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2019 Workers' Compensation Part B Fee Schedule

43262-44145

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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
43262   1 0 3 0.00 1,399.79 0.00
43262   2 0 3 0.00 1,381.71 0.00
43262   3 0 3 0.00 1,306.06 0.00
43262   4 0 3 0.00 1,289.28 0.00
43263   1 0 3 0.00 954.16 0.00
43263   2 0 3 0.00 870.60 0.00
43263   3 0 3 0.00 956.02 0.00
43263   4 0 3 0.00 864.19 0.00
43264   1 0 3 0.00 1,519.63 0.00
43264   2 0 3 0.00 1,500.61 0.00
43264   3 0 3 0.00 1,441.38 0.00
43264   4 0 3 0.00 1,463.64 0.00
43265   1 0 3 0.00 1,335.08 0.00
43265   2 0 3 0.00 1,319.30 0.00
43265   3 0 3 0.00 1,253.75 0.00
43265   4 0 3 0.00 1,238.64 0.00
43266   1 0 3 0.00 328.29 0.00
43266   2 0 3 0.00 300.00 0.00
43266   3 0 3 0.00 300.00 0.00
43266   4 0 3 0.00 300.00 0.00
43270   1 0 3 0.00 1,003.98 344.51
43270   2 0 3 0.00 880.94 314.83
43270   3 0 3 0.00 880.94 314.83
43270   4 0 3 0.00 880.94 314.83
43273   1 ZZZ 0 0.00 190.03 0.00
43273   2 ZZZ 0 0.00 174.33 0.00
43273   3 ZZZ 0 0.00 174.33 0.00
43273   4 ZZZ 0 0.00 174.33 0.00
43274   1 0 3 0.00 678.59 0.00
43274   2 0 3 0.00 621.08 0.00
43274   3 0 3 0.00 621.08 0.00
43274   4 0 3 0.00 621.08 0.00
43275   1 0 3 0.00 559.63 0.00
43275   2 0 3 0.00 512.04 0.00
43275   3 0 3 0.00 512.04 0.00
43275   4 0 3 0.00 512.04 0.00
43276   1 0 3 0.00 705.71 0.00
43276   2 0 3 0.00 646.13 0.00
43276   3 0 3 0.00 646.13 0.00
43276   4 0 3 0.00 646.13 0.00
43277   1 0 3 0.00 562.96 0.00
43277   2 0 3 0.00 515.12 0.00
43277   3 0 3 0.00 515.12 0.00
43277   4 0 3 0.00 515.12 0.00
43278   1 0 3 0.00 640.02 0.00
43278   2 0 3 0.00 585.79 0.00
43278   3 0 3 0.00 585.79 0.00
43278   4 0 3 0.00 585.79 0.00
43279   1 90 2 0.00 1,810.90 0.00
43279   2 90 2 0.00 1,650.22 0.00
43279   3 90 2 0.00 1,650.22 0.00
43279   4 90 2 0.00 1,650.22 0.00
43280   1 90 2 0.00 2,243.42 0.00
43280   2 90 2 0.00 2,008.78 0.00
43280   3 90 2 0.00 2,008.78 0.00
43280   4 90 2 0.00 2,008.78 0.00
43281   1 90 2 0.00 2,364.18 0.00
43281   2 90 2 0.00 2,119.10 0.00
43281   3 90 2 0.00 2,119.10 0.00
43281   4 90 2 0.00 2,119.10 0.00
43282   1 90 2 0.00 2,658.88 0.00
43282   2 90 2 0.00 2,384.16 0.00
43282   3 90 2 0.00 2,384.16 0.00
43282   4 90 2 0.00 2,384.16 0.00
43283   1 ZZZ 0 0.00 251.10 0.00
43283   2 ZZZ 0 0.00 226.88 0.00
43283   3 ZZZ 0 0.00 226.88 0.00
43283   4 ZZZ 0 0.00 226.88 0.00
