pbp_a_hnumber	pbp_a_plan_identifier	segment_id	pbp_a_ben_cov	pbp_a_plan_type	orgtype	bid_id	version	pbp_vbid_group_id	pbp_b19b_package_type	pbp_b19b_states_ehc_vbd	pbp_b19b_states_ehc_uf	pbp_b19b_states_uf_other1	pbp_b19b_states_uf_other2	pbp_b19b_states_uf_other3	pbp_b19b_states_uf_other4	pbp_b19b_states_uf_other5	pbp_b19b_states_uf_all_yn	pbp_b19b_states_uf_cmb_yn	pbp_b19b_mmp_yn	pbp_b19b_mmp_ehc	pbp_b19b_add_prereq_yn	pbp_b19b_add_prereq	pbp_b19b_add_nmc_bendesc_cats	pbp_b19b_add_apply_yn	pbp_b19b_add_exempt_yn	pbp_b19b_add_exempt_nmc_cats	pbp_b19b_reim_yn	pbp_b19b_reim_all_cats_yn	pbp_b19b_reim_nmc_bendesc_cats	pbp_b19b_agg_yn	pbp_b19b_agg_amt
H0028	007	0	1	01	01	H0028_007_0	6	1	1	10000000000											2		13d;		1	13d;	2			1	50.00
H0028	007	0	1	01	01	H0028_007_0	6	2	1	00000000001											1	001	13d;		1	13d;	2			1	50.00
H0028	015	0	1	01	01	H0028_015_0	7	1	1	10000000000											2		13d;		1	13d;	2			1	50.00
H0028	015	0	1	01	01	H0028_015_0	7	2	1	00000000001											1	001	13d;		1	13d;	2			1	50.00
H0028	034	0	1	01	01	H0028_034_0	6	1	1	10000000000											2		13d;		1	13d;	2			1	50.00
H0028	034	0	1	01	01	H0028_034_0	6	2	1	00000000001											1	001	13d;		1	13d;	2			1	50.00
H0028	036	0	1	01	01	H0028_036_0	6	1	1	10000000000											2		13d;		1	13d;	2			1	50.00
H0028	036	0	1	01	01	H0028_036_0	6	2	1	00000000001											1	001	13d;		1	13d;	2			1	50.00
H0111	001	0	1	04	01	H0111_001_0	6	1	1	01000110000											1	100	13d;	2	2		2			1	315.00
H0111	002	0	1	04	01	H0111_002_0	6	1	1	01000110000											1	100	13d;	2	2		2			1	315.00
H0321	002	0	1	01	01	H0321_002_0	6	1	1	00000000001											2		13d;		2		2			2	
H0321	004	0	1	01	01	H0321_004_0	6	1	1	00000000001											2		13d;		2		2			2	
H0354	027	0	1	01	01	H0354_027_0	4	1	3												2		13i;		2		2			2	
H0422	001	0	1	02	01	H0422_001_0	5	1	2		00010000000000										2		13c;	2	2		2			2	
H0422	002	0	1	02	01	H0422_002_0	6	1	2		00010000000000										2		13c;	2	2		2			2	
H0423	001	0	1	01	01	H0423_001_0	10	1	3												1	001	10b;		1	10b;	2			2	
H0544	002	0	1	01	01	H0544_002_0	10	1	3												2		13i;		2		2			2	
H0544	003	0	1	01	01	H0544_003_0	10	1	3												2		13i;		2		2			2	
H0544	004	0	1	01	01	H0544_004_0	10	1	3												2		13i;		2		2			2	
H0544	007	0	1	01	01	H0544_007_0	10	1	3												2		13i;		2		2			2	
H0544	008	0	1	01	01	H0544_008_0	10	1	3												2		13i;		2		2			2	
H0544	010	0	1	01	01	H0544_010_0	10	1	3												2		13i;		2		2			2	
H0544	012	0	1	01	01	H0544_012_0	9	1	3												2		13i;		2		2			2	
H0544	013	0	1	01	01	H0544_013_0	10	1	3												2		13i;		2		2			2	
H0544	014	0	1	01	01	H0544_014_0	10	1	3												2		13i;		2		2			2	
H0544	015	0	1	01	01	H0544_015_0	9	1	3												2		13i;		2		2			2	
H0544	019	0	1	01	01	H0544_019_0	10	1	3												2		13i;		2		2			2	
H0544	020	0	1	01	01	H0544_020_0	9	1	3												2		13i;		2		2			2	
H0544	021	0	1	01	01	H0544_021_0	11	1	3												2		13i;		2		2			2	
H0544	024	0	1	01	01	H0544_024_0	9	1	3												2		13i;		2		2			2	
H0544	025	0	1	01	01	H0544_025_0	10	1	3												2		13i;		2		2			2	
H0544	027	0	1	01	01	H0544_027_0	10	1	3												2		13i;		2		2			2	
H0544	031	0	1	01	01	H0544_031_0	11	1	3												2		13i;		2		2			2	
H0544	032	0	1	01	01	H0544_032_0	10	1	3												2		13i;		2		2			2	
H0544	036	0	1	01	01	H0544_036_0	10	1	3												2		13i;		2		2			2	
H0544	037	0	1	01	01	H0544_037_0	9	1	3												2		13i;		2		2			2	
H0544	038	0	1	01	01	H0544_038_0	11	1	3												2		13i;		2		2			2	
H0544	049	0	1	01	01	H0544_049_0	13	1	3												2		13i;		2		2			2	
H0544	058	0	1	01	01	H0544_058_0	8	1	3												2		13i;		2		2			2	
H0544	059	0	1	01	01	H0544_059_0	8	1	3												2		13i;		2		2			2	
H0544	066	0	1	01	01	H0544_066_0	8	1	3												2		13i;		2		2			2	
H0544	067	0	1	01	01	H0544_067_0	9	1	3												2		13i;		2		2			2	
H0544	070	0	1	01	01	H0544_070_0	8	1	3												2		13i;		2		2			2	
H0544	071	0	1	01	01	H0544_071_0	8	1	3												2		13i;		2		2			2	
H0544	072	0	1	01	01	H0544_072_0	10	1	3												2		13i;		2		2			2	
H0544	081	0	1	01	01	H0544_081_0	8	1	3												2		13i;		2		2			2	
H0544	094	0	1	01	01	H0544_094_0	9	1	3												2		13i;		2		2			2	
H0544	095	0	1	01	01	H0544_095_0	9	1	3												2		13i;		2		2			2	
H0545	001	0	1	01	01	H0545_001_0	8	1	2		00110000001000	CVA with Hemiparesis					2	2			1	001	13c;14c;		2		2			2	
H0755	030	0	1	01	01	H0755_030_0	7	1	1	00000000001											2		13d;		2		2			2	
H0755	031	0	1	01	01	H0755_031_0	6	1	1	00000000001											2		13d;		2		2			2	
H0755	033	0	1	01	01	H0755_033_0	6	1	1	00000000001											2		13d;		2		2			2	
H0755	038	0	1	01	01	H0755_038_0	8	1	1	00000000001											1	100	13d;		2		2			2	
H0755	040	1	1	01	01	H0755_040_1	6	1	1	00000000001											1	100	13d;		2		2			2	
H0755	040	2	1	01	01	H0755_040_2	6	1	1	00000000001											1	100	13d;		2		2			2	
H0755	041	1	1	01	01	H0755_041_1	6	1	1	00000000001											1	100	13d;		2		2			2	
H0755	041	2	1	01	01	H0755_041_2	6	1	1	00000000001											1	100	13d;		2		2			2	
H0755	042	1	1	01	01	H0755_042_1	6	1	1	00000000001											1	100	13d;		2		2			2	
H0755	042	2	1	01	01	H0755_042_2	6	1	1	00000000001											1	100	13d;		2		2			2	
H0798	001	0	1	01	01	H0798_001_0	11	1	3												2		13i;		2		2			2	
H1035	018	0	1	01	01	H1035_018_0	10	1	3												1	001	14c;		1	14c;	2			2	
H1035	022	0	1	01	01	H1035_022_0	9	1	3												1	001	10b;13b;13i;14c;		1	10b;13b;13i;14c;	2			2	
H1035	023	0	1	01	01	H1035_023_0	8	1	3												1	001	10b;13b;13i;14c;		1	10b;13b;13i;14c;	2			2	
H1035	024	0	1	01	01	H1035_024_0	8	1	3												1	001	10b;13b;13i;14c;		1	10b;13b;13i;14c;	2			2	
H1035	025	0	1	01	01	H1035_025_0	8	1	3												1	001	10b;13b;13i;14c;		1	10b;13b;13i;14c;	2			2	
H1035	026	0	1	01	01	H1035_026_0	8	1	3												1	001	10b;13b;13i;14c;		1	10b;13b;13i;14c;	2			2	
H1035	033	0	1	01	01	H1035_033_0	8	1	3												1	001	10b;13b;13i;14c;		1	10b;13b;13i;14c;	2			2	
H1035	034	0	1	01	01	H1035_034_0	8	1	3												1	001	10b;13b;13i;14c;		1	10b;13b;13i;14c;	2			2	
H1036	044	0	1	01	01	H1036_044_0	4	1	1	00100000000											1	001	13d;		2		2			2	
H1036	062	0	1	01	01	H1036_062_0	4	1	1	00100000000											1	001	13d;		2		2			2	
H1036	065	0	1	01	01	H1036_065_0	4	1	1	00100000000											1	001	13d;		2		2			2	
H1036	068	0	1	01	01	H1036_068_0	4	1	1	00100000000											1	001	13d;		2		2			2	
H1036	081	0	1	01	01	H1036_081_0	4	1	1	00100000000											1	001	13d;		2		2			2	
H1036	102	0	1	01	01	H1036_102_0	6	1	1	10000000000											2		13d;		1	13d;	2			1	25.00
H1036	102	0	1	01	01	H1036_102_0	6	2	1	00000000001											1	001	13d;		1	13d;	2			1	50.00
H1036	140	0	1	01	01	H1036_140_0	4	1	1	00100000000											1	001	13d;		2		2			2	
H1036	143	0	1	01	01	H1036_143_0	4	1	1	00100000000											1	001	13d;		2		2			2	
H1036	146	0	1	01	01	H1036_146_0	4	1	1	00100000000											1	001	13d;		2		2			2	
H1036	153	0	1	01	01	H1036_153_0	5	1	1	00100000000											1	001	13d;		2		2			2	
H1036	167	0	1	01	01	H1036_167_0	7	1	1	10000000000											2		13d;		1	13d;	2			1	25.00
H1036	167	0	1	01	01	H1036_167_0	7	2	1	00000000001											1	001	13d;		1	13d;	2			1	50.00
H1036	199	0	1	01	01	H1036_199_0	5	1	1	00100000000											1	001	13d;		2		2			2	
H1036	215	0	1	01	01	H1036_215_0	4	1	1	00100000000											1	001	13d;		2		2			2	
H1036	217	0	1	01	01	H1036_217_0	4	1	1	00100000000											1	001	13d;		2		2			2	
H1036	229	0	1	01	01	H1036_229_0	4	1	1	00100000000											1	001	13d;		2		2			2	
H1036	230	0	1	01	01	H1036_230_0	4	1	1	00100000000											1	001	13d;		2		2			2	
H1036	231	0	1	01	01	H1036_231_0	6	1	1	10000000000											2		13d;		2		2			1	25.00
H1036	231	0	1	01	01	H1036_231_0	6	2	1	00000000001											1	001	13d;		2		2			1	50.00
H1036	235	0	1	01	01	H1036_235_0	7	1	1	10000000000											2		13d;		1	13d;	2			1	25.00
H1036	235	0	1	01	01	H1036_235_0	7	2	1	00000000001											1	001	13d;		1	13d;	2			1	50.00
H1036	237	1	1	01	01	H1036_237_1	4	1	1	00100000000											1	001	13d;		2		2			2	
H1036	237	2	1	01	01	H1036_237_2	4	1	1	00100000000											1	001	13d;		2		2			2	
H1036	253	0	1	01	01	H1036_253_0	6	1	1	10000000000											2		13d;		2		2			1	25.00
