An Official Pennsylvania Government Website
Translate
Begin Main Content Area

​

2019 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 0.00 138.72 0.00
93313   2 XXX 0 0.00 137.05 0.00
93313   3 XXX 0 0.00 130.06 0.00
93313   4 XXX 0 0.00 128.53 0.00
93314   1 XXX 0 0.00 470.84 0.00
93314   2 XXX 0 0.00 462.46 0.00
93314   3 XXX 0 0.00 427.54 0.00
93314   4 XXX 0 0.00 421.38 0.00
93314 26 1 XXX 0 0.00 138.72 0.00
93314 26 2 XXX 0 0.00 137.05 0.00
93314 26 3 XXX 0 0.00 130.06 0.00
93314 26 4 XXX 0 0.00 128.53 0.00
93314 TC 1 XXX 0 0.00 332.01 0.00
93314 TC 2 XXX 0 0.00 325.43 0.00
93314 TC 3 XXX 0 0.00 297.49 0.00
93314 TC 4 XXX 0 0.00 292.90 0.00
93315   1 XXX 0 0.00 626.88 0.00
93315   2 XXX 0 0.00 555.74 0.00
93315   3 XXX 0 0.00 540.85 0.00
93315   4 XXX 0 0.00 540.85 0.00
93315 26 1 XXX 0 0.00 309.14 0.00
93315 26 2 XXX 0 0.00 288.71 0.00
93315 26 3 XXX 0 0.00 281.01 0.00
93315 26 4 XXX 0 0.00 281.01 0.00
93315 TC 1 XXX 0 0.00 317.73 0.00
93315 TC 2 XXX 0 0.00 266.98 0.00
93315 TC 3 XXX 0 0.00 259.84 0.00
93315 TC 4 XXX 0 0.00 259.84 0.00
93316   1 XXX 0 0.00 124.04 0.00
93316   2 XXX 0 0.00 114.14 0.00
93316   3 XXX 0 0.00 111.04 0.00
93316   4 XXX 0 0.00 111.04 0.00
93317   1 XXX 0 0.00 502.03 0.00
93317   2 XXX 0 0.00 440.89 0.00
93317   3 XXX 0 0.00 429.12 0.00
93317   4 XXX 0 0.00 429.12 0.00
93317 26 1 XXX 0 0.00 184.31 0.00
93317 26 2 XXX 0 0.00 173.92 0.00
93317 26 3 XXX 0 0.00 169.23 0.00
93317 26 4 XXX 0 0.00 169.23 0.00
93317 TC 1 XXX 0 0.00 317.73 0.00
93317 TC 2 XXX 0 0.00 266.98 0.00
93317 TC 3 XXX 0 0.00 259.84 0.00
93317 TC 4 XXX 0 0.00 259.84 0.00
93318     XXX 0 0.00 * 0.00
93320   1 ZZZ 0 0.00 218.49 0.00
93320   2 ZZZ 0 0.00 183.77 0.00
93320   3 ZZZ 0 0.00 183.77 0.00
93320   4 ZZZ 0 0.00 183.77 0.00
93320 26 1 ZZZ 0 0.00 68.05 0.00
93320 26 2 ZZZ 0 0.00 59.61 0.00
93320 26 3 ZZZ 0 0.00 59.61 0.00
93320 26 4 ZZZ 0 0.00 59.61 0.00
93320 TC 1 ZZZ 0 0.00 150.45 0.00
93320 TC 2 ZZZ 0 0.00 124.17 0.00
93320 TC 3 ZZZ 0 0.00 124.17 0.00
93320 TC 4 ZZZ 0 0.00 124.17 0.00
93321   1 ZZZ 0 0.00 172.54 0.00
93321   2 ZZZ 0 0.00 167.33 0.00
93321   3 ZZZ 0 0.00 153.02 0.00
93321   4 ZZZ 0 0.00 117.00 0.00
93321 26 1 ZZZ 0 0.00 65.92 0.00
93321 26 2 ZZZ 0 0.00 66.65 0.00