43284   1 90 2 0.00 867.15 0.00
43284   2 90 2 0.00 786.03 0.00
43284   3 90 2 0.00 786.03 0.00
43284   4 90 2 0.00 786.03 0.00
43285   1 90 2 0.00 877.27 0.00
43285   2 90 2 0.00 796.03 0.00
43285   3 90 2 0.00 796.03 0.00
43285   4 90 2 0.00 796.03 0.00
43286   1 90 2 0.00 4,087.20 0.00
43286   2 90 2 0.00 3,736.79 0.00
43286   3 90 2 0.00 3,736.79 0.00
43286   4 90 2 0.00 3,736.79 0.00
43287   1 90 2 0.00 4,675.02 0.00
43287   2 90 2 0.00 4,270.66 0.00
43287   3 90 2 0.00 4,270.66 0.00
43287   4 90 2 0.00 4,270.66 0.00
43288   1 90 2 0.00 4,867.67 0.00
43288   2 90 2 0.00 4,454.94 0.00
43288   3 90 2 0.00 4,454.94 0.00
43288   4 90 2 0.00 4,454.94 0.00
43289     YYY 2 0.00 * 0.00
43300   1 90 2 0.00 2,065.81 0.00
43300   2 90 2 0.00 2,015.89 0.00
43300   3 90 2 0.00 1,781.95 0.00
43300   4 90 2 0.00 2,051.19 0.00
43305   1 90 2 0.00 2,749.13 0.00
43305   2 90 2 0.00 3,072.81 0.00
43305   3 90 2 0.00 2,611.02 0.00
43305   4 90 2 0.00 2,579.88 0.00
43310   1 90 2 0.00 3,993.50 0.00
43310   2 90 2 0.00 3,410.11 0.00
43310   3 90 2 0.00 3,675.15 0.00
43310   4 90 2 0.00 3,633.44 0.00
43312   1 90 2 0.00 3,851.51 0.00
43312   2 90 2 0.00 3,800.29 0.00
43312   3 90 2 0.00 3,589.58 0.00
43312   4 90 2 0.00 3,549.92 0.00
43313   1 90 2 0.00 5,057.98 0.00
43313   2 90 2 0.00 4,500.68 0.00
43313   3 90 2 0.00 4,500.68 0.00
43313   4 90 2 0.00 4,500.68 0.00
43314   1 90 2 0.00 5,543.84 0.00
43314   2 90 2 0.00 4,949.64 0.00
43314   3 90 2 0.00 4,949.64 0.00
43314   4 90 2 0.00 4,949.64 0.00
43320   1 90 2 0.00 3,280.83 0.00
43320   2 90 2 0.00 2,956.21 0.00
43320   3 90 2 0.00 2,880.90 0.00
43320   4 90 2 0.00 2,224.61 0.00
43325   1 90 2 0.00 2,574.78 0.00
43325   2 90 2 0.00 2,532.50 0.00
43325   3 90 2 0.00 2,358.12 0.00
43325   4 90 2 0.00 2,331.06 0.00
43327   1 90 2 0.00 1,264.15 0.00
43327   2 90 2 0.00 1,137.76 0.00
43327   3 90 2 0.00 1,137.76 0.00
43327   4 90 2 0.00 1,137.76 0.00
43328   1 90 2 0.00 1,876.29 0.00
43328   2 90 2 0.00 1,677.34 0.00
43328   3 90 2 0.00 1,677.34 0.00
43328   4 90 2 0.00 1,677.34 0.00
43330   1 90 2 0.00 2,974.86 0.00
43330   2 90 2 0.00 2,991.12 0.00
43330   3 90 2 0.00 2,904.54 0.00
43330   4 90 2 0.00 2,906.01 0.00
43331   1 90 2 0.00 2,864.59 0.00
43331   2 90 2 0.00 2,815.93 0.00
43331   3 90 2 0.00 2,614.90 0.00
43331   4 90 2 0.00 2,584.04 0.00
43332   1 90 2 0.00 1,811.90 0.00
43332   2 90 2 0.00 1,631.42 0.00
43332   3 90 2 0.00 1,631.42 0.00