H1036	253	0	1	01	01	H1036_253_0	6	2	1	00000000001											1	001	13d;		2		2			1	50.00
H1036	277	0	1	01	01	H1036_277_0	4	1	1	00100000000											1	001	13d;		2		2			2	
H1036	280	0	1	01	01	H1036_280_0	3	1	1	10000000000											2		13d;		1	13d;	2			1	25.00
H1036	281	0	1	01	01	H1036_281_0	3	1	1	10000000000											2		13d;		1	13d;	2			1	25.00
H1036	282	0	1	01	01	H1036_282_0	3	1	1	10000000000											2		13d;		1	13d;	2			1	25.00
H1036	283	0	1	01	01	H1036_283_0	3	1	1	10000000000											2		13d;		2		2			1	25.00
H1112	035	0	1	01	01	H1112_035_0	6	1	1	01000110000											1	100	13d;		2		2			1	315.00
H1112	038	0	1	01	01	H1112_038_0	7	1	1	01000110000											1	100	13d;		2		2			1	315.00
H1112	039	0	1	01	01	H1112_039_0	6	1	1	01000110000											1	100	13d;		2		2			1	315.00
H1225	001	0	1	01	01	H1225_001_0	9	1	2		01000000000000										2		14c;		2		2			2	
H1225	002	0	1	01	01	H1225_002_0	9	1	2		01000000000000										2		14c;		2		2			2	
H1304	001	0	1	04	01	H1304_001_0	10	1	2		01000000000000										2		7f;	1	2		2			2	
H1304	001	0	1	04	01	H1304_001_0	10	2	2		00000000001000	Pre-diabetes									2		14c;	1	2		2			2	
H1304	004	0	1	04	01	H1304_004_0	11	1	2		01000000000000										2		7f;	1	2		2			2	
H1304	004	0	1	04	01	H1304_004_0	11	2	2		00000000001000	Pre-diabetes									2		14c;	1	2		2			2	
H1304	011	1	1	04	01	H1304_011_1	11	1	2		01000000000000										2		7f;	1	2		2			2	
H1304	011	1	1	04	01	H1304_011_1	11	2	2		00000000001000	Pre-diabetes									2		14c;	1	2		2			2	
H1304	011	2	1	04	01	H1304_011_2	11	1	2		01000000000000										2		7f;	1	2		2			2	
H1304	011	2	1	04	01	H1304_011_2	11	2	2		00000000001000	Pre-diabetes									2		14c;	1	2		2			2	
H1304	012	1	1	04	01	H1304_012_1	12	1	2		01000000000000										2		7f;	1	2		2			2	
H1304	012	1	1	04	01	H1304_012_1	12	2	2		00000000001000	Pre-diabetes									2		14c;	1	2		2			2	
H1304	012	2	1	04	01	H1304_012_2	12	1	2		01000000000000										2		7f;	1	2		2			2	
H1304	012	2	1	04	01	H1304_012_2	12	2	2		00000000001000	Pre-diabetes									2		14c;	1	2		2			2	
H1304	803	0	1	04	01	H1304_803_0	4	1	2		01000000000000										2		7f;	1	2		2			2	
H1304	803	0	1	04	01	H1304_803_0	4	2	2		00000000001000	Pre-diabetes									2		14c;	1	2		2			2	
H1304	804	0	1	04	01	H1304_804_0	3	1	2		01000000000000										2		7f;	1	2		2			2	
H1304	804	0	1	04	01	H1304_804_0	3	2	2		00000000001000	Pre-diabetes									2		14c;	1	2		2			2	
H1304	805	0	1	04	01	H1304_805_0	3	1	2		01000000000000										2		7f;	1	2		2			2	
H1304	805	0	1	04	01	H1304_805_0	3	2	2		00000000001000	Pre-diabetes									2		14c;	1	2		2			2	
H1304	806	0	1	04	01	H1304_806_0	3	1	2		01000000000000										2		7f;	1	2		2			2	
H1304	806	0	1	04	01	H1304_806_0	3	2	2		00000000001000	Pre-diabetes									2		14c;	1	2		2			2	
H1352	001	0	1	01	01	H1352_001_0	16	1	3												2		13i;		2		2			2	
H1352	002	0	1	01	01	H1352_002_0	16	1	3												2		13i;		2		2			2	
H1365	001	0	1	04	01	H1365_001_0	6	1	2		00000000001100	Opiate Use DIsorder	Chronic Pain Syndrome				2	2			1	001	13a;14c;	1	2		1	1		1	200.00
H1365	001	0	1	04	01	H1365_001_0	6	2	2		01000000000000										1	001	14c;	1	2		2			2	
H1365	001	0	1	04	01	H1365_001_0	6	3	2		00000000001100	History of Falls	Hip Fracture				2	2			1	001	14c;	1	2		1	1		1	250.00
H1365	001	0	1	04	01	H1365_001_0	6	4	3												1	001	13c;13i;	1	2		2			2	
H1365	002	0	1	04	01	H1365_002_0	6	1	2		00000000001100	Opiate Use DIsorder	Chronic Pain Syndrome				2	2			1	001	13a;14c;	1	2		1	1		1	200.00
H1365	002	0	1	04	01	H1365_002_0	6	2	2		01000000000000										1	001	14c;	1	2		2			2	
H1365	002	0	1	04	01	H1365_002_0	6	3	2		00000000001100	History of Falls	Hip Fracture				2	2			1	001	14c;	1	2		1	1		1	250.00
H1365	002	0	1	04	01	H1365_002_0	6	4	3												1	001	13c;13i;	1	2		2			2	
H1416	026	0	1	02	01	H1416_026_0	6	1	1	01000110000											1	100	13d;	2	2		2			1	315.00
H1416	031	0	1	02	01	H1416_031_0	6	1	1	01000110000											1	100	13d;	2	2		2			1	315.00
H1416	032	0	1	02	01	H1416_032_0	6	1	1	01000110000											1	100	13d;	2	2		2			1	315.00
H1416	033	0	1	02	01	H1416_033_0	6	1	1	10000000000											1	100	10b;13c;	2	2		2			2	
H1416	038	0	1	01	01	H1416_038_0	7	1	1	01000110000											1	100	13d;		2		2			1	315.00
H1416	039	0	1	01	01	H1416_039_0	6	1	1	01000110000											1	100	13d;		2		2			1	315.00
H1416	041	0	1	01	01	H1416_041_0	6	1	1	01000110000											1	100	13d;		2		2			1	315.00
H1416	042	0	1	01	01	H1416_042_0	6	1	1	01000110000											1	100	13d;		2		2			1	315.00
H1416	043	0	1	02	01	H1416_043_0	6	1	1	10000000000											1	100	10b;13c;	2	2		2			2	
H1416	055	0	1	01	01	H1416_055_0	6	1	1	01000110000											1	100	13d;		2		2			1	315.00
H1416	056	0	1	01	01	H1416_056_0	6	1	1	01000110000											1	100	13d;		2		2			1	315.00
H1416	057	0	1	01	01	H1416_057_0	6	1	1	01000110000											1	100	13d;		2		2			1	315.00
H1608	027	0	1	04	01	H1608_027_0	4	1	1	00010000000											1	001	13c;	2	2		2			2	
H1609	043	0	1	01	01	H1609_043_0	6	1	3												2		13i;		2		2			2	
H1609	046	0	1	01	01	H1609_046_0	5	1	3												2		13i;		2		2			2	
H1609	048	0	1	01	01	H1609_048_0	5	1	3												2		13i;		2		2			2	
H1644	001	0	1	01	01	H1644_001_0	4	1	2		00000000011100	Behavioral health diagnosis	Documented chronic pain				2	2			2		14c;		2		2			2	
H1947	001	0	1	01	01	H1947_001_0	8	1	3												2		13i;13i-O;		2		2			2	
H1951	033	0	1	01	01	H1951_033_0	6	1	1	10000000000											2		13d;		1	13d;	2			1	50.00
H1951	033	0	1	01	01	H1951_033_0	6	2	1	00000000001											1	001	13d;		1	13d;	2			1	50.00
H1961	003	0	1	01	01	H1961_003_0	4	1	2		00000000010000										2		14c;		1	14c;	2			2	
H1961	014	1	1	01	01	H1961_014_1	5	1	2		00000000010000										2		14c;		1	14c;	2			2	
H1961	014	2	1	01	01	H1961_014_2	5	1	2		00000000010000										2		14c;		1	14c;	2			2	
H1961	017	0	1	02	01	H1961_017_0	5	1	2		00000000010000										2		14c;	2	1	14c;	2			2	
H1969	002	0	1	01	01	H1969_002_0	10	1	2		01000000000000										2		7f;		2		2			2	
H1969	002	0	1	01	01	H1969_002_0	10	2	2		00000000001000	Pre-diabetes									2		14c;		2		2			2	
H1969	004	0	1	01	01	H1969_004_0	10	1	2		01000000000000										2		7f;		2		2			2	
H1969	004	0	1	01	01	H1969_004_0	10	2	2		00000000001000	Pre-diabetes									2		14c;		2		2			2	
H1969	006	0	1	01	01	H1969_006_0	9	1	2		01000000000000										2		7f;		2		2			2	
H1969	006	0	1	01	01	H1969_006_0	9	2	2		00000000001000	Pre-diabetes									2		14c;		2		2			2	
H1969	007	3	1	01	01	H1969_007_3	10	1	2		01000000000000										2		7f;		2		2			2	
H1969	007	3	1	01	01	H1969_007_3	10	2	2		00000000001000	Pre-diabetes									2		14c;		2		2			2	
H1969	007	4	1	01	01	H1969_007_4	11	1	2		01000000000000										2		7f;		2		2			2	
H1969	007	4	1	01	01	H1969_007_4	11	2	2		00000000001000	Pre-diabetes									2		14c;		2		2			2	
H1969	008	1	1	01	01	H1969_008_1	10	1	2		01000000000000										2		7f;		2		2			2	
H1969	008	1	1	01	01	H1969_008_1	10	2	2		00000000001000	Pre-diabetes									2		14c;		2		2			2	
H1969	008	2	1	01	01	H1969_008_2	10	1	2		01000000000000										2		7f;		2		2			2	
H1969	008	2	1	01	01	H1969_008_2	10	2	2		00000000001000	Pre-diabetes									2		14c;		2		2			2	
H1997	002	0	1	01	01	H1997_002_0	11	1	2		01000000000000										2		7f;		2		2			2	
H1997	002	0	1	01	01	H1997_002_0	11	2	2		00000000001000	Pre-diabetes									2		14c;		2		2			2	
H1997	008	0	1	01	01	H1997_008_0	10	1	2		01000000000000										2		7f;		2		2			2	
H1997	008	0	1	01	01	H1997_008_0	10	2	2		00000000001000	Pre-diabetes									2		14c;		2		2			2	
H1997	009	0	1	01	01	H1997_009_0	11	1	2		01000000000000										2		7f;		2		2			2	
H1997	009	0	1	01	01	H1997_009_0	11	2	2		00000000001000	Pre-diabetes									2		14c;		2		2			2	
H1997	010	0	1	01	01	H1997_010_0	11	1	2		01000000000000										2		7f;		2		2			2	
H1997	010	0	1	01	01	H1997_010_0	11	2	2		00000000001000	Pre-diabetes									2		14c;		2		2			2	
H1997	011	0	1	01	01	H1997_011_0	11	1	2		01000000000000										2		7f;		2		2			2	
H1997	011	0	1	01	01	H1997_011_0	11	2	2		00000000001000	Pre-diabetes									2		14c;		2		2			2	
H2256	001	1	1	01	01	H2256_001_1	8	1	2		00110000001100	Pneumonia	Cellulitis				2	2			2		13d;14c;		2		2			2	
