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Menu
Individuals
Individuals
Unemployment Benefits
Disability Services
Find A Job
Workers' Compensation Services
Workforce Development
PennSERVE
Individual Services
Uniform Construction Code
Labor Management Relations
Misclassified Workers
Businesses
Businesses
Employer UC Info
Finding Skilled Workers
Disability Services
Workforce Development
Workers' Compensation Services
Labor-Management Relations
Pennsylvania Business One-Stop
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DLI
>
Businesses
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Workers' Compensation Services
>
Workers' Compensation
>
Health Care Services Review
>
Medical Fee Review
>
Fee Schedule
>
Fee Schedule 44146-45331
Begin Main Content Area
Page Content
2019 Workers' Compensation Part B Fee Schedule
44146-45331
View the PDF
CPT/HCPC Code
Modifier
Medicare Location
Global Surgery Indicator
Multiple Surgery Indicator
Prevailing Charge Amount
Fee Schedule Amount
Site of Service Amount
44146
1
90
2
0.00
3,666.76
0.00
44146
2
90
2
0.00
3,531.32
0.00
44146
3
90
2
0.00
3,415.11
0.00
44146
4
90
2
0.00
3,321.17
0.00
44147
1
90
2
0.00
3,252.59
0.00
44147
2
90
2
0.00
3,130.90
0.00
44147
3
90
2
0.00
2,959.07
0.00
44147
4
90
2
0.00
2,920.34
0.00
44150
1
90
2
0.00
3,468.67
0.00
44150
2
90
2
0.00
3,295.60
0.00
44150
3
90
2
0.00
3,062.73
0.00
44150
4
90
2
0.00
3,027.82
0.00
44151
1
90
2
0.00
3,221.62
0.00
44151
2
90
2
0.00
2,688.65
0.00
44151
3
90
2
0.00
2,517.29
0.00
44151
4
90
2
0.00
2,489.54
0.00
44155
1
90
2
0.00
3,914.14
0.00
44155
2
90
2
0.00
3,818.39
0.00
44155
3
90
2
0.00
3,654.86
0.00
44155
4
90
2
0.00
3,636.30
0.00
44156
1
90
2
0.00
3,093.72
0.00
44156
2
90
2
0.00
3,533.17
0.00
44156
3
90
2
0.00
2,852.30
0.00
44156
4
90
2
0.00
2,820.94
0.00
44157
1
90
2
0.00
3,016.08
0.00
44157
2
90
2
0.00
2,678.19
0.00
44157
3
90
2
0.00
2,678.19
0.00
44157
4
90
2
0.00
2,678.19
0.00
44158
1
90
2
0.00
3,093.98
0.00
44158
2
90
2
0.00
2,747.54
0.00
44158
3
90
2
0.00
2,747.54
0.00
44158
4
90
2
0.00
2,747.54
0.00
44160
1
90
2
0.00
2,888.57
0.00
44160
2
90
2
0.00
2,822.85
0.00
44160
3
90
2
0.00
2,478.97
0.00
44160
4
90
2
0.00
2,384.92
0.00
44180
1
90
2
0.00
1,387.53
0.00
44180
2
90
2
0.00
1,239.89
0.00
44180
3
90
2
0.00
1,239.89
0.00
44180
4
90
2
0.00
1,239.89
0.00
44186
1
90
2
0.00
977.33
0.00
44186
2
90
2
0.00
870.16