43332   4 90 2 0.00 1,631.42 0.00
43333   1 90 2 0.00 1,967.26 0.00
43333   2 90 2 0.00 1,771.87 0.00
43333   3 90 2 0.00 1,771.87 0.00
43333   4 90 2 0.00 1,771.87 0.00
43334   1 90 2 0.00 1,990.00 0.00
43334   2 90 2 0.00 1,792.68 0.00
43334   3 90 2 0.00 1,792.68 0.00
43334   4 90 2 0.00 1,792.68 0.00
43335   1 90 2 0.00 2,143.80 0.00
43335   2 90 2 0.00 1,931.82 0.00
43335   3 90 2 0.00 1,931.82 0.00
43335   4 90 2 0.00 1,931.82 0.00
43336   1 90 2 0.00 2,357.51 0.00
43336   2 90 2 0.00 2,117.63 0.00
43336   3 90 2 0.00 2,117.63 0.00
43336   4 90 2 0.00 2,117.63 0.00
43337   1 90 2 0.00 2,572.08 0.00
43337   2 90 2 0.00 2,309.69 0.00
43337   3 90 2 0.00 2,309.69 0.00
43337   4 90 2 0.00 2,309.69 0.00
43338   1 ZZZ 0 0.00 209.30 0.00
43338   2 ZZZ 0 0.00 187.89 0.00
43338   3 ZZZ 0 0.00 187.89 0.00
43338   4 ZZZ 0 0.00 187.89 0.00
43340   1 90 2 0.00 3,232.98 0.00
43340   2 90 2 0.00 3,150.23 0.00
43340   3 90 2 0.00 2,859.44 0.00
43340   4 90 2 0.00 2,377.31 0.00
43341   1 90 2 0.00 3,148.28 0.00
43341   2 90 2 0.00 2,591.94 0.00
43341   3 90 2 0.00 2,211.69 0.00
43341   4 90 2 0.00 2,186.41 0.00
43351   1 90 2 0.00 2,123.82 0.00
43351   2 90 2 0.00 2,092.58 0.00
43351   3 90 2 0.00 1,963.77 0.00
43351   4 90 2 0.00 1,941.44 0.00
43352   1 90 2 0.00 1,907.10 0.00
43352   2 90 2 0.00 1,924.68 0.00
43352   3 90 2 0.00 1,788.56 0.00
43352   4 90 2 0.00 1,735.34 0.00
43360   1 90 2 0.00 5,213.11 0.00
43360   2 90 2 0.00 4,582.66 0.00
43360   3 90 2 0.00 4,416.68 0.00
43360   4 90 2 0.00 4,434.89 0.00
43361   1 90 2 0.00 5,801.33 0.00
43361   2 90 2 0.00 5,749.83 0.00
43361   3 90 2 0.00 4,976.87 0.00
43361   4 90 2 0.00 4,919.21 0.00
43400   1 90 2 0.00 2,801.81 0.00
43400   2 90 2 0.00 2,462.56 0.00
43400   3 90 2 0.00 2,315.79 0.00
43400   4 90 2 0.00 2,289.01 0.00
43401   1 90 2 0.00 2,492.95 0.00
43401   2 90 2 0.00 2,455.51 0.00
43401   3 90 2 0.00 2,301.63 0.00
43401   4 90 2 0.00 2,276.07 0.00
43405   1 90 2 0.00 2,864.59 0.00
43405   2 90 2 0.00 2,815.93 0.00
43405   3 90 2 0.00 2,614.90 0.00
43405   4 90 2 0.00 2,584.04 0.00
43410   1 90 2 0.00 1,806.71 0.00
43410   2 90 2 0.00 1,847.24 0.00
43410   3 90 2 0.00 1,655.19 0.00
43410   4 90 2 0.00 1,635.55 0.00
43415   1 90 2 0.00 3,123.99 0.00
43415   2 90 2 0.00 3,104.53 0.00
43415   3 90 2 0.00 2,968.57 0.00
43415   4 90 2 0.00 2,542.46 0.00
43420   1 90 2 0.00 863.47 0.00
43420   2 90 2 0.00 852.53 0.00
43420   3 90 2 0.00 1,395.93 0.00
