1,128.92 1,121.07
35685   2 ZZZ 0 X 382.05 X
35685   3 ZZZ 0 X 382.05 X
35685   4 ZZZ 0 X 382.05 X
35685   1 ZZZ 0 X 425.07 X
35686   2 ZZZ 0 X 316.01 X
35686   3 ZZZ 0 X 316.01 X
35686   4 ZZZ 0 X 316.01 X
35686   1 ZZZ 0 X 351.62 X
35691   4 90 2 X 3,367.66 X
35691   3 90 2 X 3,408.56 X
35691   1 90 2 X 3,761.46 X
35691   2 90 2 X 4,758.02 X
35693   4 90 2 X 2,136.09 X
35693   3 90 2 X 2,160.42 X
35693   2 90 2 X 2,312.58 X
35693   1 90 2 X 2,349.55 X
35694   4 90 2 X 2,478.61 X
35694   3 90 2 X 2,505.89 X
35694   2 90 2 X 2,675.91 X
35694   1 90 2 X 2,717.34 X
35695   4 90 2 X 2,478.61 X
35695   3 90 2 X 2,505.89 X
35695   2 90 2 X 2,675.91 X
35695   1 90 2 X 2,717.34 X
35697   2 ZZZ 0 X 283.07 X
35697   3 ZZZ 0 X 283.07 X
35697   4 ZZZ 0 X 283.07 X
35697   1 ZZZ 0 X 315.28 X
35700   4 ZZZ 0 X 428.28 X
35700   3 ZZZ 0 X 433.03 X
35700   2 ZZZ 0 X 462.49 X
35700   1 ZZZ 0 X 469.64 X
35701   4 90 2 X 1,007.00 X
35701   3 90 2 X 1,274.18 X
35701   2 90 2 X 1,312.29 X
35701   1 90 2 X 1,321.47 X
35702   2 90 2 X 472.44 X
35702   3 90 2 X 472.44 X
35702   4 90 2 X 472.44 X
35702   1 90 2 X 520.35 X
35703   2 90 2 X 480.33 X
35703   3 90 2 X 480.33 X
35703   4 90 2 X 480.33 X
35703   1 90 2 X 528.68 X
35800   4 90 2 X 1,034.33 X
35800   3 90 2 X 1,046.54 X
35800   2 90 2 X 1,124.05 X
35800   1 90 2 X 1,142.82 X
35820   4 90 2 X 2,080.06 X
35820   3 90 2 X 2,088.58 X
35820   1 90 2 X 2,131.08 X
35820   2 90 2 X 2,139.29 X
35840   4 90 2 X 1,992.61 X
35840   3 90 2 X 2,046.39 X
35840   2 90 2 X 2,053.22 X
35840   1 90 2 X 2,083.60 X
35860   4 90 2 X 1,337.10 X
35860   3 90 2 X 1,345.26 X
35860   2 90 2 X 1,373.21 X
35860   1 90 2 X 1,389.06 X
35870   1 90 2 X 7,515.75 X
35870   2 90 2 X 7,515.75 X
35870   3 90 2 X 7,515.75 X
35870   4 90 2 X 7,515.75 X
35875   4 90 2 X 1,994.39 X
35875   3 90 2 X 2,000.78 X
35875   2 90 2 X 2,047.77 X
35875   1 90 2 X 2,065.75 X
35876   4 90 2 X 2,103.02 X
35876   3 90 2 X 2,110.40 X
35876   2 90 2 X 2,160.06 X
35876   1 90 2 X 2,178.71 X
35879   2 90 2 X 1,826.00 X
35879   3 90 2 X 1,826.00 X
35879   4 90 2 X 1,826.00 X
35879   1 90 2 X 2,047.00 X
35881   2 90 2 X 2,003.09 X
35881   3 90 2 X 2,003.09 X
35881   4 90 2 X 2,003.09 X
35881   1 90 2 X 2,242.73 X
35883   2 90 2 X 1,760.84 X
35883   3 90 2 X 1,760.84 X
35883   4 90 2 X 1,760.84 X
35883   1 90 2 X 1,993.81 X
35884   2 90 2 X 1,870.22 X
35884   3 90 2 X 1,870.22 X
35884   4 90 2 X 1,870.22 X
35884   1 90 2 X 2,117.41 X
35901   4 90 2 X 1,356.29 X
35901   3 90 2 X 1,365.91 X
35901   2 90 2 X 1,429.40 X
35901   1 90 2 X 1,445.47 X
35903   4 90 2 X 1,395.53 X
35903   3 90 2 X 1,405.49 X
35903   2 90 2 X 1,469.96 X