H2256	001	2	1	01	01	H2256_001_2	8	1	2		00110000001100	Pneumonia	Cellulitis				2	2			2		13d;14c;		2		2			2	
H2256	001	6	1	01	01	H2256_001_6	8	1	2		00110000001100	Pneumonia	Cellulitis				2	2			2		13d;14c;		2		2			2	
H2256	015	1	1	01	01	H2256_015_1	7	1	2		00110000001100	Pneumonia	Cellulitis				2	2			2		13d;14c;		2		2			2	
H2256	015	2	1	01	01	H2256_015_2	7	1	2		00110000001100	Pneumonia	Cellulitis				2	2			2		13d;14c;		2		2			2	
H2256	015	6	1	01	01	H2256_015_6	7	1	2		00110000001100	Pneumonia	Cellulitis				2	2			2		13d;14c;		2		2			2	
H2256	016	1	1	01	01	H2256_016_1	6	1	2		00110000001100	Pneumonia	Cellulitis				2	2			2		13d;14c;		2		2			2	
H2256	016	2	1	01	01	H2256_016_2	6	1	2		00110000001100	Pneumonia	Cellulitis				2	2			2		13d;14c;		2		2			2	
H2256	018	1	1	01	01	H2256_018_1	7	1	2		00110000001100	Pneumonia	Cellulitis				2	2			2		13d;14c;		2		2			2	
H2256	018	7	1	01	01	H2256_018_7	7	1	2		00110000001100	Pneumonia	Cellulitis				2	2			2		13d;14c;		2		2			2	
H2256	018	8	1	01	01	H2256_018_8	7	1	2		00110000001100	Pneumonia	Cellulitis				2	2			2		13d;14c;		2		2			2	
H2256	019	1	1	01	01	H2256_019_1	6	1	2		00110000001100	Pneumonia	Cellulitis				2	2			2		13d;14c;		2		2			2	
H2256	019	7	1	01	01	H2256_019_7	6	1	2		00110000001100	Pneumonia	Cellulitis				2	2			2		13d;14c;		2		2			2	
H2256	026	1	1	01	01	H2256_026_1	7	1	2		00110000001100	Pneumonia	Cellulitis				2	2			2		13d;14c;		2		2			2	
H2256	026	2	1	01	01	H2256_026_2	7	1	2		00110000001100	Pneumonia	Cellulitis				2	2			2		13d;14c;		2		2			2	
H2256	026	3	1	01	01	H2256_026_3	7	1	2		00110000001100	Pneumonia	Cellulitis				2	2			2		13d;14c;		2		2			2	
H2256	028	0	1	01	01	H2256_028_0	7	1	2		00110000001100	Pneumonia	Cellulitis				2	2			2		13d;14c;		2		2			2	
H2256	033	0	1	01	01	H2256_033_0	7	1	2		00110000001100	Pneumonia	Cellulitis				2	2			2		13d;14c;		2		2			2	
H2256	034	0	1	01	01	H2256_034_0	7	1	2		00110000001100	Pneumonia	Cellulitis				2	2			2		13d;14c;		2		2			2	
H2256	036	0	1	01	01	H2256_036_0	7	1	2		00110000001100	Pneumonia	Cellulitis				2	2			2		13d;14c;		2		2			2	
H2256	039	0	1	01	01	H2256_039_0	6	1	2		00110000001100	Pneumonia	Cellulitis				2	2			2		13d;14c;		2		2			2	
H2256	040	0	1	01	01	H2256_040_0	6	1	2		00110000001100	Pneumonia	Cellulitis				2	2			2		13d;14c;		2		2			2	
H2256	041	0	1	01	01	H2256_041_0	6	1	2		00110000001100	Pneumonia	Cellulitis				2	2			2		13d;14c;		2		2			2	
H2256	042	0	1	01	01	H2256_042_0	6	1	2		00110000001100	Pneumonia	Cellulitis				2	2			2		13d;14c;		2		2			2	
H2422	002	0	1	01	01	H2422_002_0	7	1	3												1	001	10b;13i;14c;		2		2			2	
H2425	001	0	1	01	01	H2425_001_0	8	1	3												2		13i;		1	13i;	2			2	
H2456	002	0	1	01	01	H2456_002_0	6	1	2		00000000001000	History/Risk of Falls									2		14c;		1	14c;	2			2	
H2456	002	0	1	01	01	H2456_002_0	6	2	2		00000000001000	Nursing Home Certifiable									2		14c;		1	14c;	2			2	
H2456	002	0	1	01	01	H2456_002_0	6	3	3												2		10b;		1	10b;	2			2	
H2459	021	1	1	02	01	H2459_021_1	5	1	2		00010000000000										2		13c;	2	1	13c;	2			2	
H2459	021	1	1	02	01	H2459_021_1	5	2	3												2		13a;	2	1	13a;	2			2	
H2486	003	0	1	01	01	H2486_003_0	5	1	1	00100000000											1	001	13d;		2		2			2	
H2491	006	0	1	01	01	H2491_006_0	7	1	1	10000000000											1	100	10b;13c;		2		2			2	
H2491	007	0	1	01	01	H2491_007_0	6	1	1	01000110000											1	100	13d;		2		2			1	315.00
H2491	008	0	1	01	01	H2491_008_0	7	1	1	10000000000											1	100	10b;13c;		2		2			2	
H2563	003	0	1	01	01	H2563_003_0	11	1	3												2		13i;		2		2			2	
H2563	004	0	1	01	01	H2563_004_0	9	1	3												2		13i;		2		2			2	
H2563	005	1	1	01	01	H2563_005_1	11	1	3												2		13i;		2		2			2	
H2563	005	2	1	01	01	H2563_005_2	11	1	3												2		13i;		2		2			2	
H2563	008	0	1	01	01	H2563_008_0	9	1	3												2		13i;		2		2			2	
H2563	009	0	1	01	01	H2563_009_0	9	1	3												2		13i;		2		2			2	
H2563	012	0	1	01	01	H2563_012_0	8	1	3												2		13i;		2		2			2	
H2563	013	0	1	01	01	H2563_013_0	8	1	3												2		13i;		2		2			2	
H2563	014	0	1	01	01	H2563_014_0	8	1	3												2		13i;		2		2			2	
H2593	001	0	1	01	01	H2593_001_0	10	1	3												2		13i;		2		2			2	
H2593	005	0	1	01	01	H2593_005_0	9	1	3												2		13i;		2		2			2	
H2593	006	0	1	01	01	H2593_006_0	9	1	3												2		13i;		2		2			2	
H2593	013	0	1	01	01	H2593_013_0	9	1	3												2		13i;		2		2			2	
H2593	018	0	1	01	01	H2593_018_0	9	1	3												2		13i;		2		2			2	
H2593	020	0	1	01	01	H2593_020_0	11	1	3												2		13i;		2		2			2	
H2593	021	0	1	01	01	H2593_021_0	8	1	3												2		13i;13i-O;		2		2			2	
H2593	022	0	1	01	01	H2593_022_0	7	1	3												2		13i;13i-O;		2		2			2	
H2593	023	0	1	01	01	H2593_023_0	6	1	3												2		13i;13i-O;		2		2			2	
H2593	024	0	1	01	01	H2593_024_0	10	1	3												2		13i;13i-O;		2		2			2	
H2593	025	0	1	01	01	H2593_025_0	7	1	3												2		13i;13i-O;		2		2			2	
H2593	026	0	1	01	01	H2593_026_0	12	1	3												2		13i;13i-O;		2		2			2	
H2593	027	0	1	01	01	H2593_027_0	12	1	3												2		13i;13i-O;		2		2			2	
H2593	028	2	1	01	01	H2593_028_2	14	1	3												2		13i;13i-O;		2		2			2	
H2593	029	0	1	01	01	H2593_029_0	12	1	3												2		13i;13i-O;		2		2			2	
H2593	030	2	1	01	01	H2593_030_2	13	1	3												2		13i;13i-O;		2		2			2	
H2593	030	4	1	01	01	H2593_030_4	13	1	3												2		13i;13i-O;		2		2			2	
H2593	031	0	1	02	01	H2593_031_0	15	1	3												2		13i;13i-O;	2	2		2			2	
H2593	033	0	1	01	01	H2593_033_0	10	1	3												2		13i;13i-O;		2		2			2	
H2593	034	0	1	01	01	H2593_034_0	11	1	3												2		13i;13i-O;		2		2			2	
H2593	035	0	1	01	01	H2593_035_0	11	1	3												2		13i;13i-O;		2		2			2	
H2593	040	0	1	01	01	H2593_040_0	12	1	3												2		13i;		2		2			2	
H2593	041	0	1	01	01	H2593_041_0	9	1	3												2		13i;		2		2			2	
H2610	005	0	1	01	01	H2610_005_0	5	1	3												1	001	13b;		2		2			1	50.00
H2610	006	0	1	01	01	H2610_006_0	5	1	3												1	001	13b;		2		2			1	50.00
H2678	002	0	1	01	01	H2678_002_0	8	1	3												2		13i;		2		2			2	
H2678	004	0	1	01	01	H2678_004_0	8	1	3												2		13i;		2		2			2	
H3132	001	0	1	01	01	H3132_001_0	5	1	2		00000000001000	AIDS-Related Neuropathy									2		14c;		2		2			2	
H3146	001	0	1	01	01	H3146_001_0	3	1	2		00000000001000	Hyperlipidemia									1	001	10b;		1	10b;	2			2	
H3146	001	0	1	01	01	H3146_001_0	3	2	2		00000100000000										1	001	10b;13b;		1	10b;13b;	2			2	
H3227	001	0	1	01	01	H3227_001_0	6	1	3												2		13i;		2		2			2	
H3240	017	0	1	02	01	H3240_017_0	11	1	3												2		13i;13i-O;	2	2		2			2	
H3240	024	0	1	02	01	H3240_024_0	8	1	3												2		13i;	2	2		2			2	
H3288	047	0	1	04	01	H3288_047_0	5	1	2		00000100000000										1	001	10b;13b;	1	1	10b;13b;	2			2	
H3305	007	0	1	02	01	H3305_007_0	9	1	2		00000100000000										2		13b;	2	1	13b;	2			2	
H3305	007	0	1	02	01	H3305_007_0	9	2	2		00001000000000										2		14c;	2	1	14c;	2			1	250.00
H3305	015	0	1	02	01	H3305_015_0	11	1	2		00000100000000										2		13b;	2	1	13b;	2			2	
H3305	015	0	1	02	01	H3305_015_0	11	2	2		00001000000000										2		14c;	2	1	14c;	2			1	250.00
H3305	020	0	1	02	01	H3305_020_0	9	1	2		00000100000000										2		13b;	2	1	13b;	2			2	
H3305	020	0	1	02	01	H3305_020_0	9	2	2		00001000000000										2		14c;	2	1	14c;	2			1	250.00
H3305	021	0	1	02	01	H3305_021_0	10	1	2		00000100000000										2		13b;	2	1	13b;	2			2	
H3305	021	0	1	02	01	H3305_021_0	10	2	2		00001000000000										2		14c;	2	1	14c;	2			1	250.00
H3305	022	0	1	02	01	H3305_022_0	9	1	2		00000100000000										2		13b;	2	1	13b;	2			2	
H3305	022	0	1	02	01	H3305_022_0	9	2	2		00001000000000										2		14c;	2	1	14c;	2			1	250.00
H3305	030	0	1	02	01	H3305_030_0	10	1	2		00000100000000										2		13b;	2	1	13b;	2			2	
H3305	030	0	1	02	01	H3305_030_0	10	2	2		00001000000000										2		14c;	2	1	14c;	2			1	250.00
H3305	032	0	1	02	01	H3305_032_0	8	1	2		00000100000000										2		13b;	2	1	13b;	2			2	
H3305	032	0	1	02	01	H3305_032_0	8	2	2		00001000000000										2		14c;	2	1	14c;	2			1	250.00
H3307	002	0	1	01	01	H3307_002_0	5	1	1	00000000001											1	100	13d;		2		2			2	
H3307	012	0	1	01	01	H3307_012_0	6	1	1	00000000001											1	100	13d;		2		2			2	