43420   4 90 2 0.00 1,380.04 0.00
43425   1 90 2 0.00 2,434.98 0.00
43425   2 90 2 0.00 2,399.67 0.00
43425   3 90 2 0.00 2,253.97 0.00
43425   4 90 2 0.00 2,228.41 0.00
43450   1 0 2 0.00 195.54 0.00
43450   2 0 2 0.00 186.46 0.00
43450   3 0 2 0.00 176.13 0.00
43450   4 0 2 0.00 202.91 0.00
43453   1 0 2 0.00 258.63 0.00
43453   2 0 2 0.00 255.38 0.00
43453   3 0 2 0.00 241.70 0.00
43453   4 0 2 0.00 238.75 0.00
43460   1 0 2 0.00 404.02 0.00
43460   2 0 2 0.00 397.82 0.00
43460   3 0 2 0.00 378.21 0.00
43460   4 0 2 0.00 378.81 0.00
43496     90 2 0.00 * 0.00
43499     YYY 2 0.00 * 0.00
43500   1 90 2 0.00 1,444.80 0.00
43500   2 90 2 0.00 1,506.47 0.00
43500   3 90 2 0.00 1,506.93 0.00
43500   4 90 2 0.00 1,293.39 0.00
43501   1 90 2 0.00 2,052.71 0.00
43501   2 90 2 0.00 2,016.69 0.00
43501   3 90 2 0.00 1,842.25 0.00
43501   4 90 2 0.00 1,861.01 0.00
43502   1 90 2 0.00 2,052.71 0.00
43502   2 90 2 0.00 2,016.69 0.00
43502   3 90 2 0.00 1,842.25 0.00
43502   4 90 2 0.00 1,861.01 0.00
43510   1 90 2 0.00 1,538.46 0.00
43510   2 90 2 0.00 1,576.03 0.00
43510   3 90 2 0.00 1,575.91 0.00
43510   4 90 2 0.00 1,410.85 0.00
43520   1 90 2 0.00 1,345.87 0.00
43520   2 90 2 0.00 1,092.18 0.00
43520   3 90 2 0.00 1,022.72 0.00
43520   4 90 2 0.00 1,011.18 0.00
43605   1 90 2 0.00 1,394.32 0.00
43605   2 90 2 0.00 1,371.29 0.00
43605   3 90 2 0.00 1,321.09 0.00
43605   4 90 2 0.00 1,261.92 0.00
43610   1 90 2 0.00 1,879.06 0.00
43610   2 90 2 0.00 1,825.19 0.00
43610   3 90 2 0.00 1,757.33 0.00
43610   4 90 2 0.00 1,774.22 0.00
43611   1 90 2 0.00 1,945.43 0.00
43611   2 90 2 0.00 1,891.19 0.00
43611   3 90 2 0.00 1,821.73 0.00
43611   4 90 2 0.00 1,838.11 0.00
43620   1 90 2 0.00 3,737.33 0.00
43620   2 90 2 0.00 3,572.91 0.00
43620   3 90 2 0.00 3,472.01 0.00
43620   4 90 2 0.00 3,438.32 0.00
43621   1 90 2 0.00 3,750.01 0.00
43621   2 90 2 0.00 3,585.54 0.00
43621   3 90 2 0.00 3,484.41 0.00
43621   4 90 2 0.00 3,450.55 0.00
43622   1 90 2 0.00 3,788.40 0.00
43622   2 90 2 0.00 3,623.72 0.00
43622   3 90 2 0.00 3,521.69 0.00
43622   4 90 2 0.00 3,487.49 0.00
43631   1 90 2 0.00 2,993.92 0.00
43631   2 90 2 0.00 2,945.42 0.00
43631   3 90 2 0.00 2,745.91 0.00
43631   4 90 2 0.00 2,715.01 0.00
43632   1 90 2 0.00 2,993.92 0.00
43632   2 90 2 0.00 2,945.42 0.00
43632   3 90 2 0.00 2,745.91 0.00
43632   4 90 2 0.00 2,715.01 0.00
43633   1 90 2 0.00 3,032.42 0.00
