Begin Main Content Area

2018 Workers' Compensation Part B Fee Schedule

93313-93619

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
93313   1 XXX 0 0 135.60 0
93313   2 XXX 0 0 133.97 0
93313   3 XXX 0 0 127.14 0
93313   4 XXX 0 0 125.64 0
93314   1 XXX 0 0 460.25 0
93314 26 1 XXX 0 0 135.60 0
93314 TC 1 XXX 0 0 324.55 0
93314   2 XXX 0 0 452.06 0
93314 26 2 XXX 0 0 133.97 0
93314 TC 2 XXX 0 0 318.11 0
93314   3 XXX 0 0 417.93 0
93314 26 3 XXX 0 0 127.14 0
93314 TC 3 XXX 0 0 290.80 0
93314   4 XXX 0 0 411.91 0
93314 26 4 XXX 0 0 125.64 0
93314 TC 4 XXX 0 0 286.31 0
93315   1 XXX 0 0 612.79 0
93315 26 1 XXX 0 0 302.19 0
93315 TC 1 XXX 0 0 310.59 0
93315   2 XXX 0 0 543.25 0
93315 26 2 XXX 0 0 282.22 0
93315 TC 2 XXX 0 0 260.98 0
93315   3 XXX 0 0 528.69 0
93315 26 3 XXX 0 0 274.69 0
93315 TC 3 XXX 0 0 254.00 0
93315   4 XXX 0 0 528.69 0
93315 26 4 XXX 0 0 274.69 0
93315 TC 4 XXX 0 0 254.00 0
93316   1 XXX 0 0 121.25 0
93316   2 XXX 0 0 111.57 0
93316   3 XXX 0 0 108.54 0
93316   4 XXX 0 0 108.54 0
93317   1 XXX 0 0 490.74 0
93317 26 1 XXX 0 0 180.17 0
93317 TC 1 XXX 0 0 310.59 0
93317   2 XXX 0 0 430.98 0
93317 26 2 XXX 0 0 170.01 0
93317 TC 2 XXX 0 0 260.98 0
93317   3 XXX 0 0 419.47 0
93317 26 3 XXX 0 0 165.43 0
93317 TC 3 XXX 0 0 254.00 0
93317   4 XXX 0 0 419.47 0
93317 26 4 XXX 0 0 165.43 0
93317 TC 4 XXX 0 0 254.00 0
93318     XXX 0 0 * 0
93320   1 ZZZ 0 0 213.58 0
93320 26 1 ZZZ 0 0 66.52 0
93320 TC 1 ZZZ 0 0 147.07 0
93320   2 ZZZ 0 0 179.64 0
93320 26 2 ZZZ 0 0 58.27 0
93320 TC 2 ZZZ 0 0 121.38 0
93320   3 ZZZ 0 0 179.64 0
93320 26 3 ZZZ 0 0 58.27 0
93320 TC 3 ZZZ 0 0 121.38 0
93320   4 ZZZ 0 0 179.64 0
93320 26 4 ZZZ 0 0 58.27 0
93320 TC 4 ZZZ 0 0 121.38 0
93321   1 ZZZ 0 0 168.66 0
93321 26 1 ZZZ 0 0 64.44 0
93321 TC 1 ZZZ 0 0 94.57 0
93321   2 ZZZ 0 0 163.57 0
93321 26 2 ZZZ 0 0 65.15 0
93321 TC 2 ZZZ 0 0 92.76 0
93321   3 ZZZ 0 0 149.58 0
93321 26 3 ZZZ 0 0 70.28 0
93321 TC 3 ZZZ 0 0 84.91 0
93321   4 ZZZ 0 0 114.37 0
93321 26 4 ZZZ 0 0 86.12 0
93321 TC 4 ZZZ 0 0 83.63 0
93325   1 ZZZ 0 0 260.12 0
93325 26 1 ZZZ 0 0 9.22 0
93325 TC 1 ZZZ 0 0 250.84 0