H3307	015	0	1	01	01	H3307_015_0	6	1	1	00000000001											1	100	13d;		2		2			2	
H3307	023	0	1	01	01	H3307_023_0	5	1	1	00000000001											1	100	13d;		2		2			2	
H3307	025	0	1	01	01	H3307_025_0	6	1	1	00000000001											1	100	13d;		2		2			2	
H3359	034	0	1	01	01	H3359_034_0	8	1	3												2		13i;		1	13i;	2			1	0.00
H3388	001	0	1	01	01	H3388_001_0	10	1	1	01011111011											1	011	13d;		2		2			2	
H3388	002	0	1	01	01	H3388_002_0	14	1	1	01011111011											1	011	13d;		2		2			2	
H3388	004	0	1	01	01	H3388_004_0	15	1	1	01011111011											1	011	13d;		2		2			2	
H3388	013	0	1	01	01	H3388_013_0	15	1	1	01011111011											1	011	13d;		2		2			2	
H3388	014	0	1	01	01	H3388_014_0	18	1	1	01010111011											1	011	13d;		2		2			2	
H3447	011	0	1	01	01	H3447_011_0	8	1	3												2		13i;13i-O;		2		2			2	
H3447	012	0	1	01	01	H3447_012_0	8	1	3												2		13i;13i-O;		2		2			2	
H3447	013	0	1	01	01	H3447_013_0	7	1	3												2		13i;13i-O;		2		2			2	
H3447	018	0	1	01	01	H3447_018_0	7	1	3												2		13i;13i-O;		2		2			2	
H3447	019	0	1	01	01	H3447_019_0	7	1	3												2		13i;13i-O;		2		2			2	
H3447	020	0	1	01	01	H3447_020_0	9	1	3												2		13i;13i-O;		2		2			2	
H3447	021	0	1	01	01	H3447_021_0	6	1	3												2		13i;13i-O;		2		2			2	
H3447	022	0	1	01	01	H3447_022_0	6	1	3												2		13i;13i-O;		2		2			2	
H3447	023	0	1	01	01	H3447_023_0	6	1	3												2		13i;13i-O;		2		2			2	
H3447	024	0	1	01	01	H3447_024_0	6	1	3												2		13i;13i-O;		2		2			2	
H3447	025	0	1	01	01	H3447_025_0	6	1	3												2		13i;13i-O;		2		2			2	
H3447	027	0	1	01	01	H3447_027_0	6	1	3												2		13i;13i-O;		2		2			2	
H3447	028	0	1	01	01	H3447_028_0	6	1	3												2		13i;13i-O;		2		2			2	
H3447	029	0	1	01	01	H3447_029_0	8	1	3												2		13i;		2		2			2	
H3533	002	0	1	01	01	H3533_002_0	5	1	1	10000000000											2		13d;		1	13d;	2			1	25.00
H3533	002	0	1	01	01	H3533_002_0	5	2	1	00000000001											1	001	13d;		1	13d;	2			1	50.00
H3533	029	1	1	01	01	H3533_029_1	7	1	1	10000000000											2		13d;		1	13d;	2			1	25.00
H3533	029	1	1	01	01	H3533_029_1	7	2	1	00000000001											1	001	13d;		1	13d;	2			1	50.00
H3533	029	2	1	01	01	H3533_029_2	6	1	1	10000000000											2		13d;		1	13d;	2			1	25.00
H3533	029	2	1	01	01	H3533_029_2	6	2	1	00000000001											1	001	13d;		1	13d;	2			1	50.00
H3557	001	0	1	04	01	H3557_001_0	7	1	3												2		16b;	1	2		2			2	
H3632	001	0	1	04	01	H3632_001_0	11	1	3												2		13i;	1	2		2			2	
H3655	032	0	1	01	01	H3655_032_0	6	1	3												2		13i;13i-O;		2		2			2	
H3655	033	0	1	01	01	H3655_033_0	7	1	3												2		13i;13i-O;		2		2			2	
H3655	038	0	1	01	01	H3655_038_0	6	1	3												2		13i;13i-O;		2		2			2	
H3655	040	0	1	01	01	H3655_040_0	6	1	3												2		13i;13i-O;		2		2			2	
H3655	041	0	1	01	01	H3655_041_0	6	1	3												2		13i;13i-O;		2		2			2	
H3660	028	0	1	02	01	H3660_028_0	6	1	2		00000000001111	Hip Replacement	Knee Replacement	Femur Fracture	Falls or History of Falls		2	2			2		14c;	2	2		2			2	
H3660	029	0	1	02	01	H3660_029_0	5	1	2		00000000001111	Hip Replacement	Knee Replacement	Femur Fracture	Falls or History of Falls		2	2			2		14c;	2	2		2			2	
H3660	044	0	1	01	01	H3660_044_0	5	1	2		00000000001111	Hip Replacement	Knee Replacement	Femur Fracture	Falls or History of Falls		2	2			2		14c;		2		2			2	
H3660	047	0	1	01	01	H3660_047_0	5	1	2		00000000001111	Hip Replacement	Knee Replacement	Femur Fracture	Falls or History of Falls		2	2			2		14c;		2		2			2	
H3660	048	0	1	02	01	H3660_048_0	5	1	2		00000000001111	Hip Replacement	Knee Replacement	Femur Fracture	Falls or History of Falls		2	2			2		14c;	2	2		2			2	
H3660	050	0	1	01	01	H3660_050_0	5	1	2		00000000001111	Hip Replacement	Knee Replacement	Femur Fracture	Falls or History of Falls		2	2			2		14c;		2		2			2	
H3660	052	1	1	01	01	H3660_052_1	4	1	2		00000000001111	Hip Replacement	Knee Replacement	Femur Fracture	Falls or History of Falls		2	2			2		14c;		2		2			2	
H3660	052	2	1	01	01	H3660_052_2	4	1	2		00000000001111	Hip Replacement	Knee Replacement	Femur Fracture	Falls or History of Falls		2	2			2		14c;		2		2			2	
H3660	053	1	1	01	01	H3660_053_1	5	1	2		00000000001111	Hip Replacement	Knee Replacement	Femur Fracture	Falls or History of Falls		2	2			2		14c;		2		2			2	
H3660	053	2	1	01	01	H3660_053_2	5	1	2		00000000001111	Hip Replacement	Knee Replacement	Femur Fracture	Falls or History of Falls		2	2			2		14c;		2		2			2	
H3706	001	0	1	01	01	H3706_001_0	7	1	2		01110110001000	Blindness					2	2			2		10b;13c;		2		2			2	
H3706	009	0	1	01	01	H3706_009_0	6	1	2		01110110001000	Blindness					2	2			2		10b;13c;		2		2			2	
H3706	018	0	1	01	01	H3706_018_0	9	1	2		01110110001000	Blindness					2	2			2		10b;13c;		2		2			2	
H3800	001	0	1	01	01	H3800_001_0	15	1	3												2		13i;		2		2			2	
H3815	008	0	1	01	01	H3815_008_0	5	1	3												2		13i;		2		2			2	
H3815	009	0	1	01	01	H3815_009_0	5	1	3												2		13i;		2		2			2	
H3815	010	0	1	01	01	H3815_010_0	4	1	3												2		13i;		2		2			2	
H3815	011	0	1	01	01	H3815_011_0	4	1	3												2		13i;		2		2			2	
H3815	016	0	1	01	01	H3815_016_0	5	1	3												2		13i;		2		2			2	
H3815	018	0	1	01	01	H3815_018_0	6	1	3												2		13i;		2		2			2	
H3817	008	1	1	04	01	H3817_008_1	11	1	2		01000000000000										2		7f;	1	2		2			2	
H3817	008	1	1	04	01	H3817_008_1	11	2	2		00000000001000	Pre-diabetes									2		14c;	1	2		2			2	
H3817	008	2	1	04	01	H3817_008_2	12	1	2		01000000000000										2		7f;	1	2		2			2	
H3817	008	2	1	04	01	H3817_008_2	12	2	2		00000000001000	Pre-diabetes									2		14c;	1	2		2			2	
H3817	009	1	1	04	01	H3817_009_1	11	1	2		01000000000000										2		7f;	1	2		2			2	
H3817	009	1	1	04	01	H3817_009_1	11	2	2		00000000001000	Pre-diabetes									2		14c;	1	2		2			2	
H3817	009	2	1	04	01	H3817_009_2	11	1	2		01000000000000										2		7f;	1	2		2			2	
H3817	009	2	1	04	01	H3817_009_2	11	2	2		00000000001000	Pre-diabetes									2		14c;	1	2		2			2	
H3817	010	0	1	04	01	H3817_010_0	10	1	2		01000000000000										2		7f;	1	2		2			2	
H3817	010	0	1	04	01	H3817_010_0	10	2	2		00000000001000	Pre-diabetes									2		14c;	1	2		2			2	
H3817	011	1	1	04	01	H3817_011_1	11	1	2		01000000000000										2		7f;	1	2		2			2	
H3817	011	1	1	04	01	H3817_011_1	11	2	2		00000000001000	Pre-diabetes									2		14c;	1	2		2			2	
H3817	011	2	1	04	01	H3817_011_2	11	1	2		01000000000000										2		7f;	1	2		2			2	
H3817	011	2	1	04	01	H3817_011_2	11	2	2		00000000001000	Pre-diabetes									2		14c;	1	2		2			2	
H3817	801	0	1	04	01	H3817_801_0	3	1	2		01000000000000										2		7f;	1	2		2			2	
H3817	801	0	1	04	01	H3817_801_0	3	2	2		00000000001000	Pre-diabetes									2		14c;	1	2		2			2	
H3817	802	0	1	04	01	H3817_802_0	3	1	2		01000000000000										2		7f;	1	2		2			2	
H3817	802	0	1	04	01	H3817_802_0	3	2	2		00000000001000	Pre-diabetes									2		14c;	1	2		2			2	
H3817	803	0	1	04	01	H3817_803_0	3	1	2		01000000000000										2		7f;	1	2		2			2	
H3817	803	0	1	04	01	H3817_803_0	3	2	2		00000000001000	Pre-diabetes									2		14c;	1	2		2			2	
H3817	804	0	1	04	01	H3817_804_0	3	1	2		01000000000000										2		7f;	1	2		2			2	
H3817	804	0	1	04	01	H3817_804_0	3	2	2		00000000001000	Pre-diabetes									2		14c;	1	2		2			2	
H3832	011	0	1	04	01	H3832_011_0	6	1	2		01001010001000	Pregnancy					2	2			2		16a;16b;	1	2		2			2	
H3832	011	0	1	04	01	H3832_011_0	6	2	2		00000000001110	Oral Cancer	Sjorgens	Head and Neck Cancer			2	2			2		16a;16b;	1	2		2			2	
H3890	001	0	1	04	01	H3890_001_0	10	1	2		01000000000000										2		14c;	1	2		2			2	
H3890	002	0	1	04	01	H3890_002_0	10	1	2		01000000000000										2		14c;	1	2		2			2	
H3890	004	0	1	04	01	H3890_004_0	11	1	2		01000000000000										2		14c;	1	2		2			2	
H3907	002	0	1	01	01	H3907_002_0	12	1	2		01110000000000						1				2		13c;		1	13c;	2			2	
H3907	006	0	1	01	01	H3907_006_0	14	1	2		01110000000000						1				2		13c;		1	13c;	2			2	
H3907	029	0	1	01	01	H3907_029_0	12	1	2		01110000000000						1				2		13c;		1	13c;	2			2	
H3907	037	0	1	01	01	H3907_037_0	12	1	2		01110000000000						1				2		13c;		1	13c;	2			2	
H3907	044	0	1	01	01	H3907_044_0	8	1	2		01110000000000						1				2		13c;		1	13c;	2			2	
