Begin Main Content Area

2018 Workers' Compensation Part B Fee Schedule

63287-64766

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
63287   1 90 2 0 5,675.42 0
63287   2 90 2 0 4,820.44 0
63287   3 90 2 0 5,227.25 0
63287   4 90 2 0 5,167.09 0
63290   1 90 2 0 5,864.01 0
63290   2 90 2 0 5,773.61 0
63290   3 90 2 0 5,400.47 0
63290   4 90 2 0 5,337.88 0
63295   1 ZZZ 0 0 559.87 0
63295   2 ZZZ 0 0 492.93 0
63295   3 ZZZ 0 0 492.93 0
63295   4 ZZZ 0 0 492.93 0
63300   1 90 2 0 5,114.33 0
63300   2 90 2 0 5,093.85 0
63300   3 90 2 0 5,009.19 0
63300   4 90 2 0 3,357.21 0
63301   1 90 2 0 4,146.80 0
63301   2 90 2 0 4,080.81 0
63301   3 90 2 0 3,808.69 0
63301   4 90 2 0 3,765.27 0
63302   1 90 2 0 4,363.30 0
63302   2 90 2 0 5,359.41 0
63302   3 90 2 0 5,248.11 0
63302   4 90 2 0 3,986.11 0
63303   1 90 2 0 6,028.03 0
63303   2 90 2 0 4,347.59 0
63303   3 90 2 0 4,075.63 0
63303   4 90 2 0 4,029.57 0
63304   1 90 2 0 4,503.00 0
63304   2 90 2 0 4,442.48 0
63304   3 90 2 0 4,192.28 0
63304   4 90 2 0 4,142.67 0
63305   1 90 2 0 4,877.26 0
63305   2 90 2 0 6,179.64 0
63305   3 90 2 0 4,497.16 0
63305   4 90 2 0 4,445.05 0
63306   1 90 2 0 4,807.07 0
63306   2 90 2 0 4,742.60 0
63306   3 90 2 0 4,475.81 0
63306   4 90 2 0 4,422.90 0
63307   1 90 2 0 4,940.58 0
63307   2 90 2 0 4,871.56 0
63307   3 90 2 0 4,585.75 0
63307   4 90 2 0 4,531.04 0
63308   1 ZZZ 0 0 882.13 0
63308   2 ZZZ 0 0 868.25 0
63308   3 ZZZ 0 0 811.06 0
63308   4 ZZZ 0 0 801.69 0
63600   1 90 2 0 2,202.19 0
63600   2 90 2 0 2,282.44 0
63600   3 90 2 0 2,142.81 0
63600   4 90 2 0 1,975.04 0
63610     0 2 0 * 0
63615     90 2 0 * 0
63620   1 90 0 0 1,136.10 0
63620   2 90 0 0 997.95 0
63620   3 90 0 0 997.95 0
63620   4 90 0 0 997.95 0
63621   1 ZZZ 0 0 354.42 0
63621   2 ZZZ 0 0 315.73 0
63621   3 ZZZ 0 0 315.73 0
63621   4 ZZZ 0 0 315.73 0
63650   1 90 2 0 1,660.21 0
63650   2 90 2 0 1,646.36 0
63650   3 90 2 0 1,383.59 0
63650   4 90 2 0 1,366.90 0
63655   1 90 2 0 2,741.27 0
63655   2 90 2 0 2,683.43 0
63655   3 90 2 0 2,444.07 0
63655   4 90 2 0 2,413.45 0
63661   1 10 2 0 783.51 428.88
63661   2 10 2 0 694.74 395.74
63661   3 10 2 0 694.74 395.74
63661   4 10 2 0 694.74 395.74
63662   1 90 2 0 1,015.84 0
63662   2 90 2 0 915.45 0
63662   3 90 2 0 915.45 0
63662   4 90 2 0 915.45 0
63663   1 10 2 0 1,178.96 682.26
63663   2 10 2 0 1,035.56 616.74
63663   3 10 2 0 1,035.56 616.74
63663   4 10 2 0 1,035.56 616.74
63664   1 90 2 0 1,058.13 0
63664   2 90 2 0 953.78 0
63664   3 90 2 0 953.78 0
63664   4 90 2 0 953.78 0
63685   1 90 2 0 1,347.51 0
63685   2 90 2 0 1,322.71 0
63685   3 90 2 0 1,263.88 0
63685   4 90 2 0 1,205.48 0
63688   1 90 2 0 948.40 0