93321 26 3 ZZZ 0 0.00 71.90 0.00
93321 26 4 ZZZ 0 0.00 88.10 0.00
93321 TC 1 ZZZ 0 0.00 96.75 0.00
93321 TC 2 ZZZ 0 0.00 94.89 0.00
93321 TC 3 ZZZ 0 0.00 86.86 0.00
93321 TC 4 ZZZ 0 0.00 85.55 0.00
93325   1 ZZZ 0 0.00 266.10 0.00
93325   2 ZZZ 0 0.00 219.64 0.00
93325   3 ZZZ 0 0.00 219.64 0.00
93325   4 ZZZ 0 0.00 219.64 0.00
93325 26 1 ZZZ 0 0.00 9.43 0.00
93325 26 2 ZZZ 0 0.00 8.34 0.00
93325 26 3 ZZZ 0 0.00 8.34 0.00
93325 26 4 ZZZ 0 0.00 8.34 0.00
93325 TC 1 ZZZ 0 0.00 256.61 0.00
93325 TC 2 ZZZ 0 0.00 211.31 0.00
93325 TC 3 ZZZ 0 0.00 211.31 0.00
93325 TC 4 ZZZ 0 0.00 211.31 0.00
93350   1 XXX 0 0.00 870.89 0.00
93350   2 XXX 0 0.00 866.51 0.00
93350   3 XXX 0 0.00 848.29 0.00
93350   4 XXX 0 0.00 844.83 0.00
93350 26 1 XXX 0 0.00 454.74 0.00
93350 26 2 XXX 0 0.00 452.77 0.00
93350 26 3 XXX 0 0.00 444.63 0.00
93350 26 4 XXX 0 0.00 442.92 0.00
93350 TC 1 XXX 0 0.00 297.87 0.00
93350 TC 2 XXX 0 0.00 576.06 0.00
93350 TC 3 XXX 0 0.00 268.08 0.00
93350 TC 4 XXX 0 0.00 263.93 0.00
93351   1 XXX 0 0.00 432.01 0.00
93351   2 XXX 0 0.00 372.33 0.00
93351   3 XXX 0 0.00 372.33 0.00
93351   4 XXX 0 0.00 372.33 0.00
93352   1 XXX 0 0.00 60.25 0.00
93352   2 XXX 0 0.00 51.62 0.00
93352   3 XXX 0 0.00 51.62 0.00
93352   4 XXX 0 0.00 51.62 0.00
93355   1 XXX 6 0.00 298.04 0.00
93355   2 XXX 6 0.00 280.47 0.00
93355   3 XXX 6 0.00 280.47 0.00
93355   4 XXX 6 0.00 280.47 0.00
93451   1 0 2 0.00 1,149.29 0.00
93451   2 0 2 0.00 1,019.26 0.00
93451   3 0 2 0.00 1,019.26 0.00
93451   4 0 2 0.00 1,019.26 0.00
93451 26 1 0 2 0.00 228.22 0.00
93451 26 2 0 2 0.00 205.69 0.00
93451 26 3 0 2 0.00 205.69 0.00
93451 26 4 0 2 0.00 205.69 0.00
93451 TC 1 0 2 0.00 921.09 0.00
93451 TC 2 0 2 0.00 813.57 0.00
93451 TC 3 0 2 0.00 813.57 0.00
93451 TC 4 0 2 0.00 813.57 0.00
93452   1 0 2 0.00 1,280.63 0.00
93452   2 0 2 0.00 1,137.84 0.00
93452   3 0 2 0.00 1,137.84 0.00
93452   4 0 2 0.00 1,137.84 0.00
93452 26 1 0 2 0.00 400.72 0.00
93452 26 2 0 2 0.00 360.68 0.00
93452 26 3 0 2 0.00 360.68 0.00
93452 26 4 0 2 0.00 360.68 0.00
93452 TC 1 0 2 0.00 879.90 0.00
93452 TC 2 0 2 0.00 777.16 0.00
93452 TC 3 0 2 0.00 777.16 0.00
93452 TC 4 0 2 0.00 777.16 0.00
93453   1 0 2 0.00 1,675.36 0.00
93453   2 0 2 0.00 1,488.94 0.00
93453   3 0 2 0.00 1,488.94 0.00