35903   1 90 2 X 1,486.27 X
35905   4 90 2 X 1,629.33 X
35905   3 90 2 X 1,641.43 X
35905   2 90 2 X 1,711.64 X
35905   1 90 2 X 1,729.44 X
35907   4 90 2 X 1,651.74 X
35907   3 90 2 X 1,664.10 X
35907   2 90 2 X 1,734.80 X
35907   1 90 2 X 1,752.75 X
36000   2 XXX 2 X 76.73 X
36000   1 XXX 2 X 81.71 X
36000   3 XXX 2 X 110.73 X
36000   4 XXX 2 X 125.21 X
36002   2 0 2 X 316.84 197.62
36002   3 0 2 X 316.84 197.62
36002   4 0 2 X 316.84 197.62
36002   1 0 2 X 356.87 216.71
36005   2 0 2 X 110.73 X
36005   1 0 2 X 115.89 X
36005   3 0 2 X 143.82 X
36005   4 0 2 X 157.95 X
36010   4 XXX 2 X 463.98 X
36010   3 XXX 2 X 473.53 X
36010   2 XXX 2 X 495.88 X
36010   1 XXX 2 X 505.32 X
36011   4 XXX 2 X 414.73 X
36011   3 XXX 2 X 419.56 X
36011   2 XXX 2 X 442.64 X
36011   1 XXX 2 X 448.22 X
36012   4 XXX 2 X 512.74 X
36012   3 XXX 2 X 518.89 X
36012   2 XXX 2 X 549.93 X
36012   1 XXX 2 X 557.49 X
36013   4 XXX 2 X 468.71 X
36013   3 XXX 2 X 478.29 X
36013   2 XXX 2 X 501.05 X
36013   1 XXX 2 X 510.64 X
36014   4 XXX 2 X 438.73 X
36014   3 XXX 2 X 443.91 X
36014   2 XXX 2 X 470.43 X
36014   1 XXX 2 X 476.85 X
36015   4 XXX 2 X 512.74 X
36015   3 XXX 2 X 518.89 X
36015   2 XXX 2 X 549.93 X
36015   1 XXX 2 X 557.49 X
36100   3 XXX 2 X 471.86 X
36100   4 XXX 2 X 483.98 X
36100   2 XXX 2 X 501.57 X
36100   1 XXX 2 X 508.82 X
36140   3 XXX 2 X 372.48 X
36140   4 XXX 2 X 380.69 X
36140   2 XXX 2 X 399.08 X
36140   1 XXX 2 X 413.91 X
36160   4 XXX 2 X 436.44 X
36160   3 XXX 2 X 441.71 X
36160   2 XXX 2 X 472.30 X
36160   1 XXX 2 X 479.73 X
36200   4 XXX 2 X 473.59 X
36200   3 XXX 2 X 479.39 X
36200   2 XXX 2 X 508.26 X
36200   1 XXX 2 X 515.27 X
36215   4 XXX 2 X 590.05 X
36215   3 XXX 2 X 597.01 X
36215   2 XXX 2 X 627.22 X
36215   1 XXX 2 X 634.47 X
36216   4 XXX 2 X 697.75 X
36216   3 XXX 2 X 706.03 X
36216   2 XXX 2 X 741.65 X
36216   1 XXX 2 X 750.22 X
36217   4 XXX 2 X 831.26 X
36217   3 XXX 2 X 841.10 X
36217   2 XXX 2 X 883.40 X
36217   1 XXX 2 X 893.63 X
36218   4 XXX 0 X 132.70 X
36218   3 XXX 0 X 134.24 X
36218   2 XXX 0 X 140.96 X
36218   1 XXX 0 X 142.61 X
36221   2 0 2 X 1,441.54 288.59
36221   3 0 2 X 1,441.54 288.59
36221   4 0 2 X 1,441.54 288.59
36221   1 0 2 X 1,656.60 319.25
36222   2 0 2 X 1,786.20 388.44
36222   3 0 2 X 1,786.20 388.44
36222   4 0 2 X 1,786.20 388.44
36222   1 0 2 X 2,049.55 428.26
36223   2 0 2 X 1,953.83 419.97
36223   3 0 2 X 1,953.83 419.97
36223   4 0 2 X 1,953.83 419.97
36223   1 0 2 X 2,242.03 462.90
36224   2 0 2 X 2,121.60 456.66
36224   3 0 2 X 2,121.60 456.66
36224   4 0 2 X 2,121.60 456.66
36224   1 0 2 X 2,433.91 502.73
36225   2 0 2 X 1,939.66 418.24
