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Health Care Services Review
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Medical Fee Review
>
Fee Schedule
>
Fee Schedule 93313-93619
Begin Main Content Area
Page Content
Content Editor
2024 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
004
XXX
0
X
162.43
X
93313
001
XXX
0
X
175.30
X
93313
002
XXX
0
X
173.19
X
93313
003
XXX
0
X
164.36
X
93314
001
XXX
6
X
595.02
X
93314
26
001
XXX
6
X
175.30
X
93314
TC
001
XXX
6
X
419.58
X
93314
002
XXX
6
X
584.43
X
93314
26
002
XXX
6
X
173.19
X
93314
TC
002
XXX
6
X
411.25
X
93314
003
XXX
6
X
540.30
X
93314
26
003
XXX
6
X
164.36
X
93314
TC
003
XXX
6
X
375.94
X
93314
004
XXX
6
X
532.50
X
93314
26
004
XXX
6
X
162.43
X
93314
TC
004
XXX
6
X
370.15
X
93315
004
XXX
0
X
683.50
X
93315
26
004
XXX
0
X
355.12
X
93315
TC
004
XXX
0
X
328.37
X
93315
002
XXX
0
X
702.32
X
93315
26
002
XXX
0
X
364.85
X
93315
TC
002
XXX
0
X
337.39
X
93315
003
XXX
0
X
683.50
X
93315
26
003
XXX
0
X
355.12
X
93315
TC
003
XXX
0
X
328.37
X
93315
001
XXX
0
X
792.21
X
93315
26
001
XXX
0
X
390.67
X
93315
TC
001
XXX
0
X
401.52
X
93316
001
XXX
0
X
156.76
X
93316
003
XXX
0
X
140.33
X
93316
002
XXX
0
X
144.24
X
93316
004
XXX
0
X
140.33
X
93317
003
XXX
0
X
542.29
X
93317
26
003
XXX
0
X
213.88
X
93317
TC
003
XXX
0
X
328.37
X
93317
004
XXX
0
X
542.29
X
93317
26
004
XXX
0
X
213.88
X
93317
TC
004
XXX
0
X
328.37
X
93317
001
XXX
0
X
634.43
X
93317
26
001
XXX
0
X
232.92
X
93317
TC
001
XXX
0
X
401.52
X
93317
002
XXX
0
X
557.17
X
93317
26
002
XXX
0
X
219.79
X
93317
TC
002
XXX
0
X
337.39
X
93318
XXX
6
X
*
X
93319
002
ZZZ
0
X
71.31
29.78
93319
004
ZZZ
0
X
71.31
29.78
93319
003
ZZZ
0
X
71.31
29.78
93319
001
ZZZ
0
X
79.87
31.96
93320
001
ZZZ
0
X
276.11
X
93320
26
001
ZZZ
0
X
86.00
X
93320
TC
001
ZZZ
0
X
190.13
X
93320
003
ZZZ
0
X
232.24
X
93320
26
003
ZZZ
0
X
75.34
X
93320
TC
003
ZZZ
0
X
156.93
X
93320
002
ZZZ
0
X
232.24
X
93320
26
002
ZZZ
0
X
75.34
X
93320
TC
002
ZZZ
0
X
156.93
X
93320
004
ZZZ
0
X
232.24
X
93320
26
004
ZZZ
0
X
75.34
X
93320
TC
004
ZZZ
0
X
156.93
X
93321
003
ZZZ
0
X
193.38
X
93321
26
003
ZZZ
0
X
90.86
X
93321
TC
003
ZZZ
0
X
109.76
X
93321
004
ZZZ
0
X
147.87
X
93321
26
004
ZZZ
0
X
111.33
X
93321
TC
004
ZZZ
0
X
108.12
