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2020 Workers' Compensation Part B Fee Schedule

36580-38564

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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
36580   2 0 0 X 510.26 120.16
36580   3 0 0 X 510.26 120.16
36580   4 0 0 X 510.26 120.16
36580   1 0 0 X 591.55 133.06
36581   2 10 2 X 1,072.85 370.64
36581   3 10 2 X 1,072.85 370.64
36581   4 10 2 X 1,072.85 370.64
36581   1 10 2 X 1,244.86 419.53
36582   2 10 2 X 2,009.91 543.57
36582   3 10 2 X 2,009.91 543.57
36582   4 10 2 X 2,009.91 543.57
36582   1 10 2 X 2,328.65 605.00
36583   2 10 2 X 1,183.92 547.45
36583   3 10 2 X 1,183.92 547.45
36583   4 10 2 X 1,183.92 547.45
36583   1 10 2 X 1,357.20 609.14
36584   2 0 0 X 531.87 120.90
36584   3 0 0 X 531.87 120.90
36584   4 0 0 X 531.87 120.90
36584   1 0 0 X 618.07 134.98
36585   2 10 2 X 2,525.92 508.53
36585   3 10 2 X 2,525.92 508.53
36585   4 10 2 X 2,525.92 508.53
36585   1 10 2 X 2,939.23 567.82
36589   2 10 2 X 298.33 249.80
36589   3 10 2 X 298.33 249.80
36589   4 10 2 X 298.33 249.80
36589   1 10 2 X 335.58 278.50
36590   2 10 2 X 633.42 340.36
36590   3 10 2 X 633.42 340.36
36590   4 10 2 X 633.42 340.36
36590   1 10 2 X 724.06 379.61
36591   2 XXX 0 X 29.00 X
36591   3 XXX 0 X 29.00 X
36591   4 XXX 0 X 29.00 X
36591   1 XXX 0 X 35.17 X
36592   2 XXX 0 X 35.83 X
36592   3 XXX 0 X 35.83 X
36592   4 XXX 0 X 35.83 X
36592   1 XXX 0 X 43.44 X
36593   2 XXX 0 X 51.62 X
36593   3 XXX 0 X 51.62 X
36593   4 XXX 0 X 51.62 X
36593   1 XXX 0 X 69.94 X
36595   2 0 2 X 1,462.87 341.71
36595   3 0 2 X 1,462.87 341.71
36595   4 0 2 X 1,462.87 341.71
36595   1 0 2 X 1,692.04 374.20
36596   2 0 2 X 321.87 82.33
36596   3 0 2 X 321.87 82.33
36596   4 0 2 X 321.87 82.33
36596   1 0 2 X 372.37 90.73
36597   2 0 2 X 279.00 110.10
36597   3 0 2 X 279.00 110.10
36597   4 0 2 X 279.00 110.10
36597   1 0 2 X 317.96 119.39
36598   2 0 2 X 188.08 X
36598   3 0 2 X 188.08 X
36598   4 0 2 X 188.08 X
36598   1 0 2 X 222.29 X
36600   4 XXX 2 X 31.31 X
36600   3 XXX 2 X 31.66 X
36600   2 XXX 2 X 33.16 X
36600   1 XXX 2 X 33.56 X
36620   4 0 0 X 154.07 X
36620   3 0 0 X 155.85 X
36620   2 0 0 X 166.29 X
36620   1 0 0 X 168.84 X
36625   4 0 0 X 249.45 X
36625   3 0 0 X 252.13 X
36625   2 0 0 X 266.94 X
36625   1 0 0 X 286.00 X
36640   4 0 2 X 399.00 X
36640   1 0 2 X 429.87 X
36640   3 0 2 X 447.44 X
36640   2 0 2 X 451.63 X