36225   3 0 2 X 1,939.66 418.24
36225   4 0 2 X 1,939.66 418.24
36225   1 0 2 X 2,225.47 460.74
36226   2 0 2 X 2,162.12 457.48
36226   3 0 2 X 2,162.12 457.48
36226   4 0 2 X 2,162.12 457.48
36226   1 0 2 X 2,480.92 503.68
36227   2 ZZZ 0 X 317.38 144.53
36227   3 ZZZ 0 X 317.38 144.53
36227   4 ZZZ 0 X 317.38 144.53
36227   1 ZZZ 0 X 359.15 158.64
36228   2 ZZZ 0 X 1,482.53 294.41
36228   3 ZZZ 0 X 1,482.53 294.41
36228   4 ZZZ 0 X 1,482.53 294.41
36228   1 ZZZ 0 X 1,701.25 323.14
36245   4 XXX 2 X 669.67 X
36245   3 XXX 2 X 677.62 X
36245   2 XXX 2 X 711.81 X
36245   1 XXX 2 X 720.03 X
36246   4 XXX 2 X 697.75 X
36246   3 XXX 2 X 706.03 X
36246   2 XXX 2 X 741.65 X
36246   1 XXX 2 X 750.22 X
36247   4 XXX 2 X 831.26 X
36247   3 XXX 2 X 841.10 X
36247   2 XXX 2 X 883.40 X
36247   1 XXX 2 X 893.63 X
36248   4 XXX 0 X 132.70 X
36248   3 XXX 0 X 134.24 X
36248   2 XXX 0 X 140.96 X
36248   1 XXX 0 X 142.61 X
36251   2 0 2 X 1,877.88 386.34
36251   3 0 2 X 1,877.88 386.34
36251   4 0 2 X 1,877.88 386.34
36251   1 0 2 X 2,156.70 426.62
36252   2 0 2 X 2,067.86 503.24
36252   3 0 2 X 2,067.86 503.24
36252   4 0 2 X 2,067.86 503.24
36252   1 0 2 X 2,370.35 555.51
36253   2 0 2 X 2,869.15 538.22
36253   3 0 2 X 2,869.15 538.22
36253   4 0 2 X 2,869.15 538.22
36253   1 0 2 X 3,297.58 593.93
36254   2 0 2 X 2,986.78 580.63
36254   3 0 2 X 2,986.78 580.63
36254   4 0 2 X 2,986.78 580.63
36254   1 0 2 X 3,431.59 640.68
36260   4 90 2 X 1,469.21 X
36260   3 90 2 X 1,486.04 X
36260   2 90 2 X 1,595.38 X
36260   1 90 2 X 1,621.90 X
36261   4 90 2 X 650.72 X
36261   3 90 2 X 657.87 X
36261   1 90 2 X 705.35 X
36261   2 90 2 X 917.19 X
36262   4 90 2 X 509.37 X
36262   3 90 2 X 541.32 X
36262   2 90 2 X 548.11 X
36262   1 90 2 X 556.18 X
36299     YYY 2 X * X
36400   4 XXX 2 X 21.95 18.48
36400   3 XXX 2 X 22.10 18.71
36400   2 XXX 2 X 23.33 19.65
36400   1 XXX 2 X 23.55 19.82
36405   4 XXX 2 X 50.76 X
36405   3 XXX 2 X 51.46 X
36405   2 XXX 2 X 55.01 X
36405   1 XXX 2 X 55.80 X
36406   4 XXX 2 X 29.04 X
36406   3 XXX 2 X 29.42 X
36406   2 XXX 2 X 30.97 X
36406   1 XXX 2 X 31.35 X
36410   4 XXX 2 X 32.55 X
36410   3 XXX 2 X 32.97 X
36410   2 XXX 2 X 35.02 X
36410   1 XXX 2 X 35.58 X
36415     XXX 9 X 8.40 X
36416     XXX 9 X * X
36420   3 XXX 2 X 106.07 X
36420   2 XXX 2 X 132.04 X
36420   1 XXX 2 X 133.49 X
36420   4 XXX 2 X 156.12 X
36425   2 XXX 2 X 113.14 108.17
36425   4 XXX 2 X 113.32 108.22
36425   3 XXX 2 X 133.45 127.77
36425   1 XXX 2 X 135.64 129.60
36430   3 XXX 0 X 71.33 X
36430   2 XXX 0 X 73.97 X
36430   4 XXX 0 X 79.05 X
36430   1 XXX 0 X 83.97 X
36440   4 XXX 2 X 171.06 X