X
93321
001
ZZZ
0
X
218.05
X
93321
26
001
ZZZ
0
X
83.30
X
93321
TC
001
ZZZ
0
X
122.27
X
93321
002
ZZZ
0
X
211.47
X
93321
26
002
ZZZ
0
X
84.23
X
93321
TC
002
ZZZ
0
X
119.91
X
93325
003
ZZZ
0
X
277.57
X
93325
26
003
ZZZ
0
X
10.55
X
93325
TC
003
ZZZ
0
X
267.04
X
93325
002
ZZZ
0
X
277.57
X
93325
26
002
ZZZ
0
X
10.55
X
93325
TC
002
ZZZ
0
X
267.04
X
93325
001
ZZZ
0
X
336.28
X
93325
26
001
ZZZ
0
X
11.92
X
93325
TC
001
ZZZ
0
X
324.27
X
93325
004
ZZZ
0
X
277.57
X
93325
26
004
ZZZ
0
X
10.55
X
93325
TC
004
ZZZ
0
X
267.04
X
93350
001
XXX
6
X
1,100.58
X
93350
26
001
XXX
6
X
574.68
X
93350
TC
001
XXX
6
X
376.43
X
93350
004
XXX
6
X
1,067.64
X
93350
26
004
XXX
6
X
559.74
X
93350
TC
004
XXX
6
X
333.54
X
93350
003
XXX
6
X
1,072.02
X
93350
26
003
XXX
6
X
561.90
X
93350
TC
003
XXX
6
X
338.78
X
93350
002
XXX
6
X
1,095.05
X
93350
26
002
XXX
6
X
572.19
X
93350
TC
002
XXX
6
X
727.99
X
93351
002
XXX
6
X
470.53
X
93351
003
XXX
6
X
470.53
X
93351
004
XXX
6
X
470.53
X
93351
001
XXX
6
X
545.95
X
93352
004
ZZZ
0
X
65.23
X
93352
003
ZZZ
0
X
65.23
X
93352
002
ZZZ
0
X
65.23
X
93352
001
ZZZ
0
X
76.15
X
93355
002
XXX
0
X
354.43
X
93355
004
XXX
0
X
354.43
X
93355
003
XXX
0
X
354.43
X
93355
001
XXX
0
X
376.64
X
93356
004
ZZZ
0
X
53.61
16.62
93356
003
ZZZ
0
X
53.61
16.62
93356
002
ZZZ
0
X
53.61
16.62
93356
001
ZZZ
0
X
60.49
17.88
93451
004
0
2
X
1,288.08
X
93451
26
004
0
2
X
259.95
X
93451
TC
004
0
2
X
1,028.13
X
93451
002
0
2
X
1,288.08
X
93451
26
002
0
2
X
259.95
X
93451
TC
002
0
2
X
1,028.13
X
93451
003
0
2
X
1,288.08
X
93451
26
003
0
2
X
259.95
X
93451
TC
003
0
2
X
1,028.13
X
93451
001
0
2
X
1,452.40
X
93451
26
001
0
2
X
288.39
X
93451
TC
001
0
2
X
1,164.01
X
93452
004
0
2
X
1,437.92
X
93452
26
004
0
2
X
455.80
X
93452
TC
004
0
2
X
982.13
X
93452
002
0
2
X
1,437.92
X
93452
26
002
0
2
X
455.80
X
93452
TC
002
0
2
X
982.13
X
93452
003
0
2
X
1,437.92
X
93452
26
003
0
2
X
455.80
X
93452
TC
003
0
2
X
982.13
X
93452
001
0
2
X
1,618.39
X
93452
26
001
0
2
X
506.40
X
93452
TC
001
0
2
X
1,111.97
X
93453
001
0
2
X
2,117.22
X
93453
26
001
0
2
X
663.08
X
93453
TC
001
0
2
X
1,454.12
X
93453
002
0
2
X
1,881.63
X
93453
26
002
0
2
X
597.31
X
93453
TC
002
0
2
X
1,284.35
X
93453
003
0
2
X
1,881.63
X
93453
26
003
0
2
X
597.31
X