93453   4 0 2 0.00 1,488.94 0.00
93453 26 1 0 2 0.00 524.70 0.00
93453 26 2 0 2 0.00 472.66 0.00
93453 26 3 0 2 0.00 472.66 0.00
93453 26 4 0 2 0.00 472.66 0.00
93453 TC 1 0 2 0.00 1,150.65 0.00
93453 TC 2 0 2 0.00 1,016.30 0.00
93453 TC 3 0 2 0.00 1,016.30 0.00
93453 TC 4 0 2 0.00 1,016.30 0.00
93454   1 0 2 0.00 1,320.15 0.00
93454   2 0 2 0.00 1,172.98 0.00
93454   3 0 2 0.00 1,172.98 0.00
93454   4 0 2 0.00 1,172.98 0.00
93454 26 1 0 2 0.00 403.63 0.00
93454 26 2 0 2 0.00 363.47 0.00
93454 26 3 0 2 0.00 363.47 0.00
93454 26 4 0 2 0.00 363.47 0.00
93454 TC 1 0 2 0.00 916.51 0.00
93454 TC 2 0 2 0.00 809.51 0.00
93454 TC 3 0 2 0.00 809.51 0.00
93454 TC 4 0 2 0.00 809.51 0.00
93455   1 0 2 0.00 1,539.87 0.00
93455   2 0 2 0.00 1,368.31 0.00
93455   3 0 2 0.00 1,368.31 0.00
93455   4 0 2 0.00 1,368.31 0.00
93455 26 1 0 2 0.00 465.49 0.00
93455 26 2 0 2 0.00 419.42 0.00
93455 26 3 0 2 0.00 419.42 0.00
93455 26 4 0 2 0.00 419.42 0.00
93455 TC 1 0 2 0.00 1,074.41 0.00
93455 TC 2 0 2 0.00 948.89 0.00
93455 TC 3 0 2 0.00 948.89 0.00
93455 TC 4 0 2 0.00 948.89 0.00
93456   1 0 2 0.00 1,651.76 0.00
93456   2 0 2 0.00 1,468.28 0.00
93456   3 0 2 0.00 1,468.28 0.00
93456   4 0 2 0.00 1,468.28 0.00
93456 26 1 0 2 0.00 515.84 0.00
93456 26 2 0 2 0.00 465.03 0.00
93456 26 3 0 2 0.00 465.03 0.00
93456 26 4 0 2 0.00 465.03 0.00
93456 TC 1 0 2 0.00 1,135.91 0.00
93456 TC 2 0 2 0.00 1,003.28 0.00
93456 TC 3 0 2 0.00 1,003.28 0.00
93456 TC 4 0 2 0.00 1,003.28 0.00
93457   1 0 2 0.00 1,871.76 0.00
93457   2 0 2 0.00 1,663.65 0.00
93457   3 0 2 0.00 1,663.65 0.00
93457   4 0 2 0.00 1,663.65 0.00
93457 26 1 0 2 0.00 578.72 0.00
93457 26 2 0 2 0.00 521.54 0.00
93457 26 3 0 2 0.00 521.54 0.00
93457 26 4 0 2 0.00 521.54 0.00
93457 TC 1 0 2 0.00 1,293.03 0.00
93457 TC 2 0 2 0.00 1,142.13 0.00
93457 TC 3 0 2 0.00 1,142.13 0.00
93457 TC 4 0 2 0.00 1,142.13 0.00
93458   1 0 2 0.00 1,593.26 0.00
93458   2 0 2 0.00 1,415.74 0.00
93458   3 0 2 0.00 1,415.74 0.00
93458   4 0 2 0.00 1,415.74 0.00
93458 26 1 0 2 0.00 492.43 0.00
93458 26 2 0 2 0.00 443.49 0.00
93458 26 3 0 2 0.00 443.49 0.00
93458 26 4 0 2 0.00 443.49 0.00
93458 TC 1 0 2 0.00 1,100.83 0.00
93458 TC 2 0 2 0.00 972.25 0.00
93458 TC 3 0 2 0.00 972.25 0.00