36660   4 0 0 X 153.83 X
36660   3 0 0 X 155.47 X
36660   2 0 0 X 162.01 X
36660   1 0 0 X 163.63 X
36680   4 0 2 X 198.74 X
36680   3 0 2 X 201.23 X
36680   2 0 2 X 212.98 X
36680   1 0 2 X 215.82 X
36800   4 0 2 X 387.44 X
36800   1 0 2 X 444.76 X
36800   3 0 2 X 456.92 X
36800   2 0 2 X 489.54 X
36810   4 0 2 X 800.83 X
36810   2 0 2 X 896.30 X
36810   3 0 2 X 986.53 X
36810   1 0 2 X 1,038.97 X
36815   4 0 2 X 561.48 X
36815   3 0 2 X 673.24 X
36815   1 0 2 X 787.80 X
36815   2 0 2 X 787.90 X
36818   2 90 2 X 1,200.02 X
36818   3 90 2 X 1,200.02 X
36818   4 90 2 X 1,200.02 X
36818   1 90 2 X 1,356.39 X
36819   2 90 2 X 1,538.39 X
36819   3 90 2 X 1,538.39 X
36819   4 90 2 X 1,538.39 X
36819   1 90 2 X 1,715.77 X
36820   2 90 2 X 1,411.76 X
36820   3 90 2 X 1,411.76 X
36820   4 90 2 X 1,411.76 X
36820   1 90 2 X 1,580.39 X
36821   3 90 2 X 1,940.41 X
36821   4 90 2 X 1,940.50 X
36821   2 90 2 X 1,987.52 X
36821   1 90 2 X 2,005.85 X
36823     90 2 X * X
36823 26   90 2 X # X
36823 TC   90 2 X # X
36825   4 90 2 X 2,311.59 X
36825   3 90 2 X 2,379.42 X
36825   1 90 2 X 2,428.63 X
36825   2 90 2 X 2,438.28 X
36830   4 90 2 X 2,297.83 X
36830   3 90 2 X 2,346.99 X
36830   2 90 2 X 2,404.74 X
36830   1 90 2 X 2,417.94 X
36831   2 90 2 X 790.42 830.74
36831   3 90 2 X 790.42 830.74
36831   4 90 2 X 790.42 830.74
36831   1 90 2 X 890.89 937.98
36832   4 90 2 X 2,179.37 X
36832   3 90 2 X 2,226.67 X
36832   1 90 2 X 2,285.89 X
36832   2 90 2 X 2,320.02 X
36833   2 90 2 X 1,216.23 1,214.22
36833   3 90 2 X 1,216.23 1,214.22
36833   4 90 2 X 1,216.23 1,214.22
36833   1 90 2 X 1,351.06 1,348.68
36835   1 90 2 X 2,755.75 X
36835   2 90 2 X 2,755.75 X
36835   3 90 2 X 2,755.75 X
36835   4 90 2 X 2,755.75 X
36838   2 90 2 X 2,093.39 X
36838   3 90 2 X 2,093.39 X
36838   4 90 2 X 2,093.39 X
36838   1 90 2 X 2,346.22 X
36860   4 0 2 X 300.56 X
36860   3 0 2 X 317.91 X
36860   1 0 2 X 349.57 X
36860   2 0 2 X 388.83 X
36861   3 0 2 X 509.22 X
36861   4 0 2 X 510.93 X
36861   1 0 2 X 548.40 X
36861   2 0 2 X 566.78 X
36901   2 0 2 X 674.99 182.97
36901   3 0 2 X 674.99 182.97
36901   4 0 2 X 674.99 182.97
36901   1 0 2 X 768.24 198.15
36902   2 0 2 X 1,429.30 272.63
36902   3 0 2 X 1,429.30 272.63
36902   4 0 2 X 1,429.30 272.63
36902   1 0 2 X 1,635.20 295.02
36903   2 0 2 X 6,506.82 373.20
36903   3 0 2 X 6,506.82 373.20
36903   4 0 2 X 6,506.82 373.20
36903   1 0 2 X 7,510.19 403.61
36904   2 0 2 X 2,085.85 429.74