63688   2 90 2 0 936.21 0
63688   3 90 2 0 989.08 0
63688   4 90 2 0 977.09 0
63700   1 90 2 0 2,750.25 0
63700   2 90 2 0 2,668.01 0
63700   3 90 2 0 2,498.37 0
63700   4 90 2 0 2,465.22 0
63702   1 90 2 0 3,093.97 0
63702   2 90 2 0 3,001.47 0
63702   3 90 2 0 2,810.76 0
63702   4 90 2 0 2,773.50 0
63704   1 90 2 0 3,437.02 0
63704   2 90 2 0 3,334.21 0
63704   3 90 2 0 3,122.28 0
63704   4 90 2 0 3,080.93 0
63706   1 90 2 0 3,953.14 0
63706   2 90 2 0 3,834.96 0
63706   3 90 2 0 3,591.32 0
63706   4 90 2 0 3,543.74 0
63707   1 90 2 0 3,446.83 0
63707   2 90 2 0 3,186.95 0
63707   3 90 2 0 3,416.21 0
63707   4 90 2 0 3,455.66 0
63709   1 90 2 0 3,483.35 0
63709   2 90 2 0 3,579.12 0
63709   3 90 2 0 2,699.47 0
63709   4 90 2 0 3,431.68 0
63710   1 90 2 0 2,130.19 0
63710   2 90 2 0 2,098.26 0
63710   3 90 2 0 1,966.74 0
63710   4 90 2 0 1,943.98 0
63740   1 90 2 0 2,690.61 0
63740   2 90 2 0 2,669.82 0
63740   3 90 2 0 2,583.91 0
63740   4 90 2 0 2,237.46 0
63741   1 90 2 0 1,870.36 0
63741   2 90 2 0 1,832.16 0
63741   3 90 2 0 1,674.41 0
63741   4 90 2 0 1,653.94 0
63744   1 90 2 0 2,426.11 0
63744   2 90 2 0 2,313.04 0
63744   3 90 2 0 2,320.84 0
63744   4 90 2 0 1,325.90 0
63746   1 90 2 0 1,080.03 0
63746   2 90 2 0 2,090.80 0
63746   3 90 2 0 983.40 0
63746   4 90 2 0 971.81 0
64400   1 0 2 0 127.96 110.65
64400   2 0 2 0 111.96 96.90
64400   3 0 2 0 116.96 101.77
64400   4 0 2 0 119.33 103.94
64402   1 0 2 0 153.79 0
64402   2 0 2 0 139.12 0
64402   3 0 2 0 141.96 0
64402   4 0 2 0 157.26 0
64405   1 0 2 0 156.21 132.74
64405   2 0 2 0 139.98 119.24
64405   3 0 2 0 159.08 135.47
64405   4 0 2 0 154.90 131.93
64408   1 0 2 0 179.13 0
64408   2 0 2 0 176.75 0
64408   3 0 2 0 193.68 0
64408   4 0 2 0 191.39 0
64410   1 0 2 0 178.48 0
64410   2 0 2 0 176.84 0
64410   3 0 2 0 170.15 0
64410   4 0 2 0 172.25 0
64413   1 0 2 0 141.07 119.40
64413   2 0 2 0 149.20 126.61
64413   3 0 2 0 147.53 124.97
64413   4 0 2 0 147.69 125.30
64415   1 0 2 0 133.80 0
64415   2 0 2 0 131.93 0
64415   3 0 2 0 130.69 0
64415   4 0 2 0 129.82 0
64416   1 0 2 0 284.88 0
64416   2 0 2 0 266.42 0
64416   3 0 2 0 266.42 0
64416   4 0 2 0 266.42 0
64417   1 0 2 0 161.95 0
64417   2 0 2 0 165.97 0
64417   3 0 2 0 155.77 0
64417   4 0 2 0 159.54 0
64418   1 0 2 0 156.51 129.59
64418   2 0 2 0 154.75 127.98
64418   3 0 2 0 149.51 123.82
64418   4 0 2 0 148.38 122.55
64420   1 0 2 0 163.37 0
64420   2 0 2 0 150.68 0
64420   3 0 2 0 143.19 0
64420   4 0 2 0 156.92 0
64421   1 0 2 0 219.30 0
64421   2 0 2 0 216.20 0
64421   3 0 2 0 203.45 0
64421   4 0 2 0 222.85 0
64425   1 0 2 0 182.27 160.84
64425   2 0 2 0 176.44 156.35
64425   3 0 2 0 184.46 163.31