0.00
44186
3
90
2
0.00
870.16
0.00
44186
4
90
2
0.00
870.16
0.00
44187
1
90
2
0.00
1,613.38
0.00
44187
2
90
2
0.00
1,437.28
0.00
44187
3
90
2
0.00
1,437.28
0.00
44187
4
90
2
0.00
1,437.28
0.00
44188
1
90
2
0.00
1,770.77
0.00
44188
2
90
2
0.00
1,577.05
0.00
44188
3
90
2
0.00
1,577.05
0.00
44188
4
90
2
0.00
1,577.05
0.00
44202
1
90
2
0.00
2,732.88
0.00
44202
2
90
2
0.00
2,453.23
0.00
44202
3
90
2
0.00
2,453.23
0.00
44202
4
90
2
0.00
2,453.23
0.00
44203
1
ZZZ
0
0.00
449.56
0.00
44203
2
ZZZ
0
0.00
404.20
0.00
44203
3
ZZZ
0
0.00
404.20
0.00
44203
4
ZZZ
0
0.00
404.20
0.00
44204
1
90
2
0.00
2,571.15
0.00
44204
2
90
2
0.00
2,329.56
0.00
44204
3
90
2
0.00
2,329.56
0.00
44204
4
90
2
0.00
2,329.56
0.00
44205
1
90
2
0.00
2,275.12
0.00
44205
2
90
2
0.00
2,063.53
0.00
44205
3
90
2
0.00
2,063.53
0.00
44205
4
90
2
0.00
2,063.53
0.00
44206
1
90
2
0.00
2,759.36
0.00
44206
2
90
2
0.00
2,498.60
0.00
44206
3
90
2
0.00
2,498.60
0.00
44206
4
90
2
0.00
2,498.60
0.00
44207
1
90
2
0.00
3,018.12
0.00
44207
2
90
2
0.00
2,736.20
0.00
44207
3
90
2
0.00
2,736.20
0.00
44207
4
90
2
0.00
2,736.20
0.00
44208
1
90
2
0.00
3,261.23
0.00
44208
2
90
2
0.00
2,958.95
0.00
44208
3
90
2
0.00
2,958.95
0.00
44208
4
90
2
0.00
2,958.95
0.00
44210
1
YYY
2
0.00
2,890.93
0.00
44210
2
YYY
2
0.00
2,617.34
0.00
44210
3
YYY
2
0.00
2,617.34
0.00
44210
4
YYY
2
0.00
2,617.34
0.00
44211
1
90
2
0.00
3,584.14
0.00
44211
2
90
2
0.00
3,253.02
0.00
44211
3
90
2
0.00
3,253.02
0.00
44211
4
90
2
0.00
3,253.02
0.00
44212
1
90
2
0.00
3,352.00
0.00
44212
2
90
2
0.00
3,038.27
0.00
44212
3
90
2
0.00
3,038.27
0.00
44212
4
90
2
0.00
3,038.27
0.00
44213
1
ZZZ
0
0.00
317.20
0.00
44213
2
ZZZ
0
0.00
285.11
0.00
44213
3
ZZZ
0
0.00
285.11
0.00
44213
4
ZZZ
0
0.00
285.11
0.00
44227
1
90
2
0.00
2,494.46
0.00
44227
2
90
2
0.00
2,233.80
0.00
44227
3
90
2
0.00
2,233.80
0.00
44227
4
90
2
0.00
2,233.80
0.00
44238
90
2
0.00
*
0.00
44300
1
90
2
0.00
1,483.99
0.00
44300
2
90
2
0.00
1,458.82
0.00
44300
3
90
2
0.00
1,386.27
0.00
44300
4
90
2
0.00
1,390.85
0.00
44310
1
90
2
0.00
1,859.11
0.00
44310
2
90
2
0.00
1,796.47
0.00
44310
3
90
2
0.00
1,732.11
0.00
44310
4
90
2
0.00
1,761.67
0.00
44312
1
90
2
0.00
849.67
0.00
44312
2
90
2
0.00
845.30
0.00
44312
3
90
2
0.00
734.92
0.00
44312
4
90
2
0.00
823.61
0.00
44314
1
90
2
0.00
1,535.41
0.00
44314
2
90
2
0.00
1,481.93
0.00
44314
3
90
2
0.00
1,402.53
0.00
44314
4
90
2