93325   2 ZZZ 0 0 214.70 0
93325 26 2 ZZZ 0 0 8.15 0
93325 TC 2 ZZZ 0 0 206.56 0
93325   3 ZZZ 0 0 214.70 0
93325 26 3 ZZZ 0 0 8.15 0
93325 TC 3 ZZZ 0 0 206.56 0
93325   4 ZZZ 0 0 214.70 0
93325 26 4 ZZZ 0 0 8.15 0
93325 TC 4 ZZZ 0 0 206.56 0
93350   1 XXX 0 0 851.31 0
93350 26 1 XXX 0 0 444.52 0
93350 TC 1 XXX 0 0 291.17 0
93350   2 XXX 0 0 847.03 0
93350 26 2 XXX 0 0 442.59 0
93350 TC 2 XXX 0 0 563.11 0
93350   3 XXX 0 0 829.22 0
93350 26 3 XXX 0 0 434.63 0
93350 TC 3 XXX 0 0 262.05 0
93350   4 XXX 0 0 825.84 0
93350 26 4 XXX 0 0 432.96 0
93350 TC 4 XXX 0 0 258.00 0
93351   1 XXX 0 0 422.30 0
93351   2 XXX 0 0 363.96 0
93351   3 XXX 0 0 363.96 0
93351   4 XXX 0 0 363.96 0
93352   1 XXX 0 0 58.90 0
93352   2 XXX 0 0 50.46 0
93352   3 XXX 0 0 50.46 0
93352   4 XXX 0 0 50.46 0
93355   1 XXX 6 0 291.34 0
93355   2 XXX 6 0 274.16 0
93355   3 XXX 6 0 274.16 0
93355   4 XXX 6 0 274.16 0
93451   1 0 2 0 1,123.45 0
93451 26 1 0 2 0 223.09 0
93451 TC 1 0 2 0 900.38 0
93451   2 0 2 0 996.34 0
93451 26 2 0 2 0 201.07 0
93451 TC 2 0 2 0 795.28 0
93451   3 0 2 0 996.34 0
93451 26 3 0 2 0 201.07 0
93451 TC 3 0 2 0 795.28 0
93451   4 0 2 0 996.34 0
93451 26 4 0 2 0 201.07 0
93451 TC 4 0 2 0 795.28 0
93452   1 0 2 0 1,251.84 0
93452 26 1 0 2 0 391.71 0
93452 TC 1 0 2 0 860.12 0
93452   2 0 2 0 1,112.26 0
93452 26 2 0 2 0 352.57 0
93452 TC 2 0 2 0 759.69 0
93452   3 0 2 0 1,112.26 0
93452 26 3 0 2 0 352.57 0
93452 TC 3 0 2 0 759.69 0
93452   4 0 2 0 1,112.26 0
93452 26 4 0 2 0 352.57 0
93452 TC 4 0 2 0 759.69 0
93453   1 0 2 0 1,637.69 0
93453 26 1 0 2 0 512.90 0
93453 TC 1 0 2 0 1,124.78 0
93453   2 0 2 0 1,455.46 0
93453 26 2 0 2 0 462.03 0
93453 TC 2 0 2 0 993.45 0
93453   3 0 2 0 1,455.46 0
93453 26 3 0 2 0 462.03 0
93453 TC 3 0 2 0 993.45 0
93453   4 0 2 0 1,455.46 0
93453 26 4 0 2 0 462.03 0
93453 TC 4 0 2 0 993.45 0
93454   1 0 2 0 1,290.47 0
93454 26 1 0 2 0 394.56 0
93454 TC 1 0 2 0 895.90 0
93454   2 0 2 0 1,146.61 0
93454 26 2 0 2 0 355.30 0
93454 TC 2 0 2 0 791.31 0
93454   3 0 2 0 1,146.61 0
93454 26 3 0 2 0 355.30 0
93454 TC 3 0 2 0 791.31 0
93454   4 0 2 0 1,146.61 0