93458 TC 4 0 2 0.00 972.25 0.00
93459   1 0 2 0.00 1,759.08 0.00
93459   2 0 2 0.00 1,563.78 0.00
93459   3 0 2 0.00 1,563.78 0.00
93459   4 0 2 0.00 1,563.78 0.00
93459 26 1 0 2 0.00 553.50 0.00
93459 26 2 0 2 0.00 498.94 0.00
93459 26 3 0 2 0.00 498.94 0.00
93459 26 4 0 2 0.00 498.94 0.00
93459 TC 1 0 2 0.00 1,205.59 0.00
93459 TC 2 0 2 0.00 1,064.82 0.00
93459 TC 3 0 2 0.00 1,064.82 0.00
93459 TC 4 0 2 0.00 1,064.82 0.00
93460   1 0 2 0.00 1,883.23 0.00
93460   2 0 2 0.00 1,674.61 0.00
93460   3 0 2 0.00 1,674.61 0.00
93460   4 0 2 0.00 1,674.61 0.00
93460 26 1 0 2 0.00 616.61 0.00
93460 26 2 0 2 0.00 555.85 0.00
93460 26 3 0 2 0.00 555.85 0.00
93460 26 4 0 2 0.00 555.85 0.00
93460 TC 1 0 2 0.00 1,266.59 0.00
93460 TC 2 0 2 0.00 1,118.75 0.00
93460 TC 3 0 2 0.00 1,118.75 0.00
93460 TC 4 0 2 0.00 1,118.75 0.00
93461   1 0 2 0.00 2,157.60 0.00
93461   2 0 2 0.00 1,917.76 0.00
93461   3 0 2 0.00 1,917.76 0.00
93461   4 0 2 0.00 1,917.76 0.00
93461 26 1 0 2 0.00 680.72 0.00
93461 26 2 0 2 0.00 613.37 0.00
93461 26 3 0 2 0.00 613.37 0.00
93461 26 4 0 2 0.00 613.37 0.00
93461 TC 1 0 2 0.00 1,476.85 0.00
93461 TC 2 0 2 0.00 1,304.43 0.00
93461 TC 3 0 2 0.00 1,304.43 0.00
93461 TC 4 0 2 0.00 1,304.43 0.00
93462   1 ZZZ 0 0.00 313.08 0.00
93462   2 ZZZ 0 0.00 282.35 0.00
93462   3 ZZZ 0 0.00 282.35 0.00
93462   4 ZZZ 0 0.00 282.35 0.00
93463   1 ZZZ 0 0.00 165.01 0.00
93463   2 ZZZ 0 0.00 149.46 0.00
93463   3 ZZZ 0 0.00 149.46 0.00
93463   4 ZZZ 0 0.00 149.46 0.00
93464   1 ZZZ 0 0.00 380.52 0.00
93464   2 ZZZ 0 0.00 339.39 0.00
93464   3 ZZZ 0 0.00 339.39 0.00
93464   4 ZZZ 0 0.00 339.39 0.00
93464 26 1 ZZZ 0 0.00 145.33 0.00
93464 26 2 ZZZ 0 0.00 131.70 0.00
93464 26 3 ZZZ 0 0.00 131.70 0.00
93464 26 4 ZZZ 0 0.00 131.70 0.00
93464 TC 1 ZZZ 0 0.00 235.16 0.00
93464 TC 2 ZZZ 0 0.00 207.68 0.00
93464 TC 3 ZZZ 0 0.00 207.68 0.00
93464 TC 4 ZZZ 0 0.00 207.68 0.00
93503   1 0 0 0.00 528.52 0.00
93503   2 0 0 0.00 549.18 0.00
93503   3 0 0 0.00 493.28 0.00
93503   4 0 0 0.00 503.46 0.00
93505   1 0 2 0.00 823.87 0.00
93505   2 0 2 0.00 812.52 0.00
93505   3 0 2 0.00 765.26 0.00
93505   4 0 2 0.00 755.74 0.00
93505 26 1 0 2 0.00 697.00 0.00
93505 26 2 0 2 0.00 692.16 0.00
93505 26 3 0 2 0.00 648.87 0.00
93505 26 4 0 2 0.00 677.14 0.00