0.00
1,425.65
0.00
44316
1
90
2
0.00
2,200.58
0.00
44316
2
90
2
0.00
2,169.25
0.00
44316
3
90
2
0.00
2,039.71
0.00
44316
4
90
2
0.00
2,051.11
0.00
44320
1
90
2
0.00
1,869.79
0.00
44320
2
90
2
0.00
1,753.43
0.00
44320
3
90
2
0.00
1,690.69
0.00
44320
4
90
2
0.00
1,697.20
0.00
44322
1
90
2
0.00
1,925.77
0.00
44322
2
90
2
0.00
1,892.43
0.00
44322
3
90
2
0.00
1,755.16
0.00
44322
4
90
2
0.00
1,734.89
0.00
44340
1
90
2
0.00
777.44
0.00
44340
2
90
2
0.00
774.21
0.00
44340
3
90
2
0.00
730.36
0.00
44340
4
90
2
0.00
756.27
0.00
44345
1
90
2
0.00
1,424.46
0.00
44345
2
90
2
0.00
1,404.13
0.00
44345
3
90
2
0.00
1,573.32
0.00
44345
4
90
2
0.00
1,306.27
0.00
44346
1
90
2
0.00
1,687.96
0.00
44346
2
90
2
0.00
1,663.12
0.00
44346
3
90
2
0.00
1,587.08
0.00
44346
4
90
2
0.00
1,425.87
0.00
44360
1
0
2
0.00
578.37
0.00
44360
2
0
2
0.00
599.76
0.00
44360
3
0
2
0.00
536.48
0.00
44360
4
0
2
0.00
529.63
0.00
44361
1
0
3
0.00
728.21
0.00
44361
2
0
3
0.00
711.46
0.00
44361
3
0
3
0.00
707.53
0.00
44361
4
0
3
0.00
607.17
0.00
44363
1
0
3
0.00
604.91
0.00
44363
2
0
3
0.00
596.75
0.00
44363
3
0
3
0.00
562.92
0.00
44363
4
0
3
0.00
556.30
0.00
44364
1
0
3
0.00
807.32
0.00
44364
2
0
3
0.00
794.00
0.00
44364
3
0
3
0.00
738.71
0.00
44364
4
0
3
0.00
729.69
0.00
44365
1
0
3
0.00
798.48
0.00
44365
2
0
3
0.00
785.20
0.00
44365
3
0
3
0.00
730.15
0.00
44365
4
0
3
0.00
721.18
0.00
44366
1
0
3
0.00
933.20
0.00
44366
2
0
3
0.00
920.73
0.00
44366
3
0
3
0.00
868.80
0.00
44366
4
0
3
0.00
857.74
0.00
44369
1
0
3
0.00
1,012.63
0.00
44369
2
0
3
0.00
998.79
0.00
44369
3
0
3
0.00
941.06
0.00
44369
4
0
3
0.00
928.95
0.00
44370
1
0
3
0.00
455.66
0.00
44370
2
0
3
0.00
416.69
0.00
44370
3
0
3
0.00
416.69
0.00
44370
4
0
3
0.00
416.69
0.00
44372
1
0
3
0.00
958.18
0.00
44372
2
0
3
0.00
983.73
0.00
44372
3
0
3
0.00
958.61
0.00
44372
4
0
3
0.00
872.74
0.00
44373
1
0
3
0.00
801.17
0.00
44373
2
0
3
0.00
921.66
0.00
44373
3
0
3
0.00
740.39
0.00
44373
4
0
3
0.00
896.99
0.00
44376
1
0
2
0.00
774.86
0.00
44376
2
0
2
0.00
766.13
0.00
44376
3
0
2
0.00
729.78
0.00
44376
4
0
2
0.00
721.04
0.00
44377
1
0
3
0.00
819.82
0.00
44377
2
0
3
0.00
810.49
0.00
44377
3
0
3
0.00
771.85
0.00
44377
4
0
3
0.00
762.60
0.00
44378
1
0
3
0.00
1,069.14
0.00
44378
2
0
3
0.00
1,057.05
0.00
44378
3
0
3
0.00
1,006.69
0.00
44378
4
0
3
0.00
994.65
0.00
44379
1
0
3
0.00
744.33
0.00
44379
2
0
3
0.00
679.83
0.00
44379
3
0
3