93454 26 4 0 2 0 355.30 0
93454 TC 4 0 2 0 791.31 0
93455   1 0 2 0 1,505.25 0
93455 26 1 0 2 0 455.02 0
93455 TC 1 0 2 0 1,050.25 0
93455   2 0 2 0 1,337.55 0
93455 26 2 0 2 0 409.99 0
93455 TC 2 0 2 0 927.56 0
93455   3 0 2 0 1,337.55 0
93455 26 3 0 2 0 409.99 0
93455 TC 3 0 2 0 927.56 0
93455   4 0 2 0 1,337.55 0
93455 26 4 0 2 0 409.99 0
93455 TC 4 0 2 0 927.56 0
93456   1 0 2 0 1,614.62 0
93456 26 1 0 2 0 504.24 0
93456 TC 1 0 2 0 1,110.37 0
93456   2 0 2 0 1,435.27 0
93456 26 2 0 2 0 454.57 0
93456 TC 2 0 2 0 980.72 0
93456   3 0 2 0 1,435.27 0
93456 26 3 0 2 0 454.57 0
93456 TC 3 0 2 0 980.72 0
93456   4 0 2 0 1,435.27 0
93456 26 4 0 2 0 454.57 0
93456 TC 4 0 2 0 980.72 0
93457   1 0 2 0 1,829.68 0
93457 26 1 0 2 0 565.71 0
93457 TC 1 0 2 0 1,263.96 0
93457   2 0 2 0 1,626.25 0
93457 26 2 0 2 0 509.81 0
93457 TC 2 0 2 0 1,116.45 0
93457   3 0 2 0 1,626.25 0
93457 26 3 0 2 0 509.81 0
93457 TC 3 0 2 0 1,116.45 0
93457   4 0 2 0 1,626.25 0
93457 26 4 0 2 0 509.81 0
93457 TC 4 0 2 0 1,116.45 0
93458   1 0 2 0 1,557.44 0
93458 26 1 0 2 0 481.36 0
93458 TC 1 0 2 0 1,076.08 0
93458   2 0 2 0 1,383.91 0
93458 26 2 0 2 0 433.52 0
93458 TC 2 0 2 0 950.39 0
93458   3 0 2 0 1,383.91 0
93458 26 3 0 2 0 433.52 0
93458 TC 3 0 2 0 950.39 0
93458   4 0 2 0 1,383.91 0
93458 26 4 0 2 0 433.52 0
93458 TC 4 0 2 0 950.39 0
93459   1 0 2 0 1,719.53 0
93459 26 1 0 2 0 541.06 0
93459 TC 1 0 2 0 1,178.48 0
93459   2 0 2 0 1,528.62 0
93459 26 2 0 2 0 487.72 0
93459 TC 2 0 2 0 1,040.88 0
93459   3 0 2 0 1,528.62 0
93459 26 3 0 2 0 487.72 0
93459 TC 3 0 2 0 1,040.88 0
93459   4 0 2 0 1,528.62 0
93459 26 4 0 2 0 487.72 0
93459 TC 4 0 2 0 1,040.88 0
93460   1 0 2 0 1,840.89 0
93460 26 1 0 2 0 602.75 0
93460 TC 1 0 2 0 1,238.11 0
93460   2 0 2 0 1,636.96 0
93460 26 2 0 2 0 543.35 0
93460 TC 2 0 2 0 1,093.60 0
93460   3 0 2 0 1,636.96 0
93460 26 3 0 2 0 543.35 0
93460 TC 3 0 2 0 1,093.60 0
93460   4 0 2 0 1,636.96 0
93460 26 4 0 2 0 543.35 0
93460 TC 4 0 2 0 1,093.60 0
93461   1 0 2 0 2,109.09 0
93461 26 1 0 2 0 665.42 0
93461 TC 1 0 2 0 1,443.65 0
93461   2 0 2 0 1,874.64 0