64425   4 0 2 0 143.21 126.88
64430   1 0 2 0 215.90 0
64430   2 0 2 0 210.84 0
64430   3 0 2 0 185.27 0
64430   4 0 2 0 183.24 0
64435   1 0 2 0 167.55 0
64435   2 0 2 0 154.20 0
64435   3 0 2 0 149.24 0
64435   4 0 2 0 162.34 0
64445   1 0 2 0 150.68 134.27
64445   2 0 2 0 138.14 123.44
64445   3 0 2 0 144.96 129.35
64445   4 0 2 0 146.87 131.42
64446   1 0 2 0 296.30 0
64446   2 0 2 0 274.27 0
64446   3 0 2 0 274.27 0
64446   4 0 2 0 274.27 0
64447   1 10 2 0 139.86 0
64447   2 10 2 0 128.03 0
64447   3 10 2 0 128.03 0
64447   4 10 2 0 128.03 0
64448   1 0 2 0 272.57 0
64448   2 0 2 0 252.16 0
64448   3 0 2 0 252.16 0
64448   4 0 2 0 252.16 0
64449   1 10 2 0 267.58 0
64449   2 10 2 0 249.54 0
64449   3 10 2 0 249.54 0
64449   4 10 2 0 249.54 0
64450   1 0 2 0 142.82 124.15
64450   2 0 2 0 148.57 129.73
64450   3 0 2 0 140.07 122.11
64450   4 0 2 0 132.24 115.26
64455   1 0 2 0 73.82 58.46
64455   2 0 2 0 66.36 53.43
64455   3 0 2 0 66.36 53.43
64455   4 0 2 0 66.36 53.43
64461   1 0 2 0 190.73 111.01
64461   2 0 2 0 171.81 103.69
64461   3 0 2 0 171.81 103.69
64461   4 0 2 0 171.81 103.69
64462   1 ZZZ 0 0 107.78 70.01
64462   2 ZZZ 0 0 97.65 65.37
64462   3 ZZZ 0 0 97.65 65.37
64462   4 ZZZ 0 0 97.65 65.37
64463   1 0 2 0 207.44 107.02
64463   2 0 2 0 186.51 100.67
64463   3 0 2 0 186.51 100.67
64463   4 0 2 0 186.51 100.67
64479   1 0 2 0 448.38 210.41
64479   2 0 2 0 396.55 193.11
64479   3 0 2 0 396.55 193.11
64479   4 0 2 0 396.55 193.11
64480   1 ZZZ 0 0 405.67 145.78
64480   2 ZZZ 0 0 355.96 133.78
64480   3 ZZZ 0 0 355.96 133.78
64480   4 ZZZ 0 0 355.96 133.78
64483   1 0 2 0 413.82 178.82
64483   2 0 2 0 366.05 165.10
64483   3 0 2 0 366.05 165.10
64483   4 0 2 0 366.05 165.10
64484   1 ZZZ 0 0 383.92 126.27
64484   2 ZZZ 0 0 335.97 115.70
64484   3 ZZZ 0 0 335.97 115.70
64484   4 ZZZ 0 0 335.97 115.70
64486   1 0 2 0 162.63 83.46
64486   2 0 2 0 145.59 77.94
64486   3 0 2 0 145.59 77.94
64486   4 0 2 0 145.59 77.94
64487   1 0 2 0 199.07 95.74
64487   2 0 2 0 177.87 89.55
64487   3 0 2 0 177.87 89.55
64487   4 0 2 0 177.87 89.55
64488   1 0 2 0 199.59 103.37
64488   2 0 2 0 179.03 96.78
64488   3 0 2 0 179.03 96.78
64488   4 0 2 0 179.03 96.78
64489   1 0 2 0 278.73 115.21
64489   2 0 2 0 247.72 107.95
64489   3 0 2 0 247.72 107.95
64489   4 0 2 0 247.72 107.95
64490   1 0 2 0 269.59 157.90
64490   2 0 2 0 237.62 143.43
64490   3 0 2 0 237.62 143.43
64490   4 0 2 0 237.62 143.43
64491   1 ZZZ 0 0 135.39 90.39
64491   2 ZZZ 0 0 120.73 82.79
64491   3 ZZZ 0 0 120.73 82.79
64491   4 ZZZ 0 0 120.73 82.79
64492   1 ZZZ 0 0 137.02 92.02
64492   2 ZZZ 0 0 122.11 84.16
64492   3 ZZZ 0 0 122.11 84.16
64492   4 ZZZ 0 0 122.11 84.16