36904   3 0 2 X 2,085.85 429.74
36904   4 0 2 X 2,085.85 429.74
36904   1 0 2 X 2,383.62 464.83
36905   2 0 2 X 2,668.63 539.41
36905   3 0 2 X 2,668.63 539.41
36905   4 0 2 X 2,668.63 539.41
36905   1 0 2 X 3,050.39 583.41
36906   2 0 2 X 7,900.07 629.50
36906   3 0 2 X 7,900.07 629.50
36906   4 0 2 X 7,900.07 629.50
36906   1 0 2 X 9,104.75 680.86
36907   2 ZZZ 0 X 855.06 157.10
36907   3 ZZZ 0 X 855.06 157.10
36907   4 ZZZ 0 X 855.06 157.10
36907   1 ZZZ 0 X 978.50 169.84
36908   2 ZZZ 0 X 3,130.49 235.49
36908   3 ZZZ 0 X 3,130.49 235.49
36908   4 ZZZ 0 X 3,130.49 235.49
36908   1 ZZZ 0 X 3,608.76 254.54
36909   2 ZZZ 0 X 2,286.13 223.51
36909   3 ZZZ 0 X 2,286.13 223.51
36909   4 ZZZ 0 X 2,286.13 223.51
36909   1 ZZZ 0 X 2,631.73 241.91
37140   4 90 2 X 3,522.39 X
37140   3 90 2 X 3,808.61 X
37140   2 90 2 X 4,304.97 X
37140   1 90 2 X 4,331.54 X
37145   4 90 2 X 3,537.02 X
37145   3 90 2 X 3,579.48 X
37145   2 90 2 X 3,781.51 X
37145   1 90 2 X 3,830.34 X
37160   4 90 2 X 3,507.70 X
37160   3 90 2 X 3,548.56 X
37160   2 90 2 X 4,307.71 X
37160   1 90 2 X 4,336.33 X
37180   4 90 2 X 3,386.98 X
37180   3 90 2 X 3,425.25 X
37180   1 90 2 X 3,710.03 X
37180   2 90 2 X 3,800.38 X
37181   4 90 2 X 3,806.40 X
37181   3 90 2 X 4,289.25 X
37181   2 90 2 X 4,404.52 X
37181   1 90 2 X 4,432.55 X
37182   2 90 2 X 1,590.29 X
37182   3 90 2 X 1,590.29 X
37182   4 90 2 X 1,590.29 X
37182   1 90 2 X 1,761.27 X
37183   2 0 2 X 741.96 X
37183   3 0 2 X 741.96 X
37183   4 0 2 X 741.96 X
37183   1 0 2 X 812.22 X
37184   2 0 2 X 4,387.36 719.85
37184   3 0 2 X 4,387.36 719.85
37184   4 0 2 X 4,387.36 719.85
37184   1 0 2 X 5,276.08 787.23
37185   2 ZZZ 0 X 1,432.66 264.04
37185   3 ZZZ 0 X 1,432.66 264.04
37185   4 ZZZ 0 X 1,432.66 264.04
37185   1 ZZZ 0 X 1,718.01 287.64
37186   2 ZZZ 0 X 2,957.48 396.01
37186   3 ZZZ 0 X 2,957.48 396.01
37186   4 ZZZ 0 X 2,957.48 396.01
37186   1 ZZZ 0 X 3,566.67 431.55
37187   2 0 2 X 4,266.72 669.30
37187   3 0 2 X 4,266.72 669.30
37187   4 0 2 X 4,266.72 669.30
37187   1 0 2 X 5,135.27 732.22
37188   2 0 2 X 3,682.03 483.24
37188   3 0 2 X 3,682.03 483.24
37188   4 0 2 X 3,682.03 483.24
37188   1 0 2 X 4,444.91 529.78
37191   2 0 2 X 3,382.13 328.55
37191   3 0 2 X 3,382.13 328.55
37191   4 0 2 X 3,382.13 328.55
37191   1 0 2 X 3,901.19 359.30
37192   2 0 2 X 2,291.54 508.94
37192   3 0 2 X 2,291.54 508.94
37192   4 0 2 X 2,291.54 508.94
37192   1 0 2 X 2,624.05 556.38