36440   3 XXX 2 X 173.22 X
36440   2 XXX 2 X 182.77 X
36440   1 XXX 2 X 185.09 X
36450   4 XXX 2 X 336.94 X
36450   3 XXX 2 X 341.04 X
36450   1 XXX 2 X 626.71 X
36450   2 XXX 2 X 714.06 X
36455   4 XXX 2 X 387.06 X
36455   3 XXX 2 X 391.86 X
36455   2 XXX 2 X 415.32 X
36455   1 XXX 2 X 421.01 X
36456   2 XXX 2 X 133.79 X
36456   3 XXX 2 X 133.79 X
36456   4 XXX 2 X 133.79 X
36456   1 XXX 2 X 144.73 X
36460   1 XXX 2 X 1,558.82 X
36460   2 XXX 2 X 1,558.82 X
36460   3 XXX 2 X 1,558.82 X
36460   4 XXX 2 X 1,558.82 X
36465   2 0 2 X 1,820.45 147.40
36465   3 0 2 X 1,820.45 147.40
36465   4 0 2 X 1,820.45 147.40
36465   1 0 2 X 2,080.18 160.48
36466   2 0 2 X 1,903.84 187.45
36466   3 0 2 X 1,903.84 187.45
36466   4 0 2 X 1,903.84 187.45
36466   1 0 2 X 2,173.37 203.91
36468     XXX 2 X * X
36470   4 10 2 X 91.50 82.82
36470   3 10 2 X 99.65 89.98
36470   2 10 2 X 100.11 90.49
36470   1 10 2 X 102.02 92.01
36471   4 10 2 X 163.96 148.14
36471   3 10 2 X 165.68 149.63
36471   2 10 2 X 172.72 155.78
36471   1 10 2 X 174.45 157.23
36473   2 0 2 X 1,755.89 218.16
36473   3 0 2 X 1,755.89 218.16
36473   4 0 2 X 1,755.89 218.16
36473   1 0 2 X 2,017.10 235.44
36474   2 ZZZ 0 X 325.50 109.29
36474   3 ZZZ 0 X 325.50 109.29
36474   4 ZZZ 0 X 325.50 109.29
36474   1 ZZZ 0 X 368.48 117.96
36475   2 0 2 X 3,497.60 603.65
36475   3 0 2 X 3,497.60 603.65
36475   4 0 2 X 3,497.60 603.65
36475   1 0 2 X 4,124.93 656.00
36476   2 ZZZ 0 X 694.67 295.47
36476   3 ZZZ 0 X 694.67 295.47
36476   4 ZZZ 0 X 694.67 295.47
36476   1 ZZZ 0 X 798.52 319.98
36478   2 0 2 X 3,223.96 603.65
36478   3 0 2 X 3,223.96 603.65
36478   4 0 2 X 3,223.96 603.65
36478   1 0 2 X 3,796.93 656.00
36479   2 ZZZ 0 X 701.18 295.47
36479   3 ZZZ 0 X 701.18 295.47
36479   4 ZZZ 0 X 701.18 295.47
36479   1 ZZZ 0 X 806.33 319.98
36481   4 0 2 X 1,086.46 X
36481   3 0 2 X 1,099.50 X
36481   2 0 2 X 1,164.92 X
36481   1 0 2 X 1,180.68 X
36482   2 0 2 X 2,424.50 218.55
36482   3 0 2 X 2,424.50 218.55
36482   4 0 2 X 2,424.50 218.55
36482   1 0 2 X 2,768.94 237.74
36483   2 ZZZ 0 X 170.07 109.03
36483   3 ZZZ 0 X 170.07 109.03
36483   4 ZZZ 0 X 170.07 109.03
36483   1 ZZZ 0 X 188.55 118.51
36500   4 0 2 X 173.94 171.99
36500   1 0 2 X 179.26 177.65
36500   3 0 2 X 179.56 178.05
36500   2 0 2 X 179.94 178.07
36510   4 0 2 X 114.73 X
36510   3 0 2 X 115.92 X
36510   2 0 2 X 120.35 X
36510   1 0 2 X 121.42 X
36511   2 0 2 X 160.98 X
36511   3 0 2 X 160.98 X
36511   4 0 2 X 160.98 X
36511   1 0 2 X 175.05 X
36512   2 0 2 X 160.98 X
36512   3 0 2 X 160.98 X
36512   4 0 2 X 160.98 X
36512   1 0 2 X 175.05 X
36513   2 0 2 X 160.98 X
36513   3 0 2 X 160.98 X