93461 26 2 0 2 0 599.58 0
93461 TC 2 0 2 0 1,275.10 0
93461   3 0 2 0 1,874.64 0
93461 26 3 0 2 0 599.58 0
93461 TC 3 0 2 0 1,275.10 0
93461   4 0 2 0 1,874.64 0
93461 26 4 0 2 0 599.58 0
93461 TC 4 0 2 0 1,275.10 0
93462   1 ZZZ 0 0 306.04 0
93462   2 ZZZ 0 0 276.00 0
93462   3 ZZZ 0 0 276.00 0
93462   4 ZZZ 0 0 276.00 0
93463   1 ZZZ 0 0 161.30 0
93463   2 ZZZ 0 0 146.10 0
93463   3 ZZZ 0 0 146.10 0
93463   4 ZZZ 0 0 146.10 0
93464   1 ZZZ 0 0 371.96 0
93464 26 1 ZZZ 0 0 142.06 0
93464 TC 1 ZZZ 0 0 229.87 0
93464   2 ZZZ 0 0 331.76 0
93464 26 2 ZZZ 0 0 128.74 0
93464 TC 2 ZZZ 0 0 203.01 0
93464   3 ZZZ 0 0 331.76 0
93464 26 3 ZZZ 0 0 128.74 0
93464 TC 3 ZZZ 0 0 203.01 0
93464   4 ZZZ 0 0 331.76 0
93464 26 4 ZZZ 0 0 128.74 0
93464 TC 4 ZZZ 0 0 203.01 0
93503   1 0 0 0 516.64 0
93503   2 0 0 0 536.83 0
93503   3 0 0 0 482.19 0
93503   4 0 0 0 492.14 0
93505   1 0 2 0 805.35 0
93505 26 1 0 2 0 681.33 0
93505 TC 1 0 2 0 171.18 0
93505   2 0 2 0 794.25 0
93505 26 2 0 2 0 676.60 0
93505 TC 2 0 2 0 167.64 0
93505   3 0 2 0 748.05 0
93505 26 3 0 2 0 634.28 0
93505 TC 3 0 2 0 153.07 0
93505   4 0 2 0 738.75 0
93505 26 4 0 2 0 661.92 0
93505 TC 4 0 2 0 150.74 0
93530   1 0 2 0 2,076.96 0
93530 26 1 0 2 0 631.85 0
93530 TC 1 0 2 0 1,445.09 0
93530   2 0 2 0 1,757.64 0
93530 26 2 0 2 0 562.47 0
93530 TC 2 0 2 0 1,195.18 0
93530   3 0 2 0 1,757.64 0
93530 26 3 0 2 0 562.47 0
93530 TC 3 0 2 0 1,195.18 0
93530   4 0 2 0 1,757.64 0
93530 26 4 0 2 0 562.47 0
93530 TC 4 0 2 0 1,195.18 0
93531   1 0 2 0 5,212.06 0
93531 26 1 0 2 0 1,081.98 0
93531 TC 1 0 2 0 4,130.05 0
93531   2 0 2 0 4,393.31 0
93531 26 2 0 2 0 977.86 0
93531 TC 2 0 2 0 3,415.47 0
93531   3 0 2 0 4,393.31 0
93531 26 3 0 2 0 977.86 0
93531 TC 3 0 2 0 3,415.47 0
93531   4 0 2 0 4,393.31 0
93531 26 4 0 2 0 977.86 0
93531 TC 4 0 2 0 3,415.47 0
93532   1 0 2 0 5,369.46 0
93532 26 1 0 2 0 1,349.59 0
93532 TC 1 0 2 0 4,019.87 0
93532   2 0 2 0 4,540.17 0
93532 26 2 0 2 0 1,215.87 0
93532 TC 2 0 2 0 3,324.33 0
93532   3 0 2 0 4,540.17 0
93532 26 3 0 2 0 1,215.87 0
93532 TC 3 0 2 0 3,324.33 0
93532   4 0 2 0 4,540.17 0