64493   1 0 2 0 241.30 133.92
64493   2 0 2 0 212.16 121.62
64493   3 0 2 0 212.16 121.62
64493   4 0 2 0 212.16 121.62
64494   1 ZZZ 0 0 123.05 76.95
64494   2 ZZZ 0 0 109.52 70.66
64494   3 ZZZ 0 0 109.52 70.66
64494   4 ZZZ 0 0 109.52 70.66
64495   1 ZZZ 0 0 124.67 78.59
64495   2 ZZZ 0 0 110.88 72.03
64495   3 ZZZ 0 0 110.88 72.03
64495   4 ZZZ 0 0 110.88 72.03
64505   1 0 2 0 157.53 135.67
64505   2 0 2 0 141.66 121.79
64505   3 0 2 0 146.87 127.14
64505   4 0 2 0 154.71 133.78
64508   1 0 2 0 180.34 0
64508   2 0 2 0 178.04 0
64508   3 0 2 0 168.60 0
64508   4 0 2 0 166.52 0
64510   1 0 2 0 216.67 0
64510   2 0 2 0 209.21 0
64510   3 0 2 0 205.34 0
64510   4 0 2 0 207.42 0
64517   1 0 2 0 337.38 212.06
64517   2 0 2 0 301.60 195.05
64517   3 0 2 0 301.60 195.05
64517   4 0 2 0 301.60 195.05
64520   1 0 2 0 188.06 0
64520   2 0 2 0 181.96 0
64520   3 0 2 0 212.04 0
64520   4 0 2 0 211.96 0
64530   1 0 2 0 241.39 0
64530   2 0 2 0 263.65 0
64530   3 0 2 0 229.05 0
64530   4 0 2 0 226.46 0
64550     0 0 0 * 0
64553     10 2 0 * 0
64555   1 10 2 0 612.52 0
64555   2 10 2 0 585.54 0
64555   3 10 2 0 633.50 0
64555   4 10 2 0 206.38 0
64561   1 10 2 0 1,504.02 711.78
64561   2 10 2 0 1,327.24 653.20
64561   3 10 2 0 1,327.24 653.20
64561   4 10 2 0 1,327.24 653.20
64566   1 0 2 0 188.20 43.06
64566   2 0 2 0 168.41 40.15
64566   3 0 2 0 168.41 40.15
64566   4 0 2 0 168.41 40.15
64568   1 90 2 0 941.10 0
64568   2 90 2 0 855.30 0
64568   3 90 2 0 855.30 0
64568   4 90 2 0 855.30 0
64569   1 90 2 0 969.70 0
64569   2 90 2 0 861.15 0
64569   3 90 2 0 861.15 0
64569   4 90 2 0 861.15 0
64570   1 90 2 0 867.57 0
64570   2 90 2 0 760.23 0
64570   3 90 2 0 760.23 0
64570   4 90 2 0 760.23 0
64575   1 90 2 0 672.11 0
64575   2 90 2 0 662.93 0
64575   3 90 2 0 625.05 0
64575   4 90 2 0 617.76 0
64580     90 2 0 * 0
64581   1 90 2 0 1,373.21 0
64581   2 90 2 0 1,259.74 0
64581   3 90 2 0 1,259.74 0
64581   4 90 2 0 1,259.74 0
64585   1 10 2 0 263.38 0
64585   2 10 2 0 260.48 0
64585   3 10 2 0 248.57 0
64585   4 10 2 0 245.76 0
64590   1 10 2 0 399.57 0
64590   2 10 2 0 393.21 0
64590   3 10 2 0 366.77 0
64590   4 10 2 0 362.52 0
64595   1 10 2 0 263.74 0
64595   2 10 2 0 259.69 0
64595   3 10 2 0 243.23 0
64595   4 10 2 0 240.46 0
64600   1 10 2 0 604.80 0
64600   2 10 2 0 502.38 0
64600   3 10 2 0 582.31 0
64600   4 10 2 0 592.66 0
64605   1 10 2 0 916.42 0
64605   2 10 2 0 596.34 0
64605   3 10 2 0 567.48 0
64605   4 10 2 0 561.66 0
64610   1 10 2 0 1,697.30 0
64610   2 10 2 0 1,661.87 0
64610   3 10 2 0 1,648.82 0
64610   4 10 2 0 1,642.95 0
64611   1 10 2 0 150.49 136.56
64611   2 10 2 0 133.48 121.18
64611   3 10 2 0 133.48 121.18