93453
TC
003
0
2
X
1,284.35
X
93453
004
0
2
X
1,881.63
X
93453
26
004
0
2
X
597.31
X
93453
TC
004
0
2
X
1,284.35
X
93454
003
0
2
X
1,482.33
X
93454
26
003
0
2
X
459.34
X
93454
TC
003
0
2
X
1,023.00
X
93454
004
0
2
X
1,482.33
X
93454
26
004
0
2
X
459.34
X
93454
TC
004
0
2
X
1,023.00
X
93454
001
0
2
X
1,668.32
X
93454
26
001
0
2
X
510.08
X
93454
TC
001
0
2
X
1,158.23
X
93454
002
0
2
X
1,482.33
X
93454
26
002
0
2
X
459.34
X
93454
TC
002
0
2
X
1,023.00
X
93455
001
0
2
X
1,945.99
X
93455
26
001
0
2
X
588.26
X
93455
TC
001
0
2
X
1,357.77
X
93455
003
0
2
X
1,729.18
X
93455
26
003
0
2
X
530.03
X
93455
TC
003
0
2
X
1,199.15
X
93455
002
0
2
X
1,729.18
X
93455
26
002
0
2
X
530.03
X
93455
TC
002
0
2
X
1,199.15
X
93455
004
0
2
X
1,729.18
X
93455
26
004
0
2
X
530.03
X
93455
TC
004
0
2
X
1,199.15
X
93456
001
0
2
X
2,087.39
X
93456
26
001
0
2
X
651.88
X
93456
TC
001
0
2
X
1,435.48
X
93456
004
0
2
X
1,855.52
X
93456
26
004
0
2
X
587.67
X
93456
TC
004
0
2
X
1,267.87
X
93456
003
0
2
X
1,855.52
X
93456
26
003
0
2
X
587.67
X
93456
TC
003
0
2
X
1,267.87
X
93456
002
0
2
X
1,855.52
X
93456
26
002
0
2
X
587.67
X
93456
TC
002
0
2
X
1,267.87
X
93457
004
0
2
X
2,102.40
X
93457
26
004
0
2
X
659.08
X
93457
TC
004
0
2
X
1,443.35
X
93457
003
0
2
X
2,102.40
X
93457
26
003
0
2
X
659.08
X
93457
TC
003
0
2
X
1,443.35
X
93457
002
0
2
X
2,102.40
X
93457
26
002
0
2
X
659.08
X
93457
TC
002
0
2
X
1,443.35
X
93457
001
0
2
X
2,365.40
X
93457
26
001
0
2
X
731.35
X
93457
TC
001
0
2
X
1,634.04
X
93458
001
0
2
X
2,013.45
X
93458
26
001
0
2
X
622.30
X
93458
TC
001
0
2
X
1,391.16
X
93458
002
0
2
X
1,789.12
X
93458
26
002
0
2
X
560.46
X
93458
TC
002
0
2
X
1,228.67
X
93458
003
0
2
X
1,789.12
X
93458
26
003
0
2
X
560.46
X
93458
TC
003
0
2
X
1,228.67
X
93458
004
0
2
X
1,789.12
X
93458
26
004
0
2
X
560.46
X
93458
TC
004
0
2
X
1,228.67
X
93459
001
0
2
X
2,223.01
X
93459
26
001
0
2
X
699.48
X
93459
TC
001
0
2
X
1,523.55
X
93459
004
0
2
X
1,976.20
X
93459
26
004
0
2
X
630.52
X
93459
TC
004
0
2
X
1,345.65
X
93459
003
0
2
X
1,976.20
X
93459
26
003
0
2
X
630.52
X
93459
TC
003
0
2
X
1,345.65
X
93459
002
0
2
X
1,976.20
X
93459
26
002
0
2
X
630.52
X
93459
TC
002
0
2
X
1,345.65
X
93460
001
0
2
X
2,379.89
X
93460
26
001
0
2
X
779.22
X
93460