0.00
679.83
0.00
44379
4
0
3
0.00
679.83
0.00
44380
1
0
2
0.00
563.70
0.00
44380
2
0
2
0.00
538.81
0.00
44380
3
0
2
0.00
527.89
0.00
44380
4
0
2
0.00
420.71
0.00
44381
0
3
0.00
*
0.00
44382
1
0
2
0.00
582.79
0.00
44382
2
0
2
0.00
611.70
0.00
44382
3
0
2
0.00
384.36
0.00
44382
4
0
2
0.00
582.10
0.00
44384
0
3
0.00
*
0.00
44385
1
0
2
0.00
579.44
0.00
44385
2
0
2
0.00
552.04
0.00
44385
3
0
2
0.00
624.72
0.00
44385
4
0
2
0.00
397.73
0.00
44386
1
0
2
0.00
642.74
0.00
44386
2
0
2
0.00
310.86
0.00
44386
3
0
2
0.00
294.54
0.00
44386
4
0
2
0.00
291.03
0.00
44388
1
0
2
0.00
727.51
0.00
44388
2
0
2
0.00
693.57
0.00
44388
3
0
2
0.00
720.86
0.00
44388
4
0
2
0.00
742.92
0.00
44389
1
0
3
0.00
777.33
0.00
44389
2
0
3
0.00
773.62
0.00
44389
3
0
3
0.00
744.12
0.00
44389
4
0
3
0.00
757.63
0.00
44390
1
0
3
0.00
557.44
0.00
44390
2
0
3
0.00
630.36
0.00
44390
3
0
3
0.00
521.28
0.00
44390
4
0
3
0.00
515.16
0.00
44391
1
0
3
0.00
842.49
0.00
44391
2
0
3
0.00
854.96
0.00
44391
3
0
3
0.00
778.98
0.00
44391
4
0
3
0.00
769.19
0.00
44392
1
0
3
0.00
1,105.79
0.00
44392
2
0
3
0.00
1,063.93
0.00
44392
3
0
3
0.00
1,062.97
0.00
44392
4
0
3
0.00
1,035.44
0.00
44394
1
0
3
0.00
1,105.79
0.00
44394
2
0
3
0.00
1,063.93
0.00
44394
3
0
3
0.00
1,062.97
0.00
44394
4
0
3
0.00
1,035.44
0.00
44401
0
3
0.00
*
0.00
44402
0
3
0.00
*
0.00
44403
0
3
0.00
*
0.00
44404
0
3
0.00
*
0.00
44405
0
3
0.00
*
0.00
44406
0
3
0.00
*
0.00
44407
0
3
0.00
*
0.00
44408
0
3
0.00
*
0.00
44500
1
0
0
0.00
52.95
0.00
44500
2
0
0
0.00
52.32
0.00
44500
3
0
0
0.00
49.78
0.00
44500
4
0
0
0.00
49.14
0.00
44602
1
90
2
0.00
1,832.51
0.00
44602
2
90
2
0.00
1,825.11
0.00
44602
3
90
2
0.00
1,639.32
0.00
44602
4
90
2
0.00
1,637.44
0.00
44603
1
90
2
0.00
2,165.64
0.00
44603
2
90
2
0.00
2,130.17
0.00
44603
3
90
2
0.00
1,984.36
0.00
44603
4
90
2
0.00
1,962.00
0.00
44604
1
90
2
0.00
1,959.88
0.00
44604
2
90
2
0.00
1,947.85
0.00
44604
3
90
2
0.00
1,766.21
0.00
44604
4
90
2
0.00
1,760.56
0.00
44605
1
90
2
0.00
2,281.32
0.00
44605
2
90
2
0.00
2,244.55
0.00
44605
3
90
2
0.00
2,093.10
0.00
44605
4
90
2
0.00
2,009.17
0.00
44615
1
90
2
0.00
1,681.36
0.00
44615
2
90
2
0.00
1,655.76
0.00
44615
3
90
2
0.00
1,550.33
0.00
44615
4
90
2
0.00
1,533.52
0.00
44620
1
90
2
0.00
1,518.80
0.00
44620
2
90
2
0.00
1,495.24
0.00
44620
3
90
2
0.00
1,398.24
0.00
44620
4
90
2
0.00
1,400.45
0.00
44625
1
90
2
0.00
1,984.72
0.00
44625
2
90