43633   2 90 2 0.00 2,983.71 0.00
43633   3 90 2 0.00 2,783.25 0.00
43633   4 90 2 0.00 2,752.10 0.00
43634   1 90 2 0.00 4,129.27 0.00
43634   2 90 2 0.00 4,337.92 0.00
43634   3 90 2 0.00 3,734.91 0.00
43634   4 90 2 0.00 3,691.22 0.00
43635   1 ZZZ 0 0.00 305.39 0.00
43635   2 ZZZ 0 0.00 300.74 0.00
43635   3 ZZZ 0 0.00 281.35 0.00
43635   4 ZZZ 0 0.00 278.31 0.00
43640   1 90 2 0.00 2,397.29 0.00
43640   2 90 2 0.00 2,658.17 0.00
43640   3 90 2 0.00 2,077.33 0.00
43640   4 90 2 0.00 2,022.46 0.00
43641   1 90 2 0.00 2,332.27 0.00
43641   2 90 2 0.00 2,293.20 0.00
43641   3 90 2 0.00 2,132.29 0.00
43641   4 90 2 0.00 2,107.92 0.00
43644   1 90 2 0.00 2,824.32 0.00
43644   2 90 2 0.00 2,547.62 0.00
43644   3 90 2 0.00 2,547.62 0.00
43644   4 90 2 0.00 2,547.62 0.00
43645   1 90 2 0.00 3,048.73 0.00
43645   2 90 2 0.00 2,746.40 0.00
43645   3 90 2 0.00 2,746.40 0.00
43645   4 90 2 0.00 2,746.40 0.00
43647     YYY 2 0.00 * 0.00
43648     YYY 2 0.00 * 0.00
43651   1 90 2 0.00 1,219.11 0.00
43651   2 90 2 0.00 1,095.71 0.00
43651   3 90 2 0.00 1,095.71 0.00
43651   4 90 2 0.00 1,095.71 0.00
43652   1 90 2 0.00 1,455.84 0.00
43652   2 90 2 0.00 1,313.66 0.00
43652   3 90 2 0.00 1,313.66 0.00
43652   4 90 2 0.00 1,313.66 0.00
43653   1 90 2 0.00 1,054.89 0.00
43653   2 90 2 0.00 943.43 0.00
43653   3 90 2 0.00 943.43 0.00
43653   4 90 2 0.00 943.43 0.00
43659     YYY 2 0.00 * 0.00
43752     0 0 0.00 * 0.00
43753   1 0 0 0.00 30.31 0.00
43753   2 0 0 0.00 28.50 0.00
43753   3 0 0 0.00 28.50 0.00
43753   4 0 0 0.00 28.50 0.00
43754   1 0 0 0.00 117.53 46.82
43754   2 0 0 0.00 105.41 42.94
43754   3 0 0 0.00 105.41 42.94
43754   4 0 0 0.00 105.41 42.94
43755   1 0 0 0.00 178.97 85.42
43755   2 0 0 0.00 161.46 78.77
43755   3 0 0 0.00 161.46 78.77
43755   4 0 0 0.00 161.46 78.77
43756   1 0 0 0.00 325.19 76.54
43756   2 0 0 0.00 290.37 70.61
43756   3 0 0 0.00 290.37 70.61
43756   4 0 0 0.00 290.37 70.61
43757   1 0 0 0.00 417.92 110.30
43757   2 0 0 0.00 374.19 102.32
43757   3 0 0 0.00 374.19 102.32
43757   4 0 0 0.00 374.19 102.32
43761   1 0 2 0.00 279.00 0.00
43761   2 0 2 0.00 274.74 0.00
43761   3 0 2 0.00 257.16 0.00
43761   4 0 2 0.00 254.34 0.00
43762   1 0 2 0.00 275.77 47.45
43762   2 0 2 0.00 242.92 43.93
43762   3 0 2 0.00 242.92 43.93
43762   4 0 2 0.00 242.92 43.93
43763   1 0 2 0.00 409.32 104.91
43763   2 0 2 0.00 361.63 96.33
43763   3 0 2 0.00 361.63 96.33
43763   4 0 2 0.00 361.63 96.33