93505 TC 1 0 2 0.00 175.12 0.00
93505 TC 2 0 2 0.00 171.50 0.00
93505 TC 3 0 2 0.00 156.59 0.00
93505 TC 4 0 2 0.00 154.21 0.00
93530   1 0 2 0.00 2,124.73 0.00
93530   2 0 2 0.00 1,798.07 0.00
93530   3 0 2 0.00 1,798.07 0.00
93530   4 0 2 0.00 1,798.07 0.00
93530 26 1 0 2 0.00 646.38 0.00
93530 26 2 0 2 0.00 575.41 0.00
93530 26 3 0 2 0.00 575.41 0.00
93530 26 4 0 2 0.00 575.41 0.00
93530 TC 1 0 2 0.00 1,478.33 0.00
93530 TC 2 0 2 0.00 1,222.67 0.00
93530 TC 3 0 2 0.00 1,222.67 0.00
93530 TC 4 0 2 0.00 1,222.67 0.00
93531   1 0 2 0.00 5,331.94 0.00
93531   2 0 2 0.00 4,494.36 0.00
93531   3 0 2 0.00 4,494.36 0.00
93531   4 0 2 0.00 4,494.36 0.00
93531 26 1 0 2 0.00 1,106.87 0.00
93531 26 2 0 2 0.00 1,000.35 0.00
93531 26 3 0 2 0.00 1,000.35 0.00
93531 26 4 0 2 0.00 1,000.35 0.00
93531 TC 1 0 2 0.00 4,225.04 0.00
93531 TC 2 0 2 0.00 3,494.03 0.00
93531 TC 3 0 2 0.00 3,494.03 0.00
93531 TC 4 0 2 0.00 3,494.03 0.00
93532   1 0 2 0.00 5,492.96 0.00
93532   2 0 2 0.00 4,644.59 0.00
93532   3 0 2 0.00 4,644.59 0.00
93532   4 0 2 0.00 4,644.59 0.00
93532 26 1 0 2 0.00 1,380.63 0.00
93532 26 2 0 2 0.00 1,243.84 0.00
93532 26 3 0 2 0.00 1,243.84 0.00
93532 26 4 0 2 0.00 1,243.84 0.00
93532 TC 1 0 2 0.00 4,112.33 0.00
93532 TC 2 0 2 0.00 3,400.79 0.00
93532 TC 3 0 2 0.00 3,400.79 0.00
93532 TC 4 0 2 0.00 3,400.79 0.00
93533   1 0 2 0.00 4,869.51 0.00
93533   2 0 2 0.00 4,094.69 0.00
93533   3 0 2 0.00 4,094.69 0.00
93533   4 0 2 0.00 4,094.69 0.00
93533 26 1 0 2 0.00 757.16 0.00
93533 26 2 0 2 0.00 693.92 0.00
93533 26 3 0 2 0.00 693.92 0.00
93533 26 4 0 2 0.00 693.92 0.00
93533 TC 1 0 2 0.00 4,112.35 0.00
93533 TC 2 0 2 0.00 3,400.79 0.00
93533 TC 3 0 2 0.00 3,400.79 0.00
93533 TC 4 0 2 0.00 3,400.79 0.00
93561   1 0 0 0.00 214.28 0.00
93561   2 0 0 0.00 188.42 0.00
93561   3 0 0 0.00 171.55 0.00
93561   4 0 0 0.00 195.05 0.00
93561 26 1 0 0 0.00 164.85 0.00
93561 26 2 0 0 0.00 162.72 0.00
93561 26 3 0 0 0.00 145.71 0.00
93561 26 4 0 0 0.00 152.14 0.00
93561 TC 1 0 0 0.00 49.44 0.00
93561 TC 2 0 0 0.00 48.31 0.00
93561 TC 3 0 0 0.00 58.00 0.00
93561 TC 4 0 0 0.00 42.90 0.00
93562   1 0 0 0.00 103.58 0.00
93562   2 0 0 0.00 108.44 0.00
93562   3 0 0 0.00 96.59 0.00
93562   4 0 0 0.00 92.79 0.00