93532 26 4 0 2 0 1,215.87 0
93532 TC 4 0 2 0 3,324.33 0
93533   1 0 2 0 4,760.03 0
93533 26 1 0 2 0 740.14 0
93533 TC 1 0 2 0 4,019.89 0
93533   2 0 2 0 4,002.63 0
93533 26 2 0 2 0 678.32 0
93533 TC 2 0 2 0 3,324.33 0
93533   3 0 2 0 4,002.63 0
93533 26 3 0 2 0 678.32 0
93533 TC 3 0 2 0 3,324.33 0
93533   4 0 2 0 4,002.63 0
93533 26 4 0 2 0 678.32 0
93533 TC 4 0 2 0 3,324.33 0
93561   1 0 0 0 209.46 0
93561 26 1 0 0 0 161.14 0
93561 TC 1 0 0 0 48.33 0
93561   2 0 0 0 184.18 0
93561 26 2 0 0 0 159.06 0
93561 TC 2 0 0 0 47.22 0
93561   3 0 0 0 167.69 0
93561 26 3 0 0 0 142.43 0
93561 TC 3 0 0 0 56.70 0
93561   4 0 0 0 190.66 0
93561 26 4 0 0 0 148.72 0
93561 TC 4 0 0 0 41.94 0
93562   1 0 0 0 101.25 0
93562 26 1 0 0 0 109.23 0
93562 TC 1 0 0 0 28.28 0
93562   2 0 0 0 106.00 0
93562 26 2 0 0 0 91.75 0
93562 TC 2 0 0 0 27.65 0
93562   3 0 0 0 94.42 0
93562 26 3 0 0 0 108.09 0
93562 TC 3 0 0 0 24.92 0
93562   4 0 0 0 90.70 0
93562 26 4 0 0 0 121.92 0
93562 TC 4 0 0 0 24.58 0
93563   1 ZZZ 0 0 80.96 0
93563   2 ZZZ 0 0 75.28 0
93563   3 ZZZ 0 0 75.28 0
93563   4 ZZZ 0 0 75.28 0
93564   1 ZZZ 0 0 82.62 0
93564   2 ZZZ 0 0 76.69 0
93564   3 ZZZ 0 0 76.69 0
93564   4 ZZZ 0 0 76.69 0
93565   1 ZZZ 0 0 62.36 0
93565   2 ZZZ 0 0 57.96 0
93565   3 ZZZ 0 0 57.96 0
93565   4 ZZZ 0 0 57.96 0
93566   1 ZZZ 0 0 246.76 62.36
93566   2 ZZZ 0 0 220.92 57.96
93566   3 ZZZ 0 0 220.92 57.96
93566   4 ZZZ 0 0 220.92 57.96
93567   1 ZZZ 0 0 203.18 69.97
93567   2 ZZZ 0 0 182.93 65.20
93567   3 ZZZ 0 0 182.93 65.20
93567   4 ZZZ 0 0 182.93 65.20
93568   1 ZZZ 0 0 222.85 63.80
93568   2 ZZZ 0 0 199.90 59.33
93568   3 ZZZ 0 0 199.90 59.33
93568   4 ZZZ 0 0 199.90 59.33
93571   1 ZZZ 0 0 552.49 0
93571 26 1 ZZZ 0 0 181.80 0
93571 TC 1 ZZZ 0 0 370.72 0
93571   2 ZZZ 0 0 478.75 0
93571 26 2 ZZZ 0 0 167.79 0
93571 TC 2 ZZZ 0 0 311.00 0
93571   3 ZZZ 0 0 478.75 0
93571 26 3 ZZZ 0 0 167.79 0
93571 TC 3 ZZZ 0 0 311.00 0
93571   4 ZZZ 0 0 478.75 0
93571 26 4 ZZZ 0 0 167.79 0
93571 TC 4 ZZZ 0 0 311.00 0
93572   1 ZZZ 0 0 507.65 0
93572 26 1 ZZZ 0 0 146.06 0
93572 TC 1 ZZZ 0 0 361.63 0
93572   2 ZZZ 0 0 440.86 0