37193   2 0 2 X 2,188.96 508.52
37193   3 0 2 X 2,188.96 508.52
37193   4 0 2 X 2,188.96 508.52
37193   1 0 2 X 2,505.08 555.88
37195   2 XXX 0 X 599.19 X
37195   3 XXX 0 X 599.19 X
37195   4 XXX 0 X 599.19 X
37195   1 XXX 0 X 723.38 X
37197   2 0 2 X 1,956.10 403.22
37197   3 0 2 X 1,956.10 403.22
37197   4 0 2 X 1,956.10 403.22
37197   1 0 2 X 2,235.62 434.42
37200   4 0 2 X 498.36 X
37200   3 0 2 X 503.88 X
37200   2 0 2 X 525.03 X
37200   1 0 2 X 530.15 X
37211   2 0 2 X 538.93 X
37211   3 0 2 X 538.93 X
37211   4 0 2 X 538.93 X
37211   1 0 2 X 592.47 X
37212   2 0 2 X 475.82 X
37212   3 0 2 X 475.82 X
37212   4 0 2 X 475.82 X
37212   1 0 2 X 523.14 X
37213   2 0 2 X 332.77 X
37213   3 0 2 X 332.77 X
37213   4 0 2 X 332.77 X
37213   1 0 2 X 365.60 X
37214   2 0 2 X 194.43 X
37214   3 0 2 X 194.43 X
37214   4 0 2 X 194.43 X
37214   1 0 2 X 214.41 X
37215   2 90 2 X 1,805.01 X
37215   3 90 2 X 1,805.01 X
37215   4 90 2 X 1,805.01 X
37215   1 90 2 X 1,977.05 X
37216   2 90 2 X 1,738.62 X
37216   3 90 2 X 1,738.62 X
37216   4 90 2 X 1,738.62 X
37216   1 90 2 X 1,904.54 X
37217   2 90 2 X 1,506.71 X
37217   3 90 2 X 1,506.71 X
37217   4 90 2 X 1,506.71 X
37217   1 90 2 X 1,656.58 X
37218   2 90 2 X 1,056.65 1,129.31
37218   3 90 2 X 1,056.65 1,129.31
37218   4 90 2 X 1,056.65 1,129.31
37218   1 90 2 X 1,153.96 1,238.93
37220   2 0 2 X 4,353.03 622.98
37220   3 0 2 X 4,353.03 622.98
37220   4 0 2 X 4,353.03 622.98
37220   1 0 2 X 4,909.77 689.14
37221   2 0 2 X 6,423.70 757.06
37221   3 0 2 X 6,423.70 757.06
37221   4 0 2 X 6,423.70 757.06
37221   1 0 2 X 7,246.34 834.38
37222   2 ZZZ 0 X 1,260.04 282.93
37222   3 ZZZ 0 X 1,260.04 282.93
37222   4 ZZZ 0 X 1,260.04 282.93
37222   1 ZZZ 0 X 1,418.45 312.84
37223   2 ZZZ 0 X 3,533.69 321.14
37223   3 ZZZ 0 X 3,533.69 321.14
37223   4 ZZZ 0 X 3,533.69 321.14
37223   1 ZZZ 0 X 3,989.65 354.60
37224   2 0 2 X 5,226.73 685.92
37224   3 0 2 X 5,226.73 685.92
37224   4 0 2 X 5,226.73 685.92
37224   1 0 2 X 5,896.09 758.06
37225   2 0 2 X 14,710.39 924.39
37225   3 0 2 X 14,710.39 924.39
37225   4 0 2 X 14,710.39 924.39
37225   1 0 2 X 16,623.02 1,023.82
37226   2 0 2 X 12,308.17 757.15
37226   3 0 2 X 12,308.17 757.15
37226   4 0 2 X 12,308.17 757.15
37226   1 0 2 X 13,891.18 820.90
37227   2 0 2 X 19,881.25 1,116.60
37227   3 0 2 X 19,881.25 1,116.60
37227   4 0 2 X 19,881.25 1,116.60
37227   1 0 2 X 22,469.45 1,236.82