43770   1 90 2 0.00 1,641.74 0.00
43770   2 90 2 0.00 1,463.78 0.00
43770   3 90 2 0.00 1,463.78 0.00
43770   4 90 2 0.00 1,463.78 0.00
43771   1 90 2 0.00 1,889.48 0.00
43771   2 90 2 0.00 1,686.66 0.00
43771   3 90 2 0.00 1,686.66 0.00
43771   4 90 2 0.00 1,686.66 0.00
43772   1 90 2 0.00 1,439.12 0.00
43772   2 90 2 0.00 1,286.35 0.00
43772   3 90 2 0.00 1,286.35 0.00
43772   4 90 2 0.00 1,286.35 0.00
43773   1 90 2 0.00 1,890.25 0.00
43773   2 90 2 0.00 1,687.11 0.00
43773   3 90 2 0.00 1,687.11 0.00
43773   4 90 2 0.00 1,687.11 0.00
43774   1 90 2 0.00 1,441.60 0.00
43774   2 90 2 0.00 1,289.91 0.00
43774   3 90 2 0.00 1,289.91 0.00
43774   4 90 2 0.00 1,289.91 0.00
43775   1 90 2 0.00 1,984.60 0.00
43775   2 90 2 0.00 1,775.32 0.00
43775   3 90 2 0.00 1,775.32 0.00
43775   4 90 2 0.00 1,775.32 0.00
43800   1 90 2 0.00 1,969.18 0.00
43800   2 90 2 0.00 1,945.80 0.00
43800   3 90 2 0.00 1,892.52 0.00
43800   4 90 2 0.00 1,905.29 0.00
43810   1 90 2 0.00 1,736.09 0.00
43810   2 90 2 0.00 1,975.25 0.00
43810   3 90 2 0.00 1,591.23 0.00
43810   4 90 2 0.00 1,834.83 0.00
43820   1 90 2 0.00 2,132.78 0.00
43820   2 90 2 0.00 2,119.70 0.00
43820   3 90 2 0.00 2,041.51 0.00
43820   4 90 2 0.00 2,045.45 0.00
43825   1 90 2 0.00 2,413.48 0.00
43825   2 90 2 0.00 2,512.44 0.00
43825   3 90 2 0.00 2,390.49 0.00
43825   4 90 2 0.00 2,410.23 0.00
43830   1 90 2 0.00 1,305.34 0.00
43830   2 90 2 0.00 1,278.78 0.00
43830   3 90 2 0.00 1,124.82 0.00
43830   4 90 2 0.00 1,234.50 0.00
43831   1 90 2 0.00 1,128.08 0.00
43831   2 90 2 0.00 981.10 0.00
43831   3 90 2 0.00 1,036.07 0.00
43831   4 90 2 0.00 847.54 0.00
43832   1 90 2 0.00 1,793.42 0.00
43832   2 90 2 0.00 1,766.09 0.00
43832   3 90 2 0.00 1,653.31 0.00
43832   4 90 2 0.00 1,634.24 0.00
43840   1 90 2 0.00 1,803.62 0.00
43840   2 90 2 0.00 1,773.69 0.00
43840   3 90 2 0.00 2,000.69 0.00
43840   4 90 2 0.00 1,631.65 0.00
43842   1 90 2 0.00 2,601.34 0.00
43842   2 90 2 0.00 2,552.01 0.00
43842   3 90 2 0.00 2,348.73 0.00
43842   4 90 2 0.00 2,320.88 0.00
43843   1 90 2 0.00 2,601.34 0.00
43843   2 90 2 0.00 2,552.01 0.00
43843   3 90 2 0.00 2,348.73 0.00
43843   4 90 2 0.00 2,320.88 0.00
43845     90 2 0.00 * 0.00
43846   1 90 2 0.00 2,822.32 0.00
43846   2 90 2 0.00 3,552.81 0.00
43846   3 90 2 0.00 2,542.88 0.00
43846   4 90 2 0.00 2,512.86 0.00
43847   1 90 2 0.00 2,090.66 0.00
43847   2 90 2 0.00 3,477.03 0.00
43847   3 90 2 0.00 3,322.56 0.00