2
0.00
1,740.74
0.00
44625
3
90
2
0.00
1,740.74
0.00
44625
4
90
2
0.00
1,740.74
0.00
44626
1
90
2
0.00
2,840.97
0.00
44626
2
90
2
0.00
2,535.19
0.00
44626
3
90
2
0.00
2,535.19
0.00
44626
4
90
2
0.00
2,535.19
0.00
44640
1
90
2
0.00
1,813.40
0.00
44640
2
90
2
0.00
1,775.74
0.00
44640
3
90
2
0.00
1,688.11
0.00
44640
4
90
2
0.00
1,716.28
0.00
44650
1
90
2
0.00
2,018.80
0.00
44650
2
90
2
0.00
1,989.64
0.00
44650
3
90
2
0.00
1,869.72
0.00
44650
4
90
2
0.00
1,849.10
0.00
44660
1
90
2
0.00
2,018.96
0.00
44660
2
90
2
0.00
1,991.43
0.00
44660
3
90
2
0.00
1,877.92
0.00
44660
4
90
2
0.00
1,856.47
0.00
44661
1
90
2
0.00
2,584.69
0.00
44661
2
90
2
0.00
2,523.19
0.00
44661
3
90
2
0.00
2,384.75
0.00
44661
4
90
2
0.00
2,373.76
0.00
44680
1
90
2
0.00
2,432.01
0.00
44680
2
90
2
0.00
2,385.80
0.00
44680
3
90
2
0.00
2,005.54
0.00
44680
4
90
2
0.00
2,296.13
0.00
44700
1
90
2
0.00
2,240.61
0.00
44700
2
90
2
0.00
1,955.36
0.00
44700
3
90
2
0.00
1,955.36
0.00
44700
4
90
2
0.00
1,955.36
0.00
44701
1
90
2
0.00
299.41
0.00
44701
2
90
2
0.00
272.69
0.00
44701
3
90
2
0.00
272.69
0.00
44701
4
90
2
0.00
272.69
0.00
44705
XXX
9
0.00
*
0.00
44715
XXX
2
0.00
*
0.00
44720
1
XXX
2
0.00
469.75
0.00
44720
2
XXX
2
0.00
430.54
0.00
44720
3
XXX
2
0.00
430.54
0.00
44720
4
XXX
2
0.00
430.54
0.00
44721
1
XXX
2
0.00
696.71
0.00
44721
2
XXX
2
0.00
625.34
0.00
44721
3
XXX
2
0.00
625.34
0.00
44721
4
XXX
2
0.00
625.34
0.00
44799
YYY
2
0.00
*
0.00
44800
1
90
2
0.00
1,551.04
0.00
44800
2
90
2
0.00
1,493.93
0.00
44800
3
90
2
0.00
1,450.54
0.00
44800
4
90
2
0.00
1,470.75
0.00
44820
1
90
2
0.00
1,639.94
0.00
44820
2
90
2
0.00
1,542.15
0.00
44820
3
90
2
0.00
1,591.14
0.00
44820
4
90
2
0.00
1,468.13
0.00
44850
1
90
2
0.00
1,388.48
0.00
44850
2
90
2
0.00
1,690.56
0.00
44850
3
90
2
0.00
1,276.53
0.00
44850
4
90
2
0.00
1,262.26
0.00
44899
YYY
2
0.00
*
0.00
44900
1
90
2
0.00
1,090.19
0.00
44900
2
90
2
0.00
975.31
0.00
44900
3
90
2
0.00
975.31
0.00
44900
4
90
2
0.00
975.31
0.00
44950
1
90
2
0.00
1,128.50
0.00
44950
2
90
2
0.00
1,094.97
0.00
44950
3
90
2
0.00
1,027.06
0.00
44950
4
90
2
0.00
999.01
0.00
44955
1
ZZZ
0
0.00
692.02
0.00
44955
2
ZZZ
0
0.00
693.17
0.00
44955
3
ZZZ
0
0.00
389.31
0.00
44955
4
ZZZ
0
0.00
699.83
0.00
44960
1
90
2
0.00
1,492.89
0.00
44960
2
90
2
0.00
1,497.09
0.00
44960
3
90
2
0.00
1,401.01
0.00
44960
4
90
2
0.00
1,385.41
0.00
44970
1
90
2
0.00
1,076.16
0.00