TC
001
0
2
X
1,600.63
X
93460
004
0
2
X
2,116.25
X
93460
26
004
0
2
X
702.44
X
93460
TC
004
0
2
X
1,413.81
X
93460
003
0
2
X
2,116.25
X
93460
26
003
0
2
X
702.44
X
93460
TC
003
0
2
X
1,413.81
X
93460
002
0
2
X
2,116.25
X
93460
26
002
0
2
X
702.44
X
93460
TC
002
0
2
X
1,413.81
X
93461
002
0
2
X
2,423.54
X
93461
26
002
0
2
X
775.13
X
93461
TC
002
0
2
X
1,648.45
X
93461
003
0
2
X
2,423.54
X
93461
26
003
0
2
X
775.13
X
93461
TC
003
0
2
X
1,648.45
X
93461
004
0
2
X
2,423.54
X
93461
26
004
0
2
X
775.13
X
93461
TC
004
0
2
X
1,648.45
X
93461
001
0
2
X
2,726.64
X
93461
26
001
0
2
X
860.25
X
93461
TC
001
0
2
X
1,866.34
X
93462
001
ZZZ
0
X
395.66
X
93462
002
ZZZ
0
X
356.81
X
93462
003
ZZZ
0
X
356.81
X
93462
004
ZZZ
0
X
356.81
X
93463
004
ZZZ
0
X
188.87
X
93463
003
ZZZ
0
X
188.87
X
93463
002
ZZZ
0
X
188.87
X
93463
001
ZZZ
0
X
208.54
X
93464
004
ZZZ
0
X
428.91
X
93464
26
004
ZZZ
0
X
166.43
X
93464
TC
004
ZZZ
0
X
262.45
X
93464
003
ZZZ
0
X
428.91
X
93464
26
003
ZZZ
0
X
166.43
X
93464
TC
003
ZZZ
0
X
262.45
X
93464
002
ZZZ
0
X
428.91
X
93464
26
002
ZZZ
0
X
166.43
X
93464
TC
002
ZZZ
0
X
262.45
X
93464
001
ZZZ
0
X
480.88
X
93464
26
001
ZZZ
0
X
183.65
X
93464
TC
001
ZZZ
0
X
297.18
X
93503
002
0
0
X
694.02
X
93503
003
0
0
X
623.37
X
93503
004
0
0
X
636.24
X
93503
001
0
0
X
667.91
X
93505
002
0
2
X
1,026.80
X
93505
26
002
0
2
X
874.72
X
93505
TC
002
0
2
X
216.74
X
93505
003
0
2
X
967.09
X
93505
26
003
0
2
X
819.99
X
93505
TC
003
0
2
X
197.89
X
93505
004
0
2
X
955.05
X
93505
26
004
0
2
X
855.72
X
93505
TC
004
0
2
X
194.88
X
93505
001
0
2
X
1,041.15
X
93505
26
001
0
2
X
880.83
X
93505
TC
001
0
2
X
221.31
X
93563
001
ZZZ
0
X
104.68
X
93563
002
ZZZ
0
X
97.32
X
93563
003
ZZZ
0
X
97.32
X
93563
004
ZZZ
0
X
97.32
X
93564
003
ZZZ
0
X
99.13
X
93564
001
ZZZ
0
X
106.82
X
93564
002
ZZZ
0
X
99.13
X
93564
004
ZZZ
0
X
99.13
X
93565
001
ZZZ
0
X
80.62
X
93565
002
ZZZ
0
X
74.93
X
93565
003
ZZZ
0
X
74.93
X
93565
004
ZZZ
0
X
74.93
X
93566
002
ZZZ
0
X
285.62
74.93
93566
003
ZZZ
0
X
285.62
74.93
93566
004
ZZZ
0
X
285.62
74.93
93566
001
ZZZ
0
X
319.02
80.62
93567
004
ZZZ
0
X
236.50
84.29
93567
003
ZZZ
0
X
236.50
84.29
93567
002
ZZZ
0
X
236.50
84.29
93567
001
ZZZ
0
X
262.66
90.45
93568
001
ZZZ
0
X
288.11
82.49
93568