37228   2 0 2 X 7,434.13 838.56
37228   3 0 2 X 7,434.13 838.56
37228   4 0 2 X 7,434.13 838.56
37228   1 0 2 X 8,390.68 927.64
37229   2 0 2 X 14,592.64 1,082.78
37229   3 0 2 X 14,592.64 1,082.78
37229   4 0 2 X 14,592.64 1,082.78
37229   1 0 2 X 16,486.54 1,199.79
37230   2 0 2 X 11,472.48 1,043.11
37230   3 0 2 X 11,472.48 1,043.11
37230   4 0 2 X 11,472.48 1,043.11
37230   1 0 2 X 12,950.75 1,149.64
37231   2 0 2 X 18,383.85 1,133.76
37231   3 0 2 X 18,383.85 1,133.76
37231   4 0 2 X 18,383.85 1,133.76
37231   1 0 2 X 20,768.53 1,249.61
37232   2 ZZZ 0 X 1,675.19 303.38
37232   3 ZZZ 0 X 1,675.19 303.38
37232   4 ZZZ 0 X 1,675.19 303.38
37232   1 ZZZ 0 X 1,887.80 335.53
37233   2 ZZZ 0 X 2,053.32 498.50
37233   3 ZZZ 0 X 2,053.32 498.50
37233   4 ZZZ 0 X 2,053.32 498.50
37233   1 ZZZ 0 X 2,311.49 552.14
37234   2 ZZZ 0 X 5,308.23 415.30
37234   3 ZZZ 0 X 5,308.23 415.30
37234   4 ZZZ 0 X 5,308.23 415.30
37234   1 ZZZ 0 X 5,995.08 458.59
37235   2 ZZZ 0 X 5,677.94 589.48
37235   3 ZZZ 0 X 5,677.94 589.48
37235   4 ZZZ 0 X 5,677.94 589.48
37235   1 ZZZ 0 X 6,408.70 651.04
37236   2 0 2 X 3,498.26 625.46
37236   3 0 2 X 3,498.26 625.46
37236   4 0 2 X 3,498.26 625.46
37236   1 0 2 X 4,029.81 682.91
37237   2 ZZZ 0 X 1,521.38 292.71
37237   3 ZZZ 0 X 1,521.38 292.71
37237   4 ZZZ 0 X 1,521.38 292.71
37237   1 ZZZ 0 X 1,751.21 319.76
37238   2 0 2 X 5,082.09 438.12
37238   3 0 2 X 5,082.09 438.12
37238   4 0 2 X 5,082.09 438.12
37238   1 0 2 X 5,888.82 478.38
37239   2 ZZZ 0 X 2,525.46 204.31
37239   3 ZZZ 0 X 2,525.46 204.31
37239   4 ZZZ 0 X 2,525.46 204.31
37239   1 ZZZ 0 X 2,927.39 223.18
37241   2 0 2 X 5,632.49 599.84
37241   3 0 2 X 5,632.49 599.84
37241   4 0 2 X 5,632.49 599.84
37241   1 0 2 X 6,510.52 647.30
37242   2 0 2 X 9,464.53 669.83
37242   3 0 2 X 9,464.53 669.83
37242   4 0 2 X 9,464.53 669.83
37242   1 0 2 X 10,969.06 722.90
37243   2 0 2 X 11,944.73 798.64
37243   3 0 2 X 11,944.73 798.64
37243   4 0 2 X 11,944.73 798.64
37243   1 0 2 X 13,847.52 861.93
37244   2 0 2 X 8,388.31 931.64
37244   3 0 2 X 8,388.31 931.64
37244   4 0 2 X 8,388.31 931.64
37244   1 0 2 X 9,692.58 1,005.30
37246   2 0 2 X 2,515.67 447.69
37246   3 0 2 X 2,515.67 447.69
37246   4 0 2 X 2,515.67 447.69
37246   1 0 2 X 2,880.62 484.60
37247   2 ZZZ 0 X 1,020.25 221.99
37247   3 ZZZ 0 X 1,020.25 221.99
37247   4 ZZZ 0 X 1,020.25 221.99
37247   1 ZZZ 0 X 1,165.04 240.16
37248   2 0 2 X 1,746.77 384.99