93572 26 2 ZZZ 0 0 134.70 0
93572 TC 2 ZZZ 0 0 306.20 0
93572   3 ZZZ 0 0 440.86 0
93572 26 3 ZZZ 0 0 134.70 0
93572 TC 3 ZZZ 0 0 306.20 0
93572   4 ZZZ 0 0 440.86 0
93572 26 4 ZZZ 0 0 134.70 0
93572 TC 4 ZZZ 0 0 306.20 0
93580   1 ZZZ 0 0 1,770.12 0
93580   2 ZZZ 0 0 1,609.97 0
93580   3 ZZZ 0 0 1,609.97 0
93580   4 ZZZ 0 0 1,609.97 0
93581   1 0 2 0 2,357.70 0
93581   2 0 2 0 2,158.04 0
93581   3 0 2 0 2,158.04 0
93581   4 0 2 0 2,158.04 0
93582   1 0 2 0 942.29 0
93582   2 0 2 0 857.85 0
93582   3 0 2 0 857.85 0
93582   4 0 2 0 857.85 0
93583   1 0 2 0 1,048.78 0
93583   2 0 2 0 954.88 0
93583   3 0 2 0 954.88 0
93583   4 0 2 0 954.88 0
93590   1 0 2 0 1,564.21 0
93590   2 0 2 0 1,429.30 0
93590   3 0 2 0 1,429.30 0
93590   4 0 2 0 1,429.30 0
93591   1 0 2 0 1,298.35 0
93591   2 0 2 0 1,186.17 0
93591   3 0 2 0 1,186.17 0
93591   4 0 2 0 1,186.17 0
93592   1 ZZZ 0 0 572.11 0
93592   2 ZZZ 0 0 522.96 0
93592   3 ZZZ 0 0 522.96 0
93592   4 ZZZ 0 0 522.96 0
93600   1 0 0 0 595.24 0
93600 26 1 0 0 0 542.04 0
93600 TC 1 0 0 0 163.99 0
93600   2 0 0 0 586.06 0
93600 26 2 0 0 0 526.67 0
93600 TC 2 0 0 0 160.92 0
93600   3 0 0 0 547.67 0
93600 26 3 0 0 0 514.86 0
93600 TC 3 0 0 0 147.86 0
93600   4 0 0 0 540.16 0
93600 26 4 0 0 0 514.35 0
93600 TC 4 0 0 0 145.55 0
93602   1 0 0 0 417.92 0
93602 26 1 0 0 0 324.52 0
93602 TC 1 0 0 0 93.39 0
93602   2 0 0 0 412.16 0
93602 26 2 0 0 0 327.85 0
93602 TC 2 0 0 0 91.58 0
93602   3 0 0 0 388.08 0
93602 26 3 0 0 0 327.58 0
93602 TC 3 0 0 0 84.18 0
93602   4 0 0 0 383.13 0
93602 26 4 0 0 0 325.97 0
93602 TC 4 0 0 0 82.86 0
93603   1 0 0 0 501.03 0
93603 26 1 0 0 0 526.21 0
93603 TC 1 0 0 0 141.23 0
93603   2 0 0 0 579.75 0
93603 26 2 0 0 0 521.61 0
93603 TC 2 0 0 0 138.58 0
93603   3 0 0 0 463.43 0
93603 26 3 0 0 0 556.26 0
93603 TC 3 0 0 0 127.39 0
93603   4 0 0 0 457.22 0
93603 26 4 0 0 0 536.63 0
93603 TC 4 0 0 0 125.30 0
93609   1 0 0 0 1,362.55 0
93609 26 1 0 0 0 1,472.49 0
93609 TC 1 0 0 0 227.94 0
93609   2 0 0 0 1,347.22 0
93609 26 2 0 0 0 1,123.55 0
93609 TC 2 0 0 0 223.69 0
93609   3 0 0 0 1,283.80 0
93609 26 3 0 0 0 1,448.81 0