004
ZZZ
0
X
258.44
76.70
93568
003
ZZZ
0
X
258.44
76.70
93568
002
ZZZ
0
X
258.44
76.70
93569
003
ZZZ
0
X
43.26
X
93569
002
ZZZ
0
X
43.26
X
93569
004
ZZZ
0
X
43.26
X
93569
001
ZZZ
0
X
46.10
X
93571
004
ZZZ
0
X
618.92
X
93571
26
004
ZZZ
0
X
216.92
X
93571
TC
004
ZZZ
0
X
402.05
X
93571
003
ZZZ
0
X
618.92
X
93571
26
003
ZZZ
0
X
216.92
X
93571
TC
003
ZZZ
0
X
402.05
X
93571
002
ZZZ
0
X
618.92
X
93571
26
002
ZZZ
0
X
216.92
X
93571
TC
002
ZZZ
0
X
402.05
X
93571
001
ZZZ
0
X
714.27
X
93571
26
001
ZZZ
0
X
235.04
X
93571
TC
001
ZZZ
0
X
479.27
X
93572
004
ZZZ
0
X
569.94
X
93572
26
004
ZZZ
0
X
174.15
X
93572
TC
004
ZZZ
0
X
395.87
X
93572
001
ZZZ
0
X
656.29
X
93572
26
001
ZZZ
0
X
188.83
X
93572
TC
001
ZZZ
0
X
467.52
X
93572
002
ZZZ
0
X
569.94
X
93572
26
002
ZZZ
0
X
174.15
X
93572
TC
002
ZZZ
0
X
395.87
X
93572
003
ZZZ
0
X
569.94
X
93572
26
003
ZZZ
0
X
174.15
X
93572
TC
003
ZZZ
0
X
395.87
X
93573
001
ZZZ
0
X
76.84
X
93573
002
ZZZ
0
X
72.10
X
93573
003
ZZZ
0
X
72.10
X
93573
004
ZZZ
0
X
72.10
X
93574
004
ZZZ
0
X
79.54
X
93574
003
ZZZ
0
X
79.54
X
93574
002
ZZZ
0
X
79.54
X
93574
001
ZZZ
0
X
84.67
X
93575
004
ZZZ
0
X
106.40
X
93575
001
ZZZ
0
X
113.34
X
93575
002
ZZZ
0
X
106.40
X
93575
003
ZZZ
0
X
106.40
X
93580
004
0
2
X
2,081.37
X
93580
002
0
2
X
2,081.37
X
93580
003
0
2
X
2,081.37
X
93580
001
0
2
X
2,288.42
X
93581
003
0
2
X
2,789.90
X
93581
002
0
2
X
2,789.90
X
93581
001
0
2
X
3,048.04
X
93581
004
0
2
X
2,789.90
X
93582
004
0
2
X
1,109.02
X
93582
003
0
2
X
1,109.02
X
93582
002
0
2
X
1,109.02
X
93582
001
0
2
X
1,218.19
X
93583
001
0
2
X
1,355.85
X
93583
002
0
2
X
1,234.47
X
93583
003
0
2
X
1,234.47
X
93583
004
0
2
X
1,234.47
X
93584
001
ZZZ
0
X
66.58
X
93584
002
ZZZ
0
X
62.04
X
93584
003
ZZZ
0
X
62.04
X
93584
004
ZZZ
0
X
62.04
X
93585
001
ZZZ
0
X
62.75
X
93585
002
ZZZ
0
X
58.45
X
93585
003
ZZZ
0
X
58.45
X
93585
004
ZZZ
0
X
58.45
X
93586
003
ZZZ
0
X
73.88
X
93586
002
ZZZ
0
X
73.88
X
93586
001
ZZZ
0
X
79.28
X
93586
004
ZZZ
0
X
73.88
X
93587
004
ZZZ
0
X
109.02
X
93587
003
ZZZ
0
X
109.02
X
93587
002
ZZZ
0
X
109.02
X
93587
001
ZZZ
0
X
117.01
X
93588
001
ZZZ
0
X
118.15
X
93588
004
ZZZ
0
X
110.10
X
93588
003
ZZZ
0
X
110.10
X
93588
002
ZZZ
0
X
110.10
X
93590
004
0
2
X
1,847.80
X
93590
002
0
2
X
1,847.80