37248   3 0 2 X 1,746.77 384.99
37248   4 0 2 X 1,746.77 384.99
37248   1 0 2 X 1,994.63 416.82
37249   2 ZZZ 0 X 749.96 188.89
37249   3 ZZZ 0 X 749.96 188.89
37249   4 ZZZ 0 X 749.96 188.89
37249   1 ZZZ 0 X 854.47 204.40
37252   2 ZZZ 0 X 1,660.33 118.86
37252   3 ZZZ 0 X 1,660.33 118.86
37252   4 ZZZ 0 X 1,660.33 118.86
37252   1 ZZZ 0 X 1,932.67 129.04
37253   2 ZZZ 0 X 262.47 95.11
37253   3 ZZZ 0 X 262.47 95.11
37253   4 ZZZ 0 X 262.47 95.11
37253   1 ZZZ 0 X 299.12 103.31
37500   2 ZZZ 0 X 1,283.09 X
37500   3 ZZZ 0 X 1,283.09 X
37500   4 ZZZ 0 X 1,283.09 X
37500   1 ZZZ 0 X 1,419.45 X
37501     90 2 X * X
37565   1 90 2 X 1,307.20 X
37565   3 90 2 X 1,345.15 X
37565   4 90 2 X 1,375.34 X
37565   2 90 2 X 1,419.43 X
37600   4 90 2 X 1,211.82 X
37600   3 90 2 X 1,216.57 X
37600   2 90 2 X 1,245.54 X
37600   1 90 2 X 1,252.50 X
37605   4 90 2 X 941.61 X
37605   1 90 2 X 1,050.80 X
37605   3 90 2 X 1,081.19 X
37605   2 90 2 X 1,143.57 X
37606   4 90 2 X 964.28 X
37606   3 90 2 X 976.64 X
37606   2 90 2 X 1,045.64 X
37606   1 90 2 X 1,062.30 X
37607   4 90 2 X 813.09 X
37607   3 90 2 X 822.03 X
37607   2 90 2 X 877.84 X
37607   1 90 2 X 891.50 X
37609   3 10 2 X 500.27 X
37609   4 10 2 X 504.85 X
37609   2 10 2 X 516.40 X
37609   1 10 2 X 523.48 X
37615   4 90 2 X 985.46 X
37615   3 90 2 X 1,025.55 X
37615   1 90 2 X 1,064.99 X
37615   2 90 2 X 1,066.70 X
37616   4 90 2 X 1,676.60 X
37616   3 90 2 X 1,694.17 X
37616   2 90 2 X 1,779.15 X
37616   1 90 2 X 1,799.92 X
37617   3 90 2 X 1,642.89 X
37617   2 90 2 X 1,712.70 X
37617   1 90 2 X 1,723.48 X
37617   4 90 2 X 2,005.67 X
37618   4 90 2 X 1,040.32 X
37618   3 90 2 X 1,096.77 X
37618   2 90 2 X 1,128.42 X
37618   1 90 2 X 1,136.09 X
37619   2 90 2 X 2,275.08 X
37619   3 90 2 X 2,275.08 X
37619   4 90 2 X 2,275.08 X
37619   1 90 2 X 2,537.65 X
37650   3 90 2 X 791.48 X
37650   4 90 2 X 982.26 X
37650   2 90 2 X 1,014.02 X
37650   1 90 2 X 1,033.01 X
37660   4 90 2 X 1,390.62 X
37660   3 90 2 X 1,406.35 X
37660   2 90 2 X 1,497.75 X
37660   1 90 2 X 1,519.89 X
37700   4 90 2 X 663.12 X
37700   1 90 2 X 738.85 X
37700   3 90 2 X 757.44 X
37700   2 90 2 X 881.31 X
37718   2 90 2 X 625.50 X
37718   3 90 2 X 625.50 X
37718   4 90 2 X 625.50 X
37718   1 90 2 X 685.51 X
37722   2 90 2 X 739.78 X
37722   3 90 2 X 739.78 X
37722   4 90 2 X 739.78 X
37722   1 90 2 X 829.70 X
37735   4 90 2 X 1,676.84 X
37735   3 90 2 X 1,696.42 X
37735   2 90 2 X 1,825.59 X