44970
2
90
2
0.00
966.09
0.00
44970
3
90
2
0.00
966.09
0.00
44970
4
90
2
0.00
966.09
0.00
44979
YYY
2
0.00
*
0.00
45000
1
90
2
0.00
539.91
0.00
45000
2
90
2
0.00
532.53
0.00
45000
3
90
2
0.00
508.03
0.00
45000
4
90
2
0.00
502.60
0.00
45005
1
10
2
0.00
323.90
0.00
45005
2
10
2
0.00
303.87
0.00
45005
3
10
2
0.00
305.87
0.00
45005
4
10
2
0.00
313.00
0.00
45020
1
90
2
0.00
649.93
0.00
45020
2
90
2
0.00
631.98
0.00
45020
3
90
2
0.00
606.99
0.00
45020
4
90
2
0.00
614.62
0.00
45100
1
90
2
0.00
570.09
0.00
45100
2
90
2
0.00
556.79
0.00
45100
3
90
2
0.00
540.46
0.00
45100
4
90
2
0.00
543.65
0.00
45108
1
90
2
0.00
671.59
0.00
45108
2
90
2
0.00
661.36
0.00
45108
3
90
2
0.00
619.22
0.00
45108
4
90
2
0.00
612.28
0.00
45110
1
90
2
0.00
3,823.77
0.00
45110
2
90
2
0.00
3,681.18
0.00
45110
3
90
2
0.00
3,425.81
0.00
45110
4
90
2
0.00
3,369.94
0.00
45111
1
90
2
0.00
2,821.38
0.00
45111
2
90
2
0.00
2,692.84
0.00
45111
3
90
2
0.00
2,628.57
0.00
45111
4
90
2
0.00
2,681.63
0.00
45112
1
90
2
0.00
3,914.61
0.00
45112
2
90
2
0.00
3,852.35
0.00
45112
3
90
2
0.00
3,596.11
0.00
45112
4
90
2
0.00
3,440.14
0.00
45113
1
90
2
0.00
3,914.61
0.00
45113
2
90
2
0.00
3,852.35
0.00
45113
3
90
2
0.00
3,596.11
0.00
45113
4
90
2
0.00
3,440.14
0.00
45114
1
90
2
0.00
3,820.73
0.00
45114
2
90
2
0.00
3,537.83
0.00
45114
3
90
2
0.00
3,290.56
0.00
45114
4
90
2
0.00
3,257.78
0.00
45116
1
90
2
0.00
2,894.62
0.00
45116
2
90
2
0.00
2,850.51
0.00
45116
3
90
2
0.00
2,669.11
0.00
45116
4
90
2
0.00
2,639.76
0.00
45119
1
90
2
0.00
3,594.71
0.00
45119
2
90
2
0.00
3,178.34
0.00
45119
3
90
2
0.00
3,178.34
0.00
45119
4
90
2
0.00
3,178.34
0.00
45120
1
90
2
0.00
3,858.58
0.00
45120
2
90
2
0.00
3,794.94
0.00
45120
3
90
2
0.00
3,532.73
0.00
45120
4
90
2
0.00
3,492.86
0.00
45121
1
90
2
0.00
3,603.20
0.00
45121
2
90
2
0.00
3,527.27
0.00
45121
3
90
2
0.00
3,364.36
0.00
45121
4
90
2
0.00
3,101.88
0.00
45123
1
90
2
0.00
2,821.38
0.00
45123
2
90
2
0.00
2,692.84
0.00
45123
3
90
2
0.00
2,628.57
0.00
45123
4
90
2
0.00
2,681.63
0.00
45126
1
90
2
0.00
4,218.79
4,198.18
45126
2
90
2
0.00
3,778.94
3,761.35
45126
3
90
2
0.00
3,778.94
3,761.35
45126
4
90
2
0.00
3,778.94
3,761.35
45130
1
90
2
0.00
2,294.75
0.00
45130
2
90
2
0.00
2,322.64
0.00
45130
3
90
2
0.00
2,300.93
0.00
45130
4
90
2
0.00
1,941.94
0.00
45135
1
90
2
0.00
3,173.76
0.00
45135
2
90
2
0.00
3,114.76
0.00
45135
3
90
2
0.00
2,871.32
0.00