X
93590
003
0
2
X
1,847.80
X
93590
001
0
2
X
2,022.23
X
93591
001
0
2
X
1,678.50
X
93591
004
0
2
X
1,533.48
X
93591
003
0
2
X
1,533.48
X
93591
002
0
2
X
1,533.48
X
93592
004
ZZZ
0
X
676.08
X
93592
003
ZZZ
0
X
676.08
X
93592
002
ZZZ
0
X
676.08
X
93592
001
ZZZ
0
X
739.63
X
93593
26
001
0
2
X
240.38
X
93593
26
002
0
2
X
226.63
X
93593
26
003
0
2
X
226.63
X
93593
26
004
0
2
X
226.63
X
93594
26
004
0
2
X
356.68
X
93594
26
003
0
2
X
356.68
X
93594
26
002
0
2
X
356.68
X
93594
26
001
0
2
X
379.91
X
93595
26
001
0
2
X
342.93
X
93595
26
003
0
2
X
321.89
X
93595
26
002
0
2
X
321.89
X
93595
26
004
0
2
X
321.89
X
93596
26
002
0
2
X
389.64
X
93596
26
001
0
2
X
413.49
X
93596
26
004
0
2
X
389.64
X
93596
26
003
0
2
X
389.64
X
93597
26
001
0
2
X
553.35
X
93597
26
002
0
2
X
519.45
X
93597
26
003
0
2
X
519.45
X
93597
26
004
0
2
X
519.45
X
93598
26
002
ZZZ
0
X
85.02
X
93598
26
001
ZZZ
0
X
90.75
X
93598
26
003
ZZZ
0
X
85.02
X
93598
26
004
ZZZ
0
X
85.02
X
93600
001
0
0
X
769.53
X
93600
26
001
0
0
X
700.76
X
93600
TC
001
0
0
X
212.00
X
93600
003
0
0
X
708.03
X
93600
26
003
0
0
X
665.61
X
93600
TC
003
0
0
X
191.15
X
93600
004
0
0
X
698.32
X
93600
26
004
0
0
X
664.94
X
93600
TC
004
0
0
X
188.18
X
93600
002
0
0
X
757.66
X
93600
26
002
0
0
X
680.87
X
93600
TC
002
0
0
X
208.04
X
93602
001
0
0
X
540.28
X
93602
26
001
0
0
X
419.53
X
93602
TC
001
0
0
X
120.73
X
93602
003
0
0
X
501.73
X
93602
26
003
0
0
X
423.49
X
93602
TC
003
0
0
X
108.83
X
93602
004
0
0
X
495.31
X
93602
26
004
0
0
X
421.43
X
93602
TC
004
0
0
X
107.12
X
93602
002
0
0
X
532.84
X
93602
26
002
0
0
X
423.85
X
93602
TC
002
0
0
X
118.39
X
93603
003
0
0
X
599.12
X
93603
26
003
0
0
X
719.13
X
93603
TC
003
0
0
X
164.69
X
93603
004
0
0
X
591.09
X
93603
26
004
0
0
X
693.75
X
93603
TC
004
0
0
X
161.98
X
93603
001
0
0
X
647.73
X
93603
26
001
0
0
X
680.27
X
93603
TC
001
0
0
X
182.58
X
93603
002
0
0
X
749.50
X
93603
26
002
0
0
X
674.35
X
93603
TC
002
0
0
X
179.15
X
93609
004
ZZZ
0
X
1,640.11
X
93609
26
004
ZZZ
0
X
1,866.61
X
93609
TC
004
ZZZ
0
X
261.73
X
93609
001
ZZZ
0
X
1,761.51
X
93609
26
001
ZZZ
0
X
1,903.65
X
93609
TC
001
ZZZ
0
X
294.68
X
93609
002
ZZZ
0
X
1,741.69
X
93609
26
002
ZZZ
0
X
1,452.53
X
93609
TC
002
ZZZ
0
X
289.17
X
93609
003
ZZZ
0
X