64611   4 10 2 0 133.48 121.18
64612   1 10 2 0 306.24 0
64612   2 10 2 0 302.17 0
64612   3 10 2 0 285.17 0
64612   4 10 2 0 281.79 0
64615   1 10 2 0 203.35 184.27
64615   2 10 2 0 178.17 161.70
64615   3 10 2 0 178.17 161.70
64615   4 10 2 0 178.17 161.70
64616   1 10 2 0 169.53 149.95
64616   2 10 2 0 150.59 133.78
64616   3 10 2 0 150.59 133.78
64616   4 10 2 0 150.59 133.78
64617   1 10 2 0 257.03 154.83
64617   2 10 2 0 229.38 141.69
64617   3 10 2 0 229.38 141.69
64617   4 10 2 0 229.38 141.69
64620   1 10 2 0 280.64 0
64620   2 10 2 0 255.56 0
64620   3 10 2 0 259.74 0
64620   4 10 2 0 299.28 0
64630   1 10 2 0 416.74 0
64630   2 10 2 0 410.30 0
64630   3 10 2 0 383.82 0
64630   4 10 2 0 379.63 0
64632   1 10 2 0 117.01 99.44
64632   2 10 2 0 106.54 91.74
64632   3 10 2 0 106.54 91.74
64632   4 10 2 0 106.54 91.74
64633   1 10 2 0 625.24 325.86
64633   2 10 2 0 556.41 298.31
64633   3 10 2 0 556.41 298.31
64633   4 10 2 0 556.41 298.31
64634   1 ZZZ 0 0 286.35 97.42
64634   2 ZZZ 0 0 252.88 89.99
64634   3 ZZZ 0 0 252.88 89.99
64634   4 ZZZ 0 0 252.88 89.99
64635   1 10 2 0 614.30 319.15
64635   2 10 2 0 546.78 292.30
64635   3 10 2 0 546.78 292.30
64635   4 10 2 0 546.78 292.30
64636   1 ZZZ 0 0 257.50 84.54
64636   2 ZZZ 0 0 227.38 78.26
64636   3 ZZZ 0 0 227.38 78.26
64636   4 ZZZ 0 0 227.38 78.26
64640   1 10 2 0 234.40 207.11
64640   2 10 2 0 230.93 203.66
64640   3 10 2 0 223.99 198.85
64640   4 10 2 0 223.83 198.36
64642   1 0 2 0 189.71 147.21
64642   2 0 2 0 169.55 133.09
64642   3 0 2 0 169.55 133.09
64642   4 0 2 0 169.55 133.09
64643   1 ZZZ 0 0 124.82 98.54
64643   2 ZZZ 0 0 112.18 89.62
64643   3 ZZZ 0 0 112.18 89.62
64643   4 ZZZ 0 0 112.18 89.62
64644   1 0 2 0 216.36 160.48
64644   2 0 2 0 193.24 145.27
64644   3 0 2 0 193.24 145.27
64644   4 0 2 0 193.24 145.27
64645   1 ZZZ 0 0 152.75 113.12
64645   2 ZZZ 0 0 136.78 102.75
64645   3 ZZZ 0 0 136.78 102.75
64645   4 ZZZ 0 0 136.78 102.75
64646   1 0 2 0 204.00 159.10
64646   2 0 2 0 182.51 143.96
64646   3 0 2 0 182.51 143.96
64646   4 0 2 0 182.51 143.96
64647   1 0 2 0 236.06 183.54
64647   2 0 2 0 211.36 166.26
64647   3 0 2 0 211.36 166.26
64647   4 0 2 0 211.36 166.26
64650   1 0 2 0 98.69 63.30
64650   2 0 2 0 86.23 57.31
64650   3 0 2 0 86.23 57.31
64650   4 0 2 0 86.23 57.31
64653   1 0 2 0 113.65 80.12
64653   2 0 2 0 99.79 72.41
64653   3 0 2 0 99.79 72.41
64653   4 0 2 0 99.79 72.41
64680   1 10 2 0 488.04 0
64680   2 10 2 0 498.66 0
64680   3 10 2 0 493.47 0
64680   4 10 2 0 339.59 0
64681   1 10 2 0 839.17 386.62
64681   2 10 2 0 738.16 353.17
64681   3 10 2 0 738.16 353.17
64681   4 10 2 0 738.16 353.17
64702   1 90 2 0 892.51 0