H3907	045	0	1	01	01	H3907_045_0	9	1	2		01110000000000						1				2		13c;		1	13c;	2			2	
H3907	046	0	1	01	01	H3907_046_0	8	1	2		01110000000000						1				2		13c;		1	13c;	2			2	
H3907	047	0	1	01	01	H3907_047_0	8	1	2		01110000000000						1				2		13c;		1	13c;	2			2	
H3907	048	0	1	01	01	H3907_048_0	8	1	2		01110000000000						1				2		13c;		1	13c;	2			2	
H3907	049	0	1	01	01	H3907_049_0	8	1	2		01110000000000						1				2		13c;		1	13c;	2			2	
H3907	050	0	1	01	01	H3907_050_0	8	1	2		01110000000000						1				2		13c;		1	13c;	2			2	
H3907	051	0	1	01	01	H3907_051_0	8	1	2		01110000000000						1				2		13c;		1	13c;	2			2	
H3907	052	0	1	01	01	H3907_052_0	9	1	2		01110000000000						1				2		13c;		1	13c;	2			2	
H3924	059	13	1	04	01	H3924_059_13	5	1	3												1	001	13c;13i;14c;	1	2		2			1	1000.00
H3924	059	14	1	04	01	H3924_059_14	5	1	3												1	001	13c;13i;14c;	1	2		2			1	1000.00
H3924	059	15	1	04	01	H3924_059_15	5	1	3												1	001	13c;13i;14c;	1	2		2			1	1000.00
H3924	059	16	1	04	01	H3924_059_16	5	1	3												1	001	13c;13i;14c;	1	2		2			1	1000.00
H3924	059	17	1	04	01	H3924_059_17	5	1	3												1	001	13c;13i;14c;	1	2		2			1	1000.00
H3924	059	18	1	04	01	H3924_059_18	5	1	3												1	001	13c;13i;14c;	1	2		2			1	1000.00
H3924	060	13	1	04	01	H3924_060_13	7	1	3												1	001	13c;13i;14c;	1	2		2			1	1000.00
H3924	060	14	1	04	01	H3924_060_14	7	1	3												1	001	13c;13i;14c;	1	2		2			1	1000.00
H3924	060	15	1	04	01	H3924_060_15	6	1	3												1	001	13c;13i;14c;	1	2		2			1	1000.00
H3924	060	16	1	04	01	H3924_060_16	7	1	3												1	001	13c;13i;14c;	1	2		2			1	1000.00
H3924	060	17	1	04	01	H3924_060_17	6	1	3												1	001	13c;13i;14c;	1	2		2			1	1000.00
H3924	060	18	1	04	01	H3924_060_18	6	1	3												1	001	13c;13i;14c;	1	2		2			1	1000.00
H3924	062	13	1	04	01	H3924_062_13	5	1	3												1	001	13c;13i;14c;	1	2		2			1	1000.00
H3924	062	14	1	04	01	H3924_062_14	5	1	3												1	001	13c;13i;14c;	1	2		2			1	1000.00
H3924	062	15	1	04	01	H3924_062_15	4	1	3												1	001	13c;13i;14c;	1	2		2			1	1000.00
H3924	062	16	1	04	01	H3924_062_16	5	1	3												1	001	13c;13i;14c;	1	2		2			1	1000.00
H3924	062	17	1	04	01	H3924_062_17	4	1	3												1	001	13c;13i;14c;	1	2		2			1	1000.00
H3924	062	18	1	04	01	H3924_062_18	4	1	3												1	001	13c;13i;14c;	1	2		2			1	1000.00
H3930	001	0	1	01	01	H3930_001_0	8	1	2		00000000001111	Hip Replacement	Knee Replacement	Femur Fracture	Falls or History of Falls		2	2			2		14c;		2		2			2	
H3930	002	0	1	01	01	H3930_002_0	8	1	2		00000000001111	Hip Replacement	Knee Replacement	Femur Fracture	Falls or History of Falls		2	2			2		14c;		2		2			2	
H3949	024	0	1	01	01	H3949_024_0	4	1	3												2		13i;		2		2			2	
H3952	008	0	1	01	01	H3952_008_0	6	1	2		01010000000000						1				1	001	13c;		2		2			2	
H3952	020	0	1	01	01	H3952_020_0	7	1	2		01010000000000						1				1	001	13c;		2		2			2	
H3952	044	0	1	01	01	H3952_044_0	6	1	2		01010000000000						1				1	001	13c;		2		2			2	
H3952	045	0	1	01	01	H3952_045_0	7	1	2		01010000000000						1				1	001	13c;		2		2			2	
H3952	048	0	1	01	01	H3952_048_0	10	1	2		01010000000000						1				1	001	13c;		2		2			2	
H3952	049	0	1	01	01	H3952_049_0	8	1	2		01010000000000						1				1	001	13c;		2		2			2	
H3952	050	0	1	01	01	H3952_050_0	7	1	2		01010000000000						1				1	001	13c;		2		2			2	
H3952	051	0	1	01	01	H3952_051_0	7	1	2		01010000000000						1				1	001	13c;		2		2			2	
H3952	053	0	1	02	01	H3952_053_0	6	1	2		01010000000000						1				1	001	13c;	2	2		2			2	
H3952	054	0	1	02	01	H3952_054_0	7	1	2		01010000000000						1				1	001	13c;	2	2		2			2	
H3952	055	0	1	01	01	H3952_055_0	7	1	2		01010000000000						1				1	001	13c;		2		2			2	
H3952	056	0	1	01	01	H3952_056_0	7	1	2		01010000000000						1				1	001	13c;		2		2			2	
H3954	097	0	1	01	01	H3954_097_0	5	1	3												1	001	13c;13i;14c;		2		2			1	3000.00
H3954	156	13	1	01	01	H3954_156_13	3	1	3												1	001	13c;13i;14c;		2		2			1	1000.00
H3954	156	14	1	01	01	H3954_156_14	4	1	3												1	001	13c;13i;14c;		2		2			1	1000.00
H3954	156	15	1	01	01	H3954_156_15	3	1	3												1	001	13c;13i;14c;		2		2			1	1000.00
H3954	156	16	1	01	01	H3954_156_16	3	1	3												1	001	13c;13i;14c;		2		2			1	1000.00
H3954	156	17	1	01	01	H3954_156_17	3	1	3												1	001	13c;13i;14c;		2		2			1	1000.00
H3954	156	18	1	01	01	H3954_156_18	3	1	3												1	001	13c;13i;14c;		2		2			1	1000.00
H3954	157	13	1	01	01	H3954_157_13	5	1	3												1	001	13c;13i;14c;		2		2			1	1000.00
H3954	157	14	1	01	01	H3954_157_14	6	1	3												1	001	13c;13i;14c;		2		2			1	1000.00
H3954	157	15	1	01	01	H3954_157_15	5	1	3												1	001	13c;13i;14c;		2		2			1	1000.00
H3954	157	16	1	01	01	H3954_157_16	5	1	3												1	001	13c;13i;14c;		2		2			1	1000.00
H3954	157	17	1	01	01	H3954_157_17	5	1	3												1	001	13c;13i;14c;		2		2			1	1000.00
H3954	157	18	1	01	01	H3954_157_18	5	1	3												1	001	13c;13i;14c;		2		2			1	1000.00
H3954	158	13	1	01	01	H3954_158_13	6	1	3												1	001	13c;13i;14c;		2		2			1	1000.00
H3954	158	14	1	01	01	H3954_158_14	6	1	3												1	001	13c;13i;14c;		2		2			1	1000.00
H3954	158	15	1	01	01	H3954_158_15	6	1	3												1	001	13c;13i;14c;		2		2			1	1000.00
H3954	158	16	1	01	01	H3954_158_16	6	1	3												1	001	13c;13i;14c;		2		2			1	1000.00
H3954	158	17	1	01	01	H3954_158_17	6	1	3												1	001	13c;13i;14c;		2		2			1	1000.00
H3954	158	18	1	01	01	H3954_158_18	6	1	3												1	001	13c;13i;14c;		2		2			1	1000.00
H3954	159	13	1	01	01	H3954_159_13	6	1	3												1	001	13c;13i;14c;		2		2			1	1000.00
H3954	159	14	1	01	01	H3954_159_14	6	1	3												1	001	13c;13i;14c;		2		2			1	1000.00
H3954	159	15	1	01	01	H3954_159_15	6	1	3												1	001	13c;13i;14c;		2		2			1	1000.00
H3954	159	16	1	01	01	H3954_159_16	7	1	3												1	001	13c;13i;14c;		2		2			1	1000.00
H3954	159	17	1	01	01	H3954_159_17	6	1	3												1	001	13c;13i;14c;		2		2			1	1000.00
H3954	159	18	1	01	01	H3954_159_18	6	1	3												1	001	13c;13i;14c;		2		2			1	1000.00
H3954	160	0	1	01	01	H3954_160_0	5	1	3												1	001	13c;13i;14c;		2		2			1	1000.00
H3957	031	0	1	02	01	H3957_031_0	5	1	1	01000000000											1	011	16b;	2	2		2			2	
H3957	031	0	1	02	01	H3957_031_0	5	2	1	00100000000											1	011	16b;	2	2		2			2	
H3957	031	0	1	02	01	H3957_031_0	5	3	1	00000000001											1	011	13d;	2	2		2			2	
H3959	001	0	1	01	01	H3959_001_0	5	1	1	00010000000											1	001	10b;13c;		2		2			2	
H3959	002	0	1	01	01	H3959_002_0	3	1	1	00010000000											1	001	10b;13c;		2		2			2	
H3959	010	0	1	01	01	H3959_010_0	3	1	2		00000000001000	Hyperlipidemia									1	001	10b;		1	10b;	2			2	
H3959	010	0	1	01	01	H3959_010_0	3	2	2		00000100000000										1	001	10b;13b;		1	10b;13b;	2			2	
H3959	032	0	1	01	01	H3959_032_0	3	1	2		00000000001000	Hyperlipidemia									1	001	10b;		1	10b;	2			2	
H3959	032	0	1	01	01	H3959_032_0	3	2	2		00000100000000										1	001	10b;13b;		1	10b;13b;	2			2	
H3959	046	0	1	01	01	H3959_046_0	3	1	2		00000000001000	Hyperlipidemia									1	001	10b;		1	10b;	2			2	
H3959	046	0	1	01	01	H3959_046_0	3	2	2		00000100000000										1	001	10b;13b;		1	10b;13b;	2			2	
H3959	047	0	1	01	01	H3959_047_0	3	1	2		00000000001000	Hyperlipidemia									1	001	10b;		1	10b;	2			2	
H3959	047	0	1	01	01	H3959_047_0	3	2	2		00000100000000										1	001	10b;13b;		1	10b;13b;	2			2	
H3959	049	0	1	01	01	H3959_049_0	3	1	2		00000000001000	Hyperlipidemia									1	001	10b;		1	10b;	2			2	
H3959	049	0	1	01	01	H3959_049_0	3	2	2		00000100000000										1	001	10b;13b;		1	10b;13b;	2			2	
H4003	009	0	1	01	01	H4003_009_0	10	1	2		01110010001000	Cardiovascular Disorders					2	2			1	001	14c;		2		2			2	
H4003	017	0	1	01	01	H4003_017_0	12	1	2		01110010001000	Cardiovascular Disorders					2	2			1	001	14c;		2		2			2	
H4003	019	0	1	02	01	H4003_019_0	8	1	2		01110010001000	Cardiovascular Disorders					2	2			1	001	14c;	2	2		2			2	
H4003	034	0	1	02	01	H4003_034_0	8	1	2		01110010001000	Cardiovascular Disorders					2	2			1	001	14c;	2	2		2			2	
H4003	041	0	1	01	01	H4003_041_0	10	1	2		01110010001000	Cardiovascular Disorders					2	2			1	001	14c;		2		2			2	
H4003	044	0	1	02	01	H4003_044_0	8	1	2		01110010001000	Cardiovascular Disorders					2	2			1	001	14c;	2	2		2			2	