1,659.70
X
93609
26
003
ZZZ
0
X
1,873.02
X
93609
TC
003
ZZZ
0
X
265.93
X
93610
004
0
0
X
829.47
X
93610
26
004
0
0
X
774.71
X
93610
TC
004
0
0
X
130.37
X
93610
001
0
0
X
853.74
X
93610
26
001
0
0
X
791.95
X
93610
TC
001
0
0
X
147.10
X
93610
002
0
0
X
849.80
X
93610
26
002
0
0
X
789.15
X
93610
TC
002
0
0
X
144.28
X
93610
003
0
0
X
669.66
X
93610
26
003
0
0
X
770.99
X
93610
TC
003
0
0
X
132.51
X
93612
001
0
0
X
867.35
X
93612
26
001
0
0
X
793.27
X
93612
TC
001
0
0
X
176.54
X
93612
002
0
0
X
857.69
X
93612
26
002
0
0
X
784.99
X
93612
TC
002
0
0
X
173.18
X
93612
003
0
0
X
827.54
X
93612
26
003
0
0
X
760.86
X
93612
TC
003
0
0
X
158.98
X
93612
004
0
0
X
689.92
X
93612
26
004
0
0
X
775.92
X
93612
TC
004
0
0
X
156.56
X
93613
26
001
ZZZ
0
X
896.34
X
93613
26
004
ZZZ
0
X
812.42
X
93613
26
003
ZZZ
0
X
812.42
X
93613
26
002
ZZZ
0
X
812.42
X
93615
004
0
0
X
161.55
X
93615
26
004
0
0
X
131.79
X
93615
TC
004
0
0
X
29.83
X
93615
003
0
0
X
163.52
X
93615
26
003
0
0
X
133.27
X
93615
TC
003
0
0
X
30.30
X
93615
002
0
0
X
137.38
X
93615
26
002
0
0
X
138.47
X
93615
TC
002
0
0
X
32.85
X
93615
001
0
0
X
141.19
X
93615
26
001
0
0
X
139.85
X
93615
TC
001
0
0
X
33.42
X
93616
001
0
0
X
338.40
X
93616
26
001
0
0
X
305.01
X
93616
TC
001
0
0
X
33.42
X
93616
003
0
0
X
316.71
X
93616
26
003
0
0
X
286.43
X
93616
TC
003
0
0
X
30.30
X
93616
002
0
0
X
334.25
X
93616
26
002
0
0
X
301.36
X
93616
TC
002
0
0
X
32.85
X
93616
004
0
0
X
312.64
X
93616
26
004
0
0
X
282.87
X
93616
TC
004
0
0
X
29.83
X
93618
004
0
0
X
2,309.96
X
93618
26
004
0
0
X
2,149.79
X
93618
TC
004
0
0
X
381.89
X
93618
003
0
0
X
1,391.59
X
93618
26
003
0
0
X
2,155.40
X
93618
TC
003
0
0
X
387.92
X
93618
002
0
0
X
2,358.96
X
93618
26
002
0
0
X
2,181.93
X
93618
TC
002
0
0
X
422.04
X
93618
001
0
0
X
2,368.75
X
93618
26
001
0
0
X
2,188.33
X
93618
TC
001
0
0
X
430.15
X
93619
002
0
2
X
2,773.82
X
93619
26
002
0
2
X
2,605.81
X
93619
TC
002
0
2
X
820.63
X
93619
003
0
2
X
2,589.57
X
93619
26
003
0
2
X
2,553.64
X
93619
TC
003
0
2
X
754.21
X
93619
004
0
2
X
2,553.73
X
93619
26
004
0
2
X
2,542.88
X
93619
TC
004
0
2
X
742.39
X
93619
001
0
2
X
2,817.74
X
93619
26
001
0
2
X
2,618.30
X
93619
TC
001
0
2
X
836.42
X
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