43847   4 90 2 0.00 1,923.54 0.00
43848   1 90 2 0.00 2,822.32 0.00
43848   2 90 2 0.00 3,552.81 0.00
43848   3 90 2 0.00 2,542.88 0.00
43848   4 90 2 0.00 2,512.86 0.00
43850   1 90 2 0.00 2,874.67 0.00
43850   2 90 2 0.00 2,831.02 0.00
43850   3 90 2 0.00 2,783.50 0.00
43850   4 90 2 0.00 2,621.39 0.00
43855   1 90 2 0.00 2,863.67 0.00
43855   2 90 2 0.00 2,820.45 0.00
43855   3 90 2 0.00 2,642.74 0.00
43855   4 90 2 0.00 2,613.80 0.00
43860   1 90 2 0.00 2,894.64 0.00
43860   2 90 2 0.00 2,848.64 0.00
43860   3 90 2 0.00 2,659.33 0.00
43860   4 90 2 0.00 2,629.79 0.00
43865   1 90 2 0.00 3,210.43 0.00
43865   2 90 2 0.00 3,157.33 0.00
43865   3 90 2 0.00 3,019.53 0.00
43865   4 90 2 0.00 2,905.77 0.00
43870   1 90 2 0.00 1,386.81 0.00
43870   2 90 2 0.00 1,354.31 0.00
43870   3 90 2 0.00 1,286.82 0.00
43870   4 90 2 0.00 1,314.21 0.00
43880   1 90 2 0.00 2,984.34 0.00
43880   2 90 2 0.00 2,930.50 0.00
43880   3 90 2 0.00 2,791.98 0.00
43880   4 90 2 0.00 2,311.60 0.00
43881     YYY 2 0.00 * 0.00
43882     YYY 2 0.00 * 0.00
43886   1 90 2 0.00 453.24 0.00
43886   2 90 2 0.00 404.72 0.00
43886   3 90 2 0.00 404.72 0.00
43886   4 90 2 0.00 404.72 0.00
43887   1 90 2 0.00 448.19 0.00
43887   2 90 2 0.00 395.21 0.00
43887   3 90 2 0.00 395.21 0.00
43887   4 90 2 0.00 395.21 0.00
43888   1 90 2 0.00 634.34 0.00
43888   2 90 2 0.00 561.86 0.00
43888   3 90 2 0.00 561.86 0.00
43888   4 90 2 0.00 561.86 0.00
43999     YYY 2 0.00 * 0.00
44005   1 90 2 0.00 1,987.49 0.00
44005   2 90 2 0.00 1,966.48 0.00
44005   3 90 2 0.00 1,916.98 0.00
44005   4 90 2 0.00 1,896.54 0.00
44010   1 90 2 0.00 1,785.95 0.00
44010   2 90 2 0.00 1,720.15 0.00
44010   3 90 2 0.00 1,657.03 0.00
44010   4 90 2 0.00 1,692.01 0.00
44015   1 ZZZ 0 0.00 1,209.54 0.00
44015   2 ZZZ 0 0.00 1,205.69 0.00
44015   3 ZZZ 0 0.00 1,162.15 0.00
44015   4 ZZZ 0 0.00 1,179.43 0.00
44020   1 90 2 0.00 1,887.34 0.00
44020   2 90 2 0.00 1,824.33 0.00
44020   3 90 2 0.00 1,739.88 0.00
44020   4 90 2 0.00 1,748.83 0.00
44021   1 90 2 0.00 1,739.81 0.00
44021   2 90 2 0.00 1,712.28 0.00
44021   3 90 2 0.00 1,599.18 0.00
44021   4 90 2 0.00 1,581.33 0.00
44025   1 90 2 0.00 1,886.75 0.00
44025   2 90 2 0.00 1,811.92 0.00
44025   3 90 2 0.00 1,756.29 0.00
44025   4 90 2 0.00 1,762.26 0.00
44050   1 90 2 0.00 1,857.25 0.00
44050   2 90 2 0.00 1,730.45 0.00
44050   3 90 2 0.00 1,622.99 0.00
44050   4 90 2 0.00 1,590.77 0.00