93562 26 1 0 0 0.00 111.74 0.00
93562 26 2 0 0 0.00 93.86 0.00
93562 26 3 0 0 0.00 110.58 0.00
93562 26 4 0 0 0.00 124.72 0.00
93562 TC 1 0 0 0.00 28.93 0.00
93562 TC 2 0 0 0.00 28.29 0.00
93562 TC 3 0 0 0.00 25.49 0.00
93562 TC 4 0 0 0.00 25.15 0.00
93563   1 ZZZ 0 0.00 82.82 0.00
93563   2 ZZZ 0 0.00 77.01 0.00
93563   3 ZZZ 0 0.00 77.01 0.00
93563   4 ZZZ 0 0.00 77.01 0.00
93564   1 ZZZ 0 0.00 84.52 0.00
93564   2 ZZZ 0 0.00 78.45 0.00
93564   3 ZZZ 0 0.00 78.45 0.00
93564   4 ZZZ 0 0.00 78.45 0.00
93565   1 ZZZ 0 0.00 63.79 0.00
93565   2 ZZZ 0 0.00 59.29 0.00
93565   3 ZZZ 0 0.00 59.29 0.00
93565   4 ZZZ 0 0.00 59.29 0.00
93566   1 ZZZ 0 0.00 252.44 63.79
93566   2 ZZZ 0 0.00 226.00 59.29
93566   3 ZZZ 0 0.00 226.00 59.29
93566   4 ZZZ 0 0.00 226.00 59.29
93567   1 ZZZ 0 0.00 207.85 71.58
93567   2 ZZZ 0 0.00 187.14 66.70
93567   3 ZZZ 0 0.00 187.14 66.70
93567   4 ZZZ 0 0.00 187.14 66.70
93568   1 ZZZ 0 0.00 227.98 65.27
93568   2 ZZZ 0 0.00 204.50 60.69
93568   3 ZZZ 0 0.00 204.50 60.69
93568   4 ZZZ 0 0.00 204.50 60.69
93571   1 ZZZ 0 0.00 565.20 0.00
93571   2 ZZZ 0 0.00 489.76 0.00
93571   3 ZZZ 0 0.00 489.76 0.00
93571   4 ZZZ 0 0.00 489.76 0.00
93571 26 1 ZZZ 0 0.00 185.98 0.00
93571 26 2 ZZZ 0 0.00 171.65 0.00
93571 26 3 ZZZ 0 0.00 171.65 0.00
93571 26 4 ZZZ 0 0.00 171.65 0.00
93571 TC 1 ZZZ 0 0.00 379.25 0.00
93571 TC 2 ZZZ 0 0.00 318.15 0.00
93571 TC 3 ZZZ 0 0.00 318.15 0.00
93571 TC 4 ZZZ 0 0.00 318.15 0.00
93572   1 ZZZ 0 0.00 519.33 0.00
93572   2 ZZZ 0 0.00 451.00 0.00
93572   3 ZZZ 0 0.00 451.00 0.00
93572   4 ZZZ 0 0.00 451.00 0.00
93572 26 1 ZZZ 0 0.00 149.42 0.00
93572 26 2 ZZZ 0 0.00 137.80 0.00
93572 26 3 ZZZ 0 0.00 137.80 0.00
93572 26 4 ZZZ 0 0.00 137.80 0.00
93572 TC 1 ZZZ 0 0.00 369.95 0.00
93572 TC 2 ZZZ 0 0.00 313.24 0.00
93572 TC 3 ZZZ 0 0.00 313.24 0.00
93572 TC 4 ZZZ 0 0.00 313.24 0.00
93580   1 ZZZ 0 0.00 1,810.83 0.00
93580   2 ZZZ 0 0.00 1,647.00 0.00
93580   3 ZZZ 0 0.00 1,647.00 0.00
93580   4 ZZZ 0 0.00 1,647.00 0.00
93581   1 0 2 0.00 2,411.93 0.00
93581   2 0 2 0.00 2,207.67 0.00
93581   3 0 2 0.00 2,207.67 0.00
93581   4 0 2 0.00 2,207.67 0.00
93582   1 0 2 0.00 963.96 0.00
93582   2 0 2 0.00 877.58 0.00
93582   3 0 2 0.00 877.58 0.00
93582   4 0 2 0.00 877.58 0.00