37735   1 90 2 X 1,856.94 X
37760   3 90 2 X 1,611.16 X
37760   4 90 2 X 1,617.63 X
37760   2 90 2 X 1,729.76 X
37760   1 90 2 X 1,758.55 X
37761   2 90 2 X 810.49 X
37761   3 90 2 X 810.49 X
37761   4 90 2 X 810.49 X
37761   1 90 2 X 908.70 X
37765   2 90 2 X 789.97 X
37765   3 90 2 X 789.97 X
37765   4 90 2 X 789.97 X
37765   1 90 2 X 869.52 X
37766   2 90 2 X 962.51 X
37766   3 90 2 X 962.51 X
37766   4 90 2 X 962.51 X
37766   1 90 2 X 1,052.71 X
37780   4 90 2 X 486.56 X
37780   3 90 2 X 492.01 X
37780   1 90 2 X 530.03 X
37780   2 90 2 X 540.97 X
37785   4 90 2 X 400.94 X
37785   3 90 2 X 405.16 X
37785   2 90 2 X 424.60 X
37785   1 90 2 X 429.38 X
37788   4 90 2 X 3,394.44 X
37788   3 90 2 X 3,440.25 X
37788   2 90 2 X 3,634.13 X
37788   1 90 2 X 3,723.39 X
37790   4 90 2 X 1,024.50 X
37790   3 90 2 X 1,036.75 X
37790   2 90 2 X 1,094.09 X
37790   1 90 2 X 1,107.97 X
37799     YYY 2 X * X
38100   4 90 2 X 1,990.27 X
38100   3 90 2 X 2,032.78 X
38100   1 90 2 X 2,142.48 X
38100   2 90 2 X 2,205.32 X
38101   4 90 2 X 1,783.12 X
38101   3 90 2 X 1,802.93 X
38101   1 90 2 X 1,954.02 X
38101   2 90 2 X 2,223.64 X
38102   4 ZZZ 0 X 667.54 X
38102   3 ZZZ 0 X 674.85 X
38102   2 ZZZ 0 X 720.67 X
38102   1 ZZZ 0 X 731.83 X
38115   4 90 2 X 1,834.74 X
38115   1 90 2 X 2,009.50 X
38115   3 90 2 X 2,138.83 X
38115   2 90 2 X 2,249.43 X
38120     XXX 2 X * X
38129     YYY 2 X * X
38200   4 0 2 X 379.27 X
38200   1 0 2 X 382.15 X
38200   3 0 2 X 383.85 X
38200   2 0 2 X 403.74 X
38204     XXX 9 X * X
38205   2 XXX 9 X 139.07 X
38205   3 XXX 9 X 139.07 X
38205   4 XXX 9 X 139.07 X
38205   1 XXX 9 X 151.24 X
38206   2 0 2 X 139.07 X
38206   3 0 2 X 139.07 X
38206   4 0 2 X 139.07 X
38206   1 0 2 X 151.24 X
38207     XXX 9 X * X
38208     XXX 9 X * X
38209     XXX 9 X * X
38210     XXX 9 X * X
38211     XXX 9 X * X
38212     XXX 9 X * X
38213     XXX 9 X * X
38214     XXX 9 X * X
38215     XXX 9 X * X
38220   2 XXX 2 X 360.99 100.28
38220   3 XXX 2 X 360.99 100.28
38220   4 XXX 2 X 360.99 100.28
38220   1 XXX 2 X 415.28 108.78
38221   2 XXX 2 X 386.88 127.40
38221   3 XXX 2 X 386.88 127.40
38221   4 XXX 2 X 386.88 127.40
38221   1 XXX 2 X 443.35 138.32
38222   2 XXX 2 X 198.74 94.34
38222   3 XXX 2 X 198.74 94.34
38222   4 XXX 2 X 198.74 94.34
38222   1 XXX 2 X 221.12 101.32
38230   4 10 2 X 483.62 X
38230   3 10 2 X 489.57 X
38230   2 10 2 X 516.43 X
38230   1 10 2 X 1,771.77 X