44055   1 90 2 0.00 1,907.04 0.00
44055   2 90 2 0.00 1,877.12 0.00
44055   3 90 2 0.00 1,706.36 0.00
44055   4 90 2 0.00 1,734.35 0.00
44100   1 0 2 0.00 331.35 0.00
44100   2 0 2 0.00 284.54 0.00
44100   3 0 2 0.00 320.69 0.00
44100   4 0 2 0.00 245.69 0.00
44110   1 90 2 0.00 1,812.61 0.00
44110   2 90 2 0.00 1,965.96 0.00
44110   3 90 2 0.00 1,751.94 0.00
44110   4 90 2 0.00 1,632.71 0.00
44111   1 90 2 0.00 2,076.20 0.00
44111   2 90 2 0.00 2,152.61 0.00
44111   3 90 2 0.00 1,911.10 0.00
44111   4 90 2 0.00 1,866.06 0.00
44120   1 90 2 0.00 2,323.46 0.00
44120   2 90 2 0.00 2,295.45 0.00
44120   3 90 2 0.00 2,178.26 0.00
44120   4 90 2 0.00 2,162.74 0.00
44121   1 ZZZ 0 0.00 703.73 0.00
44121   2 ZZZ 0 0.00 683.50 0.00
44121   3 ZZZ 0 0.00 642.80 0.00
44121   4 ZZZ 0 0.00 634.64 0.00
44125   1 90 2 0.00 2,410.91 0.00
44125   2 90 2 0.00 2,403.73 0.00
44125   3 90 2 0.00 2,305.86 0.00
44125   4 90 2 0.00 2,328.99 0.00
44126   1 90 2 0.00 3,663.31 0.00
44126   2 90 2 0.00 3,379.65 0.00
44126   3 90 2 0.00 3,379.65 0.00
44126   4 90 2 0.00 3,379.65 0.00
44127   1 90 2 0.00 4,211.70 0.00
44127   2 90 2 0.00 3,887.16 0.00
44127   3 90 2 0.00 3,887.16 0.00
44127   4 90 2 0.00 3,887.16 0.00
44128   1 ZZZ 0 0.00 462.28 0.00
44128   2 ZZZ 0 0.00 415.04 0.00
44128   3 ZZZ 0 0.00 415.04 0.00
44128   4 ZZZ 0 0.00 415.04 0.00
44130   1 90 2 0.00 2,080.22 0.00
44130   2 90 2 0.00 2,059.91 0.00
44130   3 90 2 0.00 1,950.81 0.00
44130   4 90 2 0.00 1,949.28 0.00
44132     XXX 0 0.00 * 0.00
44133     XXX 0 0.00 * 0.00
44135     XXX 0 0.00 * 0.00
44136     XXX 0 0.00 * 0.00
44137     XXX 2 0.00 * 0.00
44139   1 ZZZ 0 0.00 353.26 0.00
44139   2 ZZZ 0 0.00 343.10 0.00
44139   3 ZZZ 0 0.00 322.70 0.00
44139   4 ZZZ 0 0.00 318.58 0.00
44140   1 90 2 0.00 2,794.74 0.00
44140   2 90 2 0.00 2,745.67 0.00
44140   3 90 2 0.00 2,548.87 0.00
44140   4 90 2 0.00 2,498.25 0.00
44141   1 90 2 0.00 2,902.58 0.00
44141   2 90 2 0.00 2,862.55 0.00
44141   3 90 2 0.00 2,680.57 0.00
44141   4 90 2 0.00 2,659.43 0.00
44143   1 90 2 0.00 2,951.52 0.00
44143   2 90 2 0.00 2,906.75 0.00
44143   3 90 2 0.00 2,725.28 0.00
44143   4 90 2 0.00 2,711.82 0.00
44144   1 90 2 0.00 2,869.08 0.00
44144   2 90 2 0.00 2,821.63 0.00
44144   3 90 2 0.00 2,650.15 0.00
44144   4 90 2 0.00 2,644.64 0.00
44145   1 90 2 0.00 3,393.14 0.00
44145   2 90 2 0.00 3,295.84 0.00
44145   3 90 2 0.00 3,167.42 0.00
44145   4 90 2 0.00 3,132.20 0.00