93583   1 0 2 0.00 1,072.90 0.00
93583   2 0 2 0.00 976.84 0.00
93583   3 0 2 0.00 976.84 0.00
93583   4 0 2 0.00 976.84 0.00
93590   1 0 2 0.00 1,600.19 0.00
93590   2 0 2 0.00 1,462.17 0.00
93590   3 0 2 0.00 1,462.17 0.00
93590   4 0 2 0.00 1,462.17 0.00
93591   1 0 2 0.00 1,328.21 0.00
93591   2 0 2 0.00 1,213.45 0.00
93591   3 0 2 0.00 1,213.45 0.00
93591   4 0 2 0.00 1,213.45 0.00
93592   1 ZZZ 0 0.00 585.27 0.00
93592   2 ZZZ 0 0.00 534.99 0.00
93592   3 ZZZ 0 0.00 534.99 0.00
93592   4 ZZZ 0 0.00 534.99 0.00
93600   1 0 0 0.00 608.93 0.00
93600   2 0 0 0.00 599.54 0.00
93600   3 0 0 0.00 560.27 0.00
93600   4 0 0 0.00 552.58 0.00
93600 26 1 0 0 0.00 554.51 0.00
93600 26 2 0 0 0.00 538.78 0.00
93600 26 3 0 0 0.00 526.70 0.00
93600 26 4 0 0 0.00 526.18 0.00
93600 TC 1 0 0 0.00 167.76 0.00
93600 TC 2 0 0 0.00 164.62 0.00
93600 TC 3 0 0 0.00 151.26 0.00
93600 TC 4 0 0 0.00 148.90 0.00
93602   1 0 0 0.00 427.53 0.00
93602   2 0 0 0.00 421.64 0.00
93602   3 0 0 0.00 397.01 0.00
93602   4 0 0 0.00 391.94 0.00
93602 26 1 0 0 0.00 331.98 0.00
93602 26 2 0 0 0.00 335.39 0.00
93602 26 3 0 0 0.00 335.11 0.00
93602 26 4 0 0 0.00 333.47 0.00
93602 TC 1 0 0 0.00 95.54 0.00
93602 TC 2 0 0 0.00 93.69 0.00
93602 TC 3 0 0 0.00 86.12 0.00
93602 TC 4 0 0 0.00 84.77 0.00
93603   1 0 0 0.00 512.55 0.00
93603   2 0 0 0.00 593.08 0.00
93603   3 0 0 0.00 474.09 0.00
93603   4 0 0 0.00 467.74 0.00
93603 26 1 0 0 0.00 538.31 0.00
93603 26 2 0 0 0.00 533.61 0.00
93603 26 3 0 0 0.00 569.05 0.00
93603 26 4 0 0 0.00 548.97 0.00
93603 TC 1 0 0 0.00 144.48 0.00
93603 TC 2 0 0 0.00 141.77 0.00
93603 TC 3 0 0 0.00 130.32 0.00
93603 TC 4 0 0 0.00 128.18 0.00
93609   1 0 0 0.00 1,393.89 0.00
93609   2 0 0 0.00 1,378.21 0.00
93609   3 0 0 0.00 1,313.33 0.00
93609   4 0 0 0.00 1,297.84 0.00
93609 26 1 0 0 0.00 1,506.36 0.00
93609 26 2 0 0 0.00 1,149.39 0.00
93609 26 3 0 0 0.00 1,482.13 0.00
93609 26 4 0 0 0.00 1,477.06 0.00
93609 TC 1 0 0 0.00 233.18 0.00
93609 TC 2 0 0 0.00 228.83 0.00
93609 TC 3 0 0 0.00 210.43 0.00
93609 TC 4 0 0 0.00 207.11 0.00
93610   1 0 0 0.00 675.57 0.00
93610   2 0 0 0.00 672.46 0.00
93610   3 0 0 0.00 529.90 0.00
93610   4 0 0 0.00 656.36 0.00
93610 26 1 0 0 0.00 626.68 0.00
93610 26 2 0 0 0.00 624.45 0.00