36513   4 0 2 X 160.98 X
36513   1 0 2 X 175.05 X
36514   2 0 2 X 160.98 X
36514   3 0 2 X 160.98 X
36514   4 0 2 X 160.98 X
36514   1 0 2 X 175.05 X
36516   2 0 2 X 160.98 X
36516   3 0 2 X 160.98 X
36516   4 0 2 X 160.98 X
36516   1 0 2 X 175.05 X
36522   4 0 2 X 513.95 X
36522   3 0 2 X 521.09 X
36522   2 0 2 X 559.67 X
36522   1 0 2 X 1,253.14 X
36555   2 0 0 X 556.78 238.55
36555   3 0 0 X 556.78 238.55
36555   4 0 0 X 556.78 238.55
36555   1 0 0 X 634.02 259.95
36556   2 0 0 X 529.92 215.98
36556   3 0 0 X 529.92 215.98
36556   4 0 0 X 529.92 215.98
36556   1 0 0 X 600.80 231.83
36557   2 10 2 X 1,200.39 525.90
36557   3 10 2 X 1,200.39 525.90
36557   4 10 2 X 1,200.39 525.90
36557   1 10 2 X 1,378.10 585.25
36558   2 10 2 X 1,173.82 499.30
36558   3 10 2 X 1,173.82 499.30
36558   4 10 2 X 1,173.82 499.30
36558   1 10 2 X 1,349.88 557.02
36560   2 10 2 X 2,236.64 625.28
36560   3 10 2 X 2,236.64 625.28
36560   4 10 2 X 2,236.64 625.28
36560   1 10 2 X 2,584.52 690.48
36561   2 10 2 X 2,215.19 603.22
36561   3 10 2 X 2,215.19 603.22
36561   4 10 2 X 2,215.19 603.22
36561   1 10 2 X 2,561.86 667.05
36563   2 10 2 X 2,784.75 627.90
36563   3 10 2 X 2,784.75 627.90
36563   4 10 2 X 2,784.75 627.90
36563   1 10 2 X 3,232.16 696.86
36565   2 10 2 X 1,787.63 603.22
36565   3 10 2 X 1,787.63 603.22
36565   4 10 2 X 1,787.63 603.22
36565   1 10 2 X 2,059.31 667.05
36566   2 10 2 X 1,869.84 646.73
36566   3 10 2 X 1,869.84 646.73
36566   4 10 2 X 1,869.84 646.73
36566   1 10 2 X 2,150.85 713.17
36568   2 0 0 X 641.02 174.17
36568   3 0 0 X 641.02 174.17
36568   4 0 0 X 641.02 174.17
36568   1 0 0 X 740.70 191.92
36569   2 0 0 X 582.69 163.71
36569   3 0 0 X 582.69 163.71
36569   4 0 0 X 582.69 163.71
36569   1 0 0 X 671.53 179.11
36570   2 10 2 X 2,855.77 544.12
36570   3 10 2 X 2,855.77 544.12
36570   4 10 2 X 2,855.77 544.12
36570   1 10 2 X 3,321.73 604.46
36571   2 10 2 X 2,570.04 542.18
36571   3 10 2 X 2,570.04 542.18
36571   4 10 2 X 2,570.04 542.18
36571   1 10 2 X 2,986.01 602.41
36572   2 0 0 X 458.98 106.39
36572   3 0 0 X 458.98 106.39
36572   4 0 0 X 458.98 106.39
36572   1 0 0 X 518.61 114.04
36573   2 0 0 X 432.07 98.54
36573   3 0 0 X 432.07 98.54
36573   4 0 0 X 432.07 98.54
36573   1 0 0 X 488.50 105.79
36575   2 0 2 X 280.96 91.11
36575   3 0 2 X 280.96 91.11
36575   4 0 2 X 280.96 91.11
36575   1 0 2 X 341.85 118.71
36576   2 10 2 X 715.41 349.86
36576   3 10 2 X 715.41 349.86
36576   4 10 2 X 715.41 349.86
36576   1 10 2 X 827.15 397.53
36578   2 10 2 X 909.10 396.75
36578   3 10 2 X 909.10 396.75
36578   4 10 2 X 909.10 396.75
36578   1 10 2 X 1,051.81 449.58