H4003	045	0	1	02	01	H4003_045_0	9	1	2		01110010001000	Cardiovascular Disorders					2	2			1	001	14c;	2	2		2			2	
H4003	047	0	1	01	01	H4003_047_0	7	1	2		01110010001000	Cardiovascular Disorders					2	2			1	001	14c;		2		2			2	
H4003	049	0	1	01	01	H4003_049_0	8	1	2		01110010001000	Cardiovascular Disorders					2	2			1	001	14c;		2		2			2	
H4003	049	0	1	01	01	H4003_049_0	8	2	3												2		13i;		2		2			2	
H4004	048	0	1	01	01	H4004_048_0	10	1	2		01110010001000	Cardiovascular Disorders					2	2			1	001	14c;		2		2			2	
H4004	048	0	1	01	01	H4004_048_0	10	2	3												2		13i;		2		2			2	
H4004	056	0	1	02	01	H4004_056_0	10	1	2		01110010001000	Cardiovascular Disorders					2	2			1	001	14c;	2	2		2			2	
H4004	061	0	1	01	01	H4004_061_0	10	1	2		01110010001000	Cardiovascular Disorders					2	2			1	001	14c;		2		2			2	
H4093	001	0	1	01	01	H4093_001_0	15	1	3												2		13i;		2		2			2	
H4141	015	0	1	01	01	H4141_015_0	4	1	1	00100000000											1	001	13d;		2		2			2	
H4152	005	0	1	01	01	H4152_005_0	7	1	3												2		16b;		2		2			2	
H4152	007	0	1	02	01	H4152_007_0	7	1	3												2		16b;	2	2		2			2	
H4152	013	0	1	01	01	H4152_013_0	7	1	3												2		16b;		2		2			2	
H4152	018	0	1	02	01	H4152_018_0	8	1	3												2		16b;	2	2		2			2	
H4152	020	0	1	02	01	H4152_020_0	6	1	3												2		16b;	2	2		2			2	
H4236	001	0	1	01	01	H4236_001_0	8	1	2		00000000001111	Hip Replacement	Knee Replacement	Femur Fracture	Falls or History of Falls		2	2			2		14c;		2		2			2	
H4236	002	0	1	01	01	H4236_002_0	8	1	2		00000000001111	Hip Replacement	Knee Replacement	Femur Fracture	Falls or History of Falls		2	2			2		14c;		2		2			2	
H4346	005	0	1	01	01	H4346_005_0	9	1	3												2		13i;		2		2			2	
H4346	006	0	1	01	01	H4346_006_0	11	1	3												2		13i;		2		2			2	
H4346	008	0	1	01	01	H4346_008_0	9	1	3												2		13i;		2		2			2	
H4346	022	0	1	01	01	H4346_022_0	10	1	3												2		13i;		2		2			2	
H4513	009	0	1	01	01	H4513_009_0	3	1	3												1	001	13i;		2		2			1	150.00
H4513	025	0	1	01	01	H4513_025_0	5	1	3												1	001	13i;		2		2			1	150.00
H4513	026	0	1	01	01	H4513_026_0	4	1	3												1	001	13i;		2		2			1	150.00
H4513	028	0	1	01	01	H4513_028_0	5	1	3												1	001	13i;		2		2			1	150.00
H4605	001	0	1	04	01	H4605_001_0	9	1	2		01000000000000										2		7f;	1	2		2			2	
H4605	001	0	1	04	01	H4605_001_0	9	2	2		00000000001000	Pre-diabetes									2		14c;	1	2		2			2	
H4605	002	0	1	04	01	H4605_002_0	11	1	2		01000000000000										2		7f;	1	2		2			2	
H4605	002	0	1	04	01	H4605_002_0	11	2	2		00000000001000	Pre-diabetes									2		14c;	1	2		2			2	
H4605	004	0	1	04	01	H4605_004_0	11	1	2		01000000000000										2		7f;	1	2		2			2	
H4605	004	0	1	04	01	H4605_004_0	11	2	2		00000000001000	Pre-diabetes									2		14c;	1	2		2			2	
H4605	007	0	1	04	01	H4605_007_0	11	1	2		01000000000000										2		7f;	1	2		2			2	
H4605	007	0	1	04	01	H4605_007_0	11	2	2		00000000001000	Pre-diabetes									2		14c;	1	2		2			2	
H4605	801	0	1	04	01	H4605_801_0	3	1	2		01000000000000										2		7f;	1	2		2			2	
H4605	801	0	1	04	01	H4605_801_0	3	2	2		00000000001000	Pre-diabetes									2		14c;	1	2		2			2	
H4605	802	0	1	04	01	H4605_802_0	3	1	2		01000000000000										2		7f;	1	2		2			2	
H4605	802	0	1	04	01	H4605_802_0	3	2	2		00000000001000	Pre-diabetes									2		14c;	1	2		2			2	
H4605	803	0	1	04	01	H4605_803_0	3	1	2		01000000000000										2		7f;	1	2		2			2	
H4605	803	0	1	04	01	H4605_803_0	3	2	2		00000000001000	Pre-diabetes									2		14c;	1	2		2			2	
H4605	804	0	1	04	01	H4605_804_0	3	1	2		01000000000000										2		7f;	1	2		2			2	
H4605	804	0	1	04	01	H4605_804_0	3	2	2		00000000001000	Pre-diabetes									2		14c;	1	2		2			2	
H4778	001	0	1	01	01	H4778_001_0	8	1	2		00000000001111	Hip Replacement	Knee Replacement	Femur Fracture	Falls or History of Falls		2	2			2		14c;		2		2			2	
H4778	002	0	1	01	01	H4778_002_0	8	1	2		00000000001111	Hip Replacement	Knee Replacement	Femur Fracture	Falls or History of Falls		2	2			2		14c;		2		2			2	
H4875	018	1	1	04	01	H4875_018_1	9	1	3												2		10b;14c;	1	1	10b;14c;	2			2	
H4875	018	2	1	04	01	H4875_018_2	9	1	3												2		10b;14c;	1	1	10b;14c;	2			2	
H4875	018	3	1	04	01	H4875_018_3	9	1	3												2		10b;14c;	1	1	10b;14c;	2			2	
H4875	018	4	1	04	01	H4875_018_4	9	1	3												2		10b;14c;	1	1	10b;14c;	2			2	
H4875	018	5	1	04	01	H4875_018_5	9	1	3												2		10b;14c;	1	1	10b;14c;	2			2	
H4875	019	0	1	04	01	H4875_019_0	9	1	3												2		10b;14c;	1	1	10b;14c;	2			2	
H5009	001	0	1	04	01	H5009_001_0	10	1	2		01000000000000										2		7f;	1	2		2			2	
H5009	001	0	1	04	01	H5009_001_0	10	2	2		00000000001000	Pre-diabetes									2		14c;	1	2		2			2	
H5009	002	0	1	04	01	H5009_002_0	11	1	2		01000000000000										2		7f;	1	2		2			2	
H5009	002	0	1	04	01	H5009_002_0	11	2	2		00000000001000	Pre-diabetes									2		14c;	1	2		2			2	
H5009	008	0	1	04	01	H5009_008_0	11	1	2		01000000000000										2		7f;	1	2		2			2	
H5009	008	0	1	04	01	H5009_008_0	11	2	2		00000000001000	Pre-diabetes									2		14c;	1	2		2			2	
H5009	009	0	1	04	01	H5009_009_0	11	1	2		01000000000000										2		7f;	1	2		2			2	
H5009	009	0	1	04	01	H5009_009_0	11	2	2		00000000001000	Pre-diabetes									2		14c;	1	2		2			2	
H5009	801	0	1	04	01	H5009_801_0	3	1	2		01000000000000										2		7f;	1	2		2			2	
H5009	801	0	1	04	01	H5009_801_0	3	2	2		00000000001000	Pre-diabetes									2		14c;	1	2		2			2	
H5009	802	0	1	04	01	H5009_802_0	3	1	2		01000000000000										2		7f;	1	2		2			2	
H5009	802	0	1	04	01	H5009_802_0	3	2	2		00000000001000	Pre-diabetes									2		14c;	1	2		2			2	
H5009	803	0	1	04	01	H5009_803_0	3	1	2		01000000000000										2		7f;	1	2		2			2	
H5009	803	0	1	04	01	H5009_803_0	3	2	2		00000000001000	Pre-diabetes									2		14c;	1	2		2			2	
H5009	804	0	1	04	01	H5009_804_0	3	1	2		01000000000000										2		7f;	1	2		2			2	
H5009	804	0	1	04	01	H5009_804_0	3	2	2		00000000001000	Pre-diabetes									2		14c;	1	2		2			2	
H5010	001	0	1	04	01	H5010_001_0	9	1	2		01000000000000										2		7f;	1	2		2			2	
H5010	001	0	1	04	01	H5010_001_0	9	2	2		00000000001000	Pre-diabetes									2		14c;	1	2		2			2	
H5010	002	0	1	04	01	H5010_002_0	11	1	2		01000000000000										2		7f;	1	2		2			2	
H5010	002	0	1	04	01	H5010_002_0	11	2	2		00000000001000	Pre-diabetes									2		14c;	1	2		2			2	
H5010	004	0	1	04	01	H5010_004_0	11	1	2		01000000000000										2		7f;	1	2		2			2	
H5010	004	0	1	04	01	H5010_004_0	11	2	2		00000000001000	Pre-diabetes									2		14c;	1	2		2			2	
H5010	007	0	1	04	01	H5010_007_0	11	1	2		01000000000000										2		7f;	1	2		2			2	
H5010	007	0	1	04	01	H5010_007_0	11	2	2		00000000001000	Pre-diabetes									2		14c;	1	2		2			2	
H5015	001	0	1	01	01	H5015_001_0	15	1	3												2		13i;		2		2			2	
H5042	009	0	1	04	01	H5042_009_0	16	1	1	01011111011											1	011	13d;	2	2		2			2	
H5042	011	0	1	04	01	H5042_011_0	19	1	1	01011111011											1	011	13d;	2	2		2			2	
H5042	012	0	1	04	01	H5042_012_0	12	1	1	01011111011											1	011	13d;	2	2		2			2	
H5126	001	0	1	01	01	H5126_001_0	4	1	3												1	001	10b;		2		2			2	
H5211	001	0	1	02	01	H5211_001_0	10	1	2		00010000000000										2		13c;	2	1	13c;	2			2	
H5211	002	0	1	02	01	H5211_002_0	11	1	2		00010000000000										2		13c;	2	1	13c;	2			2	
H5211	003	0	1	02	01	H5211_003_0	7	1	2		00010000000000										2		13c;	2	1	13c;	2			2	
H5211	004	0	1	02	01	H5211_004_0	8	1	2		00010000000000										2		13c;	2	1	13c;	2			2	
H5211	007	0	1	02	01	H5211_007_0	8	1	2		00010000000000										2		13c;	2	1	13c;	2			2	
H5211	008	0	1	02	01	H5211_008_0	8	1	2		00010000000000										2		13c;	2	1	13c;	2			2	
H5211	009	0	1	02	01	H5211_009_0	6	1	2		00010000000000										2		13c;	2	1	13c;	2			2	
H5211	010	0	1	01	01	H5211_010_0	9	1	2		00010000000000										2		13c;		2		2			2	
H5211	012	0	1	02	01	H5211_012_0	8	1	2		00010000000000										2		13c;	2	1	13c;	2			2	
H5216	044	0	1	04	01	H5216_044_0	5	1	1	00100000000											1	001	13d;	2	2		2			2	
H5216	047	0	1	04	01	H5216_047_0	5	1	1	00100000000											1	001	13d;	2	2		2			2	
H5216	062	0	1	04	01	H5216_062_0	4	1	1	00100000000											1	001	13d;	2	2		2			2	
H5216	065	0	1	04	01	H5216_065_0	4	1	1	00100000000											1	001	13d;	2	2		2			2	