93610 26 3 0 0 0.00 610.10 0.00
93610 26 4 0 0 0.00 613.04 0.00
93610 TC 1 0 0 0.00 116.40 0.00
93610 TC 2 0 0 0.00 114.17 0.00
93610 TC 3 0 0 0.00 104.86 0.00
93610 TC 4 0 0 0.00 103.17 0.00
93612   1 0 0 0.00 686.34 0.00
93612   2 0 0 0.00 678.69 0.00
93612   3 0 0 0.00 654.83 0.00
93612   4 0 0 0.00 545.94 0.00
93612 26 1 0 0 0.00 627.72 0.00
93612 26 2 0 0 0.00 621.17 0.00
93612 26 3 0 0 0.00 602.09 0.00
93612 26 4 0 0 0.00 614.00 0.00
93612 TC 1 0 0 0.00 139.70 0.00
93612 TC 2 0 0 0.00 137.04 0.00
93612 TC 3 0 0 0.00 125.81 0.00
93612 TC 4 0 0 0.00 123.88 0.00
93613 26 1 XXX 0 0.00 709.28 0.00
93613 26 2 XXX 0 0.00 642.86 0.00
93613 26 3 XXX 0 0.00 642.86 0.00
93613 26 4 XXX 0 0.00 642.86 0.00
93615   1 0 0 0.00 111.73 0.00
93615   2 0 0 0.00 108.71 0.00
93615   3 0 0 0.00 129.39 0.00
93615   4 0 0 0.00 127.84 0.00
93615 26 1 0 0 0.00 110.66 0.00
93615 26 2 0 0 0.00 109.56 0.00
93615 26 3 0 0 0.00 105.45 0.00
93615 26 4 0 0 0.00 104.29 0.00
93615 TC 1 0 0 0.00 26.45 0.00
93615 TC 2 0 0 0.00 26.00 0.00
93615 TC 3 0 0 0.00 23.97 0.00
93615 TC 4 0 0 0.00 23.60 0.00
93616   1 0 0 0.00 267.77 0.00
93616   2 0 0 0.00 264.49 0.00
93616   3 0 0 0.00 250.61 0.00
93616   4 0 0 0.00 247.40 0.00
93616 26 1 0 0 0.00 241.35 0.00
93616 26 2 0 0 0.00 238.47 0.00
93616 26 3 0 0 0.00 226.65 0.00
93616 26 4 0 0 0.00 223.83 0.00
93616 TC 1 0 0 0.00 26.45 0.00
93616 TC 2 0 0 0.00 26.00 0.00
93616 TC 3 0 0 0.00 23.97 0.00
93616 TC 4 0 0 0.00 23.60 0.00
93618   1 0 0 0.00 1,874.40 0.00
93618   2 0 0 0.00 1,866.65 0.00
93618   3 0 0 0.00 1,101.17 0.00
93618   4 0 0 0.00 1,827.89 0.00
93618 26 1 0 0 0.00 1,731.64 0.00
93618 26 2 0 0 0.00 1,726.58 0.00
93618 26 3 0 0 0.00 1,705.58 0.00
93618 26 4 0 0 0.00 1,701.14 0.00
93618 TC 1 0 0 0.00 340.39 0.00
93618 TC 2 0 0 0.00 333.97 0.00
93618 TC 3 0 0 0.00 306.96 0.00
93618 TC 4 0 0 0.00 302.19 0.00
93619   1 0 0 0.00 2,229.69 0.00
93619   2 0 0 0.00 2,194.93 0.00
93619   3 0 0 0.00 2,049.15 0.00
93619   4 0 0 0.00 2,020.78 0.00
93619 26 1 0 0 0.00 2,071.88 0.00
93619 26 2 0 0 0.00 2,062.00 0.00
93619 26 3 0 0 0.00 2,020.71 0.00
93619 26 4 0 0 0.00 2,012.20 0.00
93619 TC 1 0 0 0.00 661.86 0.00
93619 TC 2 0 0 0.00 649.37 0.00
93619 TC 3 0 0 0.00 596.81 0.00
93619 TC 4 0 0 0.00 587.47 0.00