93609 TC 3 0 0 0 205.70 0
93609   4 0 0 0 1,268.66 0
93609 26 4 0 0 0 1,443.85 0
93609 TC 4 0 0 0 202.45 0
93610   1 0 0 0 660.38 0
93610 26 1 0 0 0 612.59 0
93610 TC 1 0 0 0 113.78 0
93610   2 0 0 0 657.34 0
93610 26 2 0 0 0 610.41 0
93610 TC 2 0 0 0 111.60 0
93610   3 0 0 0 517.99 0
93610 26 3 0 0 0 596.38 0
93610 TC 3 0 0 0 102.50 0
93610   4 0 0 0 641.60 0
93610 26 4 0 0 0 599.26 0
93610 TC 4 0 0 0 100.85 0
93612   1 0 0 0 670.91 0
93612 26 1 0 0 0 613.61 0
93612 TC 1 0 0 0 136.56 0
93612   2 0 0 0 663.43 0
93612 26 2 0 0 0 607.20 0
93612 TC 2 0 0 0 133.96 0
93612   3 0 0 0 640.11 0
93612 26 3 0 0 0 588.55 0
93612 TC 3 0 0 0 122.98 0
93612   4 0 0 0 533.67 0
93612 26 4 0 0 0 600.20 0
93612 TC 4 0 0 0 121.09 0
93613 26 1 XXX 0 0 693.33 0
93613 26 2 XXX 0 0 628.41 0
93613 26 3 XXX 0 0 628.41 0
93613 26 4 XXX 0 0 628.41 0
93615   1 0 0 0 109.22 0
93615 26 1 0 0 0 108.17 0
93615 TC 1 0 0 0 25.86 0
93615   2 0 0 0 106.27 0
93615 26 2 0 0 0 107.10 0
93615 TC 2 0 0 0 25.42 0
93615   3 0 0 0 126.48 0
93615 26 3 0 0 0 103.08 0
93615 TC 3 0 0 0 23.43 0
93615   4 0 0 0 124.97 0
93615 26 4 0 0 0 101.95 0
93615 TC 4 0 0 0 23.07 0
93616   1 0 0 0 261.75 0
93616 26 1 0 0 0 235.92 0
93616 TC 1 0 0 0 25.86 0
93616   2 0 0 0 258.54 0
93616 26 2 0 0 0 233.11 0
93616 TC 2 0 0 0 25.42 0
93616   3 0 0 0 244.98 0
93616 26 3 0 0 0 221.55 0
93616 TC 3 0 0 0 23.43 0
93616   4 0 0 0 241.84 0
93616 26 4 0 0 0 218.80 0
93616 TC 4 0 0 0 23.07 0
93618   1 0 0 0 1,832.26 0
93618 26 1 0 0 0 1,692.71 0
93618 TC 1 0 0 0 332.74 0
93618   2 0 0 0 1,824.68 0
93618 26 2 0 0 0 1,687.76 0
93618 TC 2 0 0 0 326.46 0
93618   3 0 0 0 1,076.41 0
93618 26 3 0 0 0 1,667.23 0
93618 TC 3 0 0 0 300.06 0
93618   4 0 0 0 1,786.79 0
93618 26 4 0 0 0 1,662.89 0
93618 TC 4 0 0 0 295.40 0
93619   1 0 0 0 2,179.56 0
93619 26 1 0 0 0 2,025.30 0
93619 TC 1 0 0 0 646.98 0
93619   2 0 0 0 2,145.58 0
93619 26 2 0 0 0 2,015.64 0
93619 TC 2 0 0 0 634.77 0
93619   3 0 0 0 2,003.08 0
93619 26 3 0 0 0 1,975.28 0
93619 TC 3 0 0 0 583.39 0
93619   4 0 0 0 1,975.35 0
93619 26 4 0 0 0 1,966.96 0
93619 TC 4 0 0 0 574.26 0