64702   2 90 2 0 838.84 0
64702   3 90 2 0 807.53 0
64702   4 90 2 0 813.95 0
64704   1 90 2 0 1,022.74 0
64704   2 90 2 0 948.44 0
64704   3 90 2 0 849.77 0
64704   4 90 2 0 902.76 0
64708   1 90 2 0 1,263.76 0
64708   2 90 2 0 1,241.22 0
64708   3 90 2 0 1,148.06 0
64708   4 90 2 0 1,134.00 0
64712   1 90 2 0 1,602.47 0
64712   2 90 2 0 1,578.77 0
64712   3 90 2 0 1,452.21 0
64712   4 90 2 0 1,434.54 0
64713   1 90 2 0 1,892.06 0
64713   2 90 2 0 1,860.65 0
64713   3 90 2 0 1,806.07 0
64713   4 90 2 0 1,710.57 0
64714   1 90 2 0 2,015.33 0
64714   2 90 2 0 1,512.12 0
64714   3 90 2 0 1,410.19 0
64714   4 90 2 0 1,394.56 0
64716   1 90 2 0 985.75 0
64716   2 90 2 0 971.28 0
64716   3 90 2 0 911.67 0
64716   4 90 2 0 900.88 0
64718   1 90 2 0 1,177.64 0
64718   2 90 2 0 1,157.10 0
64718   3 90 2 0 1,091.53 0
64718   4 90 2 0 1,087.86 0
64719   1 90 2 0 958.00 0
64719   2 90 2 0 939.79 0
64719   3 90 2 0 875.83 0
64719   4 90 2 0 874.10 0
64721   1 90 2 0 891.23 0
64721   2 90 2 0 882.64 0
64721   3 90 2 0 817.39 0
64721   4 90 2 0 814.66 0
64722   1 90 2 0 1,355.51 0
64722   2 90 2 0 1,357.08 0
64722   3 90 2 0 1,228.24 0
64722   4 90 2 0 1,158.50 0
64726   1 90 2 0 405.54 0
64726   2 90 2 0 402.17 0
64726   3 90 2 0 388.19 0
64726   4 90 2 0 384.27 0
64727   1 ZZZ 0 0 1,113.19 0
64727   2 ZZZ 0 0 1,108.87 0
64727   3 ZZZ 0 0 1,091.17 0
64727   4 ZZZ 0 0 1,088.36 0
64732   1 90 2 0 824.57 0
64732   2 90 2 0 796.21 0
64732   3 90 2 0 783.29 0
64732   4 90 2 0 731.52 0
64734   1 90 2 0 867.74 0
64734   2 90 2 0 1,055.53 0
64734   3 90 2 0 1,031.94 0
64734   4 90 2 0 788.25 0
64736   1 90 2 0 803.48 0
64736   2 90 2 0 792.55 0
64736   3 90 2 0 747.20 0
64736   4 90 2 0 737.91 0
64738   1 90 2 0 1,284.10 0
64738   2 90 2 0 1,039.08 0
64738   3 90 2 0 895.44 0
64738   4 90 2 0 884.57 0
64740   1 90 2 0 965.93 0
64740   2 90 2 0 951.81 0
64740   3 90 2 0 893.46 0
64740   4 90 2 0 882.62 0
64742   1 90 2 0 980.09 0
64742   2 90 2 0 967.58 0
64742   3 90 2 0 915.92 0
64742   4 90 2 0 904.79 0
64744   1 90 2 0 1,070.08 0
64744   2 90 2 0 1,060.55 0
64744   3 90 2 0 970.90 0
64744   4 90 2 0 959.16 0
64746   1 90 2 0 893.93 0
64746   2 90 2 0 879.86 0
64746   3 90 2 0 816.40 0
64746   4 90 2 0 812.53 0
64755   1 90 2 0 2,501.56 0
64755   2 90 2 0 2,250.11 0
64755   3 90 2 0 2,088.79 0
64755   4 90 2 0 2,064.92 0
64760   1 90 2 0 1,309.98 0
64760   2 90 2 0 1,285.49 0
64760   3 90 2 0 1,626.28 0
64760   4 90 2 0 1,170.62 0
64763   1 90 2 0 1,093.02 0
64763   2 90 2 0 1,075.91 0
64763   3 90 2 0 1,005.19 0
64763   4 90 2 0 993.73 0
64766   1 90 2 0 1,421.73 0
64766   2 90 2 0 1,399.14 0
64766   3 90 2 0 1,306.07 0
64766   4 90 2 0 1,290.91 0