H5216	068	0	1	04	01	H5216_068_0	4	1	1	00100000000											1	001	13d;	2	2		2			2	
H5216	072	0	1	04	01	H5216_072_0	7	1	1	00000000001											1	001	13d;	2	2		2			1	50.00
H5216	131	0	1	04	01	H5216_131_0	5	1	1	00100000000											1	001	13d;	2	2		2			2	
H5216	182	0	1	04	01	H5216_182_0	4	1	1	00100000000											1	001	13d;	2	2		2			2	
H5216	185	0	1	04	01	H5216_185_0	4	1	1	00100000000											1	001	13d;	2	2		2			2	
H5216	188	0	1	04	01	H5216_188_0	4	1	1	00100000000											1	001	13d;	2	2		2			2	
H5253	036	0	1	01	01	H5253_036_0	3	1	1	00000000010											1	001	14c;		2		2			2	
H5422	011	0	1	01	01	H5422_011_0	7	1	3												2		13i;13i-O;		2		2			2	
H5422	013	0	1	01	01	H5422_013_0	6	1	3												2		13i;13i-O;		2		2			2	
H5425	010	0	1	01	01	H5425_010_0	9	1	3												2		13i;		2		2			2	
H5425	028	0	1	01	01	H5425_028_0	8	1	3												2		13i;		2		2			2	
H5425	029	0	1	01	01	H5425_029_0	7	1	3												2		13i;		2		2			2	
H5425	030	0	1	01	01	H5425_030_0	7	1	3												2		13i;		2		2			2	
H5425	031	0	1	01	01	H5425_031_0	7	1	3												2		13i;		2		2			2	
H5425	033	0	1	01	01	H5425_033_0	8	1	3												2		13i;		2		2			2	
H5425	034	0	1	01	01	H5425_034_0	7	1	3												2		13i;		2		2			2	
H5425	040	0	1	01	01	H5425_040_0	7	1	3												2		13i;		2		2			2	
H5425	045	0	1	01	01	H5425_045_0	7	1	3												2		13i;		2		2			2	
H5425	055	0	1	01	01	H5425_055_0	7	1	3												2		13i;		2		2			2	
H5425	071	0	1	01	01	H5425_071_0	8	1	3												2		13i;		2		2			2	
H5425	072	0	1	01	01	H5425_072_0	8	1	3												2		13i;		2		2			2	
H5434	002	0	1	04	01	H5434_002_0	11	1	3												1	001	14c;	1	1	14c;	2			2	
H5522	001	0	1	04	01	H5522_001_0	5	1	1	00010000000											1	001	10b;13c;	2	2		2			2	
H5522	002	0	1	04	01	H5522_002_0	4	1	2		00000000001000	Hyperlipidemia									1	001	10b;	1	1	10b;	2			2	
H5522	002	0	1	04	01	H5522_002_0	4	2	2		00000100000000										1	001	10b;13b;	1	1	10b;13b;	2			2	
H5522	005	0	1	04	01	H5522_005_0	3	1	1	00010000000											1	001	10b;13c;	2	2		2			2	
H5522	018	0	1	04	01	H5522_018_0	3	1	2		00000000001000	Hyperlipidemia									1	001	10b;	1	1	10b;	2			2	
H5522	018	0	1	04	01	H5522_018_0	3	2	2		00000100000000										1	001	10b;13b;	1	1	10b;13b;	2			2	
H5525	038	0	1	04	01	H5525_038_0	4	1	1	00100000000											1	001	13d;	2	2		2			2	
H5533	003	0	1	04	01	H5533_003_0	12	1	2		01110000000000						1				2		13c;	1	1	13c;	2			2	
H5533	005	0	1	04	01	H5533_005_0	12	1	2		01110000000000						1				2		13c;	1	1	13c;	2			2	
H5533	007	0	1	04	01	H5533_007_0	8	1	2		01110000000000						1				2		13c;	1	1	13c;	2			2	
H5533	008	0	1	04	01	H5533_008_0	8	1	2		01110000000000						1				2		13c;	1	1	13c;	2			2	
H5577	002	0	1	01	01	H5577_002_0	9	1	3												2		13i;		2		2			1	160.00
H5577	002	0	1	01	01	H5577_002_0	9	2	1	00000000001											2		13d;		2		2			2	
H5577	005	0	1	01	01	H5577_005_0	7	1	3												2		13i;		2		2			2	
H5577	008	0	1	02	01	H5577_008_0	7	1	3												2		13i;	2	2		2			2	
H5577	014	0	1	01	01	H5577_014_0	6	1	3												2		13i;		2		2			1	200.00
H5577	016	0	1	01	01	H5577_016_0	4	1	3												2		13i;		2		2			1	240.00
H5577	017	0	1	01	01	H5577_017_0	8	1	3												2		13i;		2		2			1	120.00
H5577	017	0	1	01	01	H5577_017_0	8	2	1	00000000001											2		13d;		2		2			2	
H5577	028	0	1	01	01	H5577_028_0	8	1	3												2		13i;		2		2			2	
H5577	028	0	1	01	01	H5577_028_0	8	2	1	00000000001											2		13d;		2		2			2	
H5577	029	0	1	01	01	H5577_029_0	8	1	3												2		13i;		2		2			2	
H5577	029	0	1	01	01	H5577_029_0	8	2	1	00000000001											2		13d;		2		2			2	
H5577	031	0	1	01	01	H5577_031_0	7	1	3												2		13i;		2		2			1	120.00
H5577	036	0	1	01	01	H5577_036_0	9	1	3												2		13i;		2		2			1	240.00
H5577	036	0	1	01	01	H5577_036_0	9	2	1	00000000001											2		13d;		2		2			2	
H5577	037	0	1	01	01	H5577_037_0	8	1	3												2		13i;		2		2			1	240.00
H5577	037	0	1	01	01	H5577_037_0	8	2	1	00000000001											2		13d;		2		2			2	
H5577	038	0	1	01	01	H5577_038_0	7	1	3												2		13i;		2		2			1	65.00
H5577	039	0	1	01	01	H5577_039_0	7	1	3												2		13i;		2		2			1	240.00
H5587	002	0	1	01	01	H5587_002_0	7	1	3												2		10b;13i;14c;		1	10b;13i;14c;	2			2	
H5591	001	0	1	02	01	H5591_001_0	6	1	2		00000000001100	Opiate Use DIsorder	Chronic Pain Syndrome				2	2			1	001	13a;14c;	1	2		1	1		1	200.00
H5591	001	0	1	02	01	H5591_001_0	6	2	2		01000000000000										1	001	14c;	2	2		2			2	
H5591	001	0	1	02	01	H5591_001_0	6	3	2		00000000001100	History of Falls	Hip Fracture				2	2			1	001	14c;	1	2		1	1		1	250.00
H5591	001	0	1	02	01	H5591_001_0	6	4	3												1	001	13c;13i;	2	2		2			2	
H5591	003	0	1	01	01	H5591_003_0	5	1	2		00000000001100	Opiate Use DIsorder	Chronic Pain Syndrome				2	2			1	001	13a;14c;		2		1	1		1	200.00
H5591	003	0	1	01	01	H5591_003_0	5	2	2		01000000000000										1	001	14c;		2		2			2	
H5591	003	0	1	01	01	H5591_003_0	5	3	2		00000000001100	History of Falls	Hip Fracture				2	2			1	001	14c;		2		1	1		1	250.00
H5591	003	0	1	01	01	H5591_003_0	5	4	3												1	001	13c;13i;		2		2			2	
H5591	005	0	1	02	01	H5591_005_0	6	1	2		00000000001100	Opiate Use DIsorder	Chronic Pain Syndrome				2	2			1	001	13a;14c;	1	2		1	1		1	200.00
H5591	005	0	1	02	01	H5591_005_0	6	2	2		01000000000000										1	001	14c;	2	2		2			2	
H5591	005	0	1	02	01	H5591_005_0	6	3	2		00000000001100	History of Falls	Hip Fracture				2	2			1	001	14c;	1	2		1	1		1	250.00
H5591	005	0	1	02	01	H5591_005_0	6	4	3												1	001	13c;13i;	2	2		2			2	
H5591	006	1	1	02	01	H5591_006_1	6	1	2		00000000001100	Opiate Use DIsorder	Chronic Pain Syndrome				2	2			1	001	13a;14c;	1	2		1	1		1	200.00
H5591	006	1	1	02	01	H5591_006_1	6	2	2		01000000000000										1	001	14c;	2	2		2			2	
H5591	006	1	1	02	01	H5591_006_1	6	3	2		00000000001100	History of Falls	Hip Fracture				2	2			1	001	14c;	1	2		1	1		1	250.00
H5591	006	1	1	02	01	H5591_006_1	6	4	3												1	001	13c;13i;	2	2		2			2	
H5591	006	2	1	02	01	H5591_006_2	6	1	2		00000000001100	Opiate Use DIsorder	Chronic Pain Syndrome				2	2			1	001	13a;14c;	1	2		1	1		1	200.00
H5591	006	2	1	02	01	H5591_006_2	6	2	2		01000000000000										1	001	14c;	2	2		2			2	
H5591	006	2	1	02	01	H5591_006_2	6	3	2		00000000001100	History of Falls	Hip Fracture				2	2			1	001	14c;	1	2		1	1		1	250.00
H5591	006	2	1	02	01	H5591_006_2	6	4	3												1	001	13c;13i;	2	2		2			2	
H5591	006	4	1	02	01	H5591_006_4	6	1	2		00000000001100	Opiate Use DIsorder	Chronic Pain Syndrome				2	2			1	001	13a;14c;	1	2		1	1		1	200.00
H5591	006	4	1	02	01	H5591_006_4	6	2	2		01000000000000										1	001	14c;	2	2		2			2	
H5591	006	4	1	02	01	H5591_006_4	6	3	2		00000000001100	History of Falls	Hip Fracture				2	2			1	001	14c;	1	2		1	1		1	250.00
H5591	006	4	1	02	01	H5591_006_4	6	4	3												1	001	13c;13i;	2	2		2			2	
H5591	007	0	1	01	01	H5591_007_0	6	1	2		00000000001100	Opiate Use DIsorder	Chronic Pain Syndrome				2	2			1	001	13a;14c;		2		1	1		1	200.00
H5591	007	0	1	01	01	H5591_007_0	6	2	2		01000000000000										1	001	14c;		2		2			2	
H5591	007	0	1	01	01	H5591_007_0	6	3	2		00000000001100	History of Falls	Hip Fracture				2	2			1	001	14c;		2		1	1		1	250.00
H5591	007	0	1	01	01	H5591_007_0	6	4	3												1	001	13c;13i;		2		2			2	
H5591	009	0	1	01	01	H5591_009_0	6	1	2		00000000001100	Opiate Use DIsorder	Chronic Pain Syndrome				2	2			1	001	13a;14c;		2		1	1		1	200.00
H5591	009	0	1	01	01	H5591_009_0	6	2	2		01000000000000										1	001	14c;		2		2			2	
H5591	009	0	1	01	01	H5591_009_0	6	3	2		00000000001100	History of Falls	Hip Fracture				2	2			1	001	14c;		2		1	1		1	250.00
H5591	009	0	1	01	01	H5591_009_0	6	4	3												1	001	13c;13i;		2		2			2	
H5591	013	0	1	01	01	H5591_013_0	6	1	2		00000000001100	Opiate Use DIsorder	Chronic Pain Syndrome				2	2			1	001	13a;14c;		2		1	1		1	200.00
H5591	013	0	1	01	01	H5591_013_0	6	2	2		01000000000000										1	001	14c;		2		2			2	
H5591	013	0	1	01	01	H5591_013_0	6	3	2		00000000001100	History of Falls	Hip Fracture				2	2			1	001	14c;		2		1	1		1	250.00
H5591	013	0	1	01	01	H5591_013_0	6	4	3												1	001	13c;13i;		2		2			2	
H5619	001	0	1	01	01	H5619_001_0	4	1	1	00100000000											1	001	13d;		2		2			2	