38232   2 0 2 X 252.38 X
38232   3 0 2 X 252.38 X
38232   4 0 2 X 252.38 X
38232   1 0 2 X 282.16 X
38240   4 XXX 2 X 349.61 X
38240   3 XXX 2 X 354.04 X
38240   2 XXX 2 X 373.20 X
38240   1 XXX 2 X 377.82 X
38241   4 XXX 2 X 345.79 X
38241   3 XXX 2 X 350.15 X
38241   1 XXX 2 X 373.25 X
38241   2 XXX 2 X 450.77 X
38242   2 XXX 2 X 158.48 X
38242   3 XXX 2 X 158.48 X
38242   4 XXX 2 X 158.48 X
38242   1 XXX 2 X 172.08 X
38243   2 0 2 X 150.96 X
38243   3 0 2 X 150.96 X
38243   4 0 2 X 150.96 X
38243   1 0 2 X 162.78 X
38300   4 10 2 X 179.90 X
38300   3 10 2 X 185.57 X
38300   2 10 2 X 195.52 X
38300   1 10 2 X 197.94 X
38305   4 90 2 X 555.01 X
38305   3 90 2 X 561.11 X
38305   2 90 2 X 593.94 X
38305   1 90 2 X 601.92 X
38308   4 90 2 X 704.69 X
38308   3 90 2 X 713.01 X
38308   2 90 2 X 757.03 X
38308   1 90 2 X 767.63 X
38380   4 90 2 X 989.13 X
38380   3 90 2 X 1,000.60 X
38380   1 90 2 X 1,082.69 X
38380   2 90 2 X 1,166.39 X
38381   4 90 2 X 1,785.89 X
38381   3 90 2 X 1,806.17 X
38381   2 90 2 X 1,929.00 X
38381   1 90 2 X 1,958.81 X
38382   4 90 2 X 1,285.72 X
38382   3 90 2 X 1,299.86 X
38382   2 90 2 X 1,388.22 X
38382   1 90 2 X 1,409.78 X
38500   3 10 2 X 403.89 X
38500   4 10 2 X 418.11 X
38500   1 10 2 X 436.32 X
38500   2 10 2 X 459.24 X
38505   1 0 2 X 285.91 X
38505   4 0 2 X 288.11 X
38505   3 0 2 X 291.26 X
38505   2 0 2 X 335.89 X
38510   3 90 2 X 579.60 X
38510   4 90 2 X 585.76 X
38510   1 90 2 X 635.30 X
38510   2 90 2 X 657.04 X
38520   4 90 2 X 695.91 X
38520   3 90 2 X 717.74 X
38520   1 90 2 X 751.09 X
38520   2 90 2 X 751.85 X
38525   4 90 2 X 590.74 X
38525   3 90 2 X 611.11 X
38525   1 90 2 X 696.12 X
38525   2 90 2 X 698.82 X
38530   4 90 2 X 684.41 X
38530   2 90 2 X 720.64 X
38530   3 90 2 X 824.18 X
38530   1 90 2 X 891.34 X
38531   2 90 2 X 502.83 X
38531   3 90 2 X 502.83 X
38531   4 90 2 X 502.83 X
38531   1 90 2 X 552.47 X
38542   4 90 2 X 784.78 X
38542   3 90 2 X 790.64 X
38542   2 90 2 X 856.17 X
38542   1 90 2 X 902.77 X
38550   4 90 2 X 870.02 X
38550   3 90 2 X 879.64 X
38550   2 90 2 X 934.43 X
38550   1 90 2 X 947.76 X
38555   4 90 2 X 1,834.50 X
38555   3 90 2 X 1,855.05 X
38555   2 90 2 X 1,973.80 X
38555   1 90 2 X 2,002.60 X
38562   4 90 2 X 1,508.70 X
38562   3 90 2 X 1,518.67 X
38562   2 90 2 X 1,577.34 X
38562   1 90 2 X 1,591.57 X
38564   3 90 2 X 1,575.65 X
38564   4 90 2 X 1,593.15 X
38564   2 90 2 X 1,643.36 X
38564   1 90 2 X 1,659.83 X