45135
4
90
2
0.00
2,837.77
0.00
45136
1
90
2
0.00
2,907.06
0.00
45136
2
90
2
0.00
2,622.39
0.00
45136
3
90
2
0.00
2,622.39
0.00
45136
4
90
2
0.00
2,622.39
0.00
45150
1
90
2
0.00
831.95
0.00
45150
2
90
2
0.00
1,030.57
0.00
45150
3
90
2
0.00
1,149.52
0.00
45150
4
90
2
0.00
759.30
0.00
45160
1
90
2
0.00
1,802.02
0.00
45160
2
90
2
0.00
1,785.08
0.00
45160
3
90
2
0.00
1,505.59
0.00
45160
4
90
2
0.00
1,704.05
0.00
45171
1
90
2
0.00
887.08
0.00
45171
2
90
2
0.00
788.90
0.00
45171
3
90
2
0.00
788.90
0.00
45171
4
90
2
0.00
788.90
0.00
45172
1
90
2
0.00
1,217.47
0.00
45172
2
90
2
0.00
1,087.46
0.00
45172
3
90
2
0.00
1,087.46
0.00
45172
4
90
2
0.00
1,087.46
0.00
45190
1
90
2
0.00
1,248.70
0.00
45190
2
90
2
0.00
1,230.42
0.00
45190
3
90
2
0.00
1,149.43
0.00
45190
4
90
2
0.00
1,136.54
0.00
45300
1
0
2
0.00
117.90
93.90
45300
2
0
2
0.00
116.25
92.57
45300
3
0
2
0.00
108.96
86.84
45300
4
0
2
0.00
115.57
91.97
45303
1
0
3
0.00
121.88
90.63
45303
2
0
3
0.00
119.66
88.82
45303
3
0
3
0.00
116.90
85.33
45303
4
0
3
0.00
109.22
80.56
45305
1
0
3
0.00
211.27
0.00
45305
2
0
3
0.00
210.18
0.00
45305
3
0
3
0.00
204.30
0.00
45305
4
0
3
0.00
212.85
0.00
45307
1
0
3
0.00
345.63
0.00
45307
2
0
3
0.00
361.60
0.00
45307
3
0
3
0.00
368.73
0.00
45307
4
0
3
0.00
366.00
0.00
45308
1
0
3
0.00
342.22
0.00
45308
2
0
3
0.00
323.34
0.00
45308
3
0
3
0.00
320.49
0.00
45308
4
0
3
0.00
277.57
0.00
45309
1
0
3
0.00
342.22
0.00
45309
2
0
3
0.00
323.34
0.00
45309
3
0
3
0.00
320.49
0.00
45309
4
0
3
0.00
277.57
0.00
45315
1
0
3
0.00
357.06
0.00
45315
2
0
3
0.00
334.85
0.00
45315
3
0
3
0.00
321.06
0.00
45315
4
0
3
0.00
276.15
0.00
45317
1
0
3
0.00
417.92
0.00
45317
2
0
3
0.00
410.16
0.00
45317
3
0
3
0.00
408.01
0.00
45317
4
0
3
0.00
406.39
0.00
45320
1
0
3
0.00
574.01
0.00
45320
2
0
3
0.00
545.02
0.00
45320
3
0
3
0.00
559.32
0.00
45320
4
0
3
0.00
557.27
0.00
45321
1
0
3
0.00
460.58
0.00
45321
2
0
3
0.00
458.33
0.00
45321
3
0
3
0.00
449.23
0.00
45321
4
0
3
0.00
447.74
0.00
45327
1
0
3
0.00
179.99
0.00
45327
2
0
3
0.00
161.98
0.00
45327
3
0
3
0.00
161.98
0.00
45327
4
0
3
0.00
161.98
0.00
45330
1
0
2
0.00
191.75
142.09
45330
2
0
2
0.00
189.00
139.94
45330
3
0
2
0.00
217.69
159.60
45330
4
0
2
0.00
175.12
129.59
45331
1
0
3
0.00
349.54
0.00
45331
2
0
3
0.00
348.34
0.00
45331
3
0
3
0.00
341.38
0.00
45331
4
0
3
0.00
330.82
0.00
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