H5619	003	0	1	01	01	H5619_003_0	5	1	1	10000000000											2		13d;		1	13d;	2			1	25.00
H5619	003	0	1	01	01	H5619_003_0	5	2	1	00000000001											1	001	13d;		1	13d;	2			1	50.00
H5619	038	0	1	01	01	H5619_038_0	7	1	1	10000000000											2		13d;		1	13d;	2			1	25.00
H5619	038	0	1	01	01	H5619_038_0	7	2	1	00000000001											1	001	13d;		1	13d;	2			1	50.00
H5619	040	1	1	01	01	H5619_040_1	4	1	1	00100000000											1	001	13d;		2		2			2	
H5619	040	2	1	01	01	H5619_040_2	4	1	1	00100000000											1	001	13d;		2		2			2	
H5619	040	3	1	01	01	H5619_040_3	4	1	1	00100000000											1	001	13d;		2		2			2	
H5619	049	0	1	01	01	H5619_049_0	4	1	1	00100000000											1	001	13d;		2		2			2	
H5619	054	0	1	01	01	H5619_054_0	6	1	1	10000000000											2		13d;		1	13d;	2			1	25.00
H5619	054	0	1	01	01	H5619_054_0	6	2	1	00000000001											1	001	13d;		1	13d;	2			1	50.00
H5619	056	0	1	01	01	H5619_056_0	5	1	1	00100000000											1	001	13d;		2		2			2	
H5619	057	0	1	01	01	H5619_057_0	5	1	1	00100000000											1	001	13d;		2		2			2	
H5619	059	0	1	01	01	H5619_059_0	7	1	3												1	001	10b;13i;		2		2			2	
H5619	059	0	1	01	01	H5619_059_0	7	2	1	00100000000											1	001	13d;		2		2			2	
H5619	060	0	1	01	01	H5619_060_0	5	1	1	00100000000											1	001	13d;		2		2			2	
H5619	061	0	1	01	01	H5619_061_0	6	1	1	00100000000											1	001	13d;		2		2			2	
H5619	063	0	1	01	01	H5619_063_0	7	1	3												1	001	10b;13i;		2		2			2	
H5619	063	0	1	01	01	H5619_063_0	7	2	1	00100000000											1	001	13d;		2		2			2	
H5619	067	0	1	01	01	H5619_067_0	6	1	1	10000000000											2		13d;		1	13d;	2			1	50.00
H5619	067	0	1	01	01	H5619_067_0	6	2	1	00000000001											1	001	13d;		1	13d;	2			1	50.00
H5619	075	0	1	01	01	H5619_075_0	6	1	1	10000000000											2		13d;		1	13d;	2			1	25.00
H5619	075	0	1	01	01	H5619_075_0	6	2	1	00000000001											1	001	13d;		1	13d;	2			1	50.00
H5619	086	0	1	01	01	H5619_086_0	5	1	3												1	001	10b;13b;13i;14c;16a;16b;17a;17b;		2		1	1		1	500.00
H5619	086	0	1	01	01	H5619_086_0	5	2	1	00100000000											1	001	13d;		2		2			2	
H5619	097	0	1	01	01	H5619_097_0	4	1	1	00100000000											1	001	13d;		2		2			2	
H5619	100	0	1	01	01	H5619_100_0	4	1	1	00100000000											1	001	13d;		2		2			2	
H5619	101	0	1	01	01	H5619_101_0	4	1	1	00100000000											1	001	13d;		2		2			2	
H5619	102	0	1	01	01	H5619_102_0	4	1	1	00100000000											1	001	13d;		2		2			2	
H5619	114	0	1	01	01	H5619_114_0	5	1	1	00100000000											1	001	13d;		2		2			2	
H5619	115	0	1	01	01	H5619_115_0	5	1	1	00100000000											1	001	13d;		2		2			2	
H5774	022	0	1	01	01	H5774_022_0	5	1	2		00110000001100	Oncology patients with active chemo by infusion	Acute Stroke				2	2			2		14c;		1	14c;	2			2	
H5774	032	0	1	01	01	H5774_032_0	6	1	2		00110000001100	Oncology patients with active chemo by infusion	Acute Stroke				2	2			2		14c;		1	14c;	2			2	
H5774	033	0	1	01	01	H5774_033_0	5	1	2		00110000001100	Oncology patients with active chemo by infusion	Acute Stroke				2	2			2		14c;		1	14c;	2			2	
H5826	006	0	1	01	01	H5826_006_0	5	1	2		01000000000000										2		7f;		2		2			2	
H5826	006	0	1	01	01	H5826_006_0	5	2	2		00000000001000	Frailty									1	001	14c;		2		2			2	
H5826	006	0	1	01	01	H5826_006_0	5	3	2		00000000001000	Refractory Hypertension									1	001	13b;		2		2			2	
H5826	008	0	1	01	01	H5826_008_0	7	1	2		01000000000000										2		7f;		2		2			2	
H5826	008	0	1	01	01	H5826_008_0	7	2	2		00000000001000	Frailty									1	001	14c;		2		2			2	
H5826	008	0	1	01	01	H5826_008_0	7	3	2		00000000001000	Refractory Hypertension									1	001	13b;		2		2			2	
H5826	009	0	1	01	01	H5826_009_0	7	1	2		01000000000000										2		7f;		2		2			2	
H5826	009	0	1	01	01	H5826_009_0	7	2	2		00000000001000	Frailty									1	001	14c;		2		2			2	
H5826	009	0	1	01	01	H5826_009_0	7	3	2		00000000001000	Refractory Hypertension									1	001	13b;		2		2			2	
H5826	010	0	1	01	01	H5826_010_0	7	1	2		00000000001000	refractory hypertension									1	001	13b;		2		2			2	
H5826	010	0	1	01	01	H5826_010_0	7	2	2		00000000001000	Frailty									1	001	14c;		2		2			2	
H5826	010	0	1	01	01	H5826_010_0	7	3	2		01000000000000										2		7f;		2		2			2	
H5826	014	0	1	01	01	H5826_014_0	6	1	2		01000000000000										2		7f;		2		2			2	
H5826	014	0	1	01	01	H5826_014_0	6	2	2		00000000001000	Frailty									1	001	14c;		2		2			2	
H5826	014	0	1	01	01	H5826_014_0	6	3	2		00000000001000	Refractory Hypertension									1	001	13b;		2		2			2	
H5826	016	0	1	01	01	H5826_016_0	8	1	2		01000000000000										2		7f;		2		2			2	
H5826	016	0	1	01	01	H5826_016_0	8	2	2		00000000001000	Frailty									1	001	14c;		2		2			2	
H5826	016	0	1	01	01	H5826_016_0	8	3	2		00000000001000	Refractory Hypertension									1	001	13b;		2		2			2	
H5852	001	0	1	01	01	H5852_001_0	4	1	2		00000000001000	Cancer									2		10b;		2		2			2	
H5852	001	0	1	01	01	H5852_001_0	4	2	2		00000000001000	End Stage Renal Dialysis (ESRD)									2		10b;		2		2			2	
H5854	012	0	1	02	01	H5854_012_0	9	1	3												2		13i;13i-O;	2	2		2			2	
H5854	013	0	1	01	01	H5854_013_0	9	1	3												2		13i;13i-O;		2		2			2	
H5854	015	0	1	01	01	H5854_015_0	9	1	3												2		13i;		2		2			2	
H5859	001	0	1	02	01	H5859_001_0	8	1	1	01000000000											2		13d;	2	2		2			2	
H5883	003	1	1	02	01	H5883_003_1	7	1	1	00010010000											2		13d;	2	2		2			2	
H5883	003	2	1	02	01	H5883_003_2	7	1	1	00010010000											2		13d;	2	2		2			2	
H5883	003	3	1	02	01	H5883_003_3	7	1	1	00010010000											2		13d;	2	2		2			2	
H5883	003	4	1	02	01	H5883_003_4	7	1	1	00010010000											2		13d;	2	2		2			2	
H5883	003	5	1	02	01	H5883_003_5	7	1	1	00010010000											2		13d;	2	2		2			2	
H5932	001	0	1	01	01	H5932_001_0	5	1	3												1	001	13i;		1	13i;	2			2	
H5970	001	0	1	04	01	H5970_001_0	4	1	1	00100000000											1	001	13d;	2	2		2			2	
H5970	019	0	1	04	01	H5970_019_0	4	1	1	00100000000											1	001	13d;	2	2		2			2	
H5970	020	0	1	04	01	H5970_020_0	5	1	1	10000000000											2		13d;	2	1	13d;	2			1	25.00
H5970	020	0	1	04	01	H5970_020_0	5	2	1	00000000001											1	001	13d;	2	1	13d;	2			1	50.00
H6154	001	0	1	02	01	H6154_001_0	11	1	3												1	001	13i;14c;	2	2		2			2	
H6154	002	0	1	02	01	H6154_002_0	10	1	3												2		13i;	2	2		2			2	
H6237	006	0	1	01	01	H6237_006_0	10	1	2		01000000000000										2		7f;		2		2			2	
H6237	006	0	1	01	01	H6237_006_0	10	2	2		00000000001000	Pre-diabetes									2		14c;		2		2			2	
H6237	007	1	1	01	01	H6237_007_1	10	1	2		01000000000000										2		7f;		2		2			2	
H6237	007	1	1	01	01	H6237_007_1	10	2	2		00000000001000	Pre-diabetes									2		14c;		2		2			2	
H6237	007	2	1	01	01	H6237_007_2	11	1	2		01000000000000										2		7f;		2		2			2	
H6237	007	2	1	01	01	H6237_007_2	11	2	2		00000000001000	Pre-diabetes									2		14c;		2		2			2	
H6237	007	3	1	01	01	H6237_007_3	11	1	2		01000000000000										2		7f;		2		2			2	
H6237	007	3	1	01	01	H6237_007_3	11	2	2		00000000001000	Pre-diabetes									2		14c;		2		2			2	
H6237	008	1	1	01	01	H6237_008_1	11	1	2		01000000000000										2		7f;		2		2			2	
H6237	008	1	1	01	01	H6237_008_1	11	2	2		00000000001000	Pre-diabetes									2		14c;		2		2			2	
H6237	008	2	1	01	01	H6237_008_2	11	1	2		01000000000000										2		7f;		2		2			2	
H6237	008	2	1	01	01	H6237_008_2	11	2	2		00000000001000	Pre-diabetes									2		14c;		2		2			2	
H6237	008	3	1	01	01	H6237_008_3	11	1	2		01000000000000										2		7f;		2		2			2	
H6237	008	3	1	01	01	H6237_008_3	11	2	2		00000000001000	Pre-diabetes									2		14c;		2		2			2	
H6396	001	0	1	01	01	H6396_001_0	7	1	2		01000100000000						2	2			1	001	10b;		2		2			2	
H6396	004	0	1	01	01	H6396_004_0	8	1	2		01000100000000						2	2			1	001	10b;		2		2			2	
H6502	001	0	1	04	01	H6502_001_0	16	1	3												2		13i;	1	2		2			2	
H6502	002	0	1	04	01	H6502_002_0	16	1	3												2		13i;	1	2		2			2	
H6622	008	0	1	01	01	H6622_008_0	6	1	1	10000000000											2		13d;		1	13d;	2			1	25.00
H6622	008	0	1	01	01	H6622_008_0	6	2	1	00000000001											1	001	13d;		1	13d;	2			1	50.00
H6622	015	0	1	01	01	H6622_015_0	6	1	1	10000000000											2		13d;		1	13d;	2			1	25.00
H6622	015	0	1	01	01	H6622_015_0	6	2	1	00000000001											1	001	13d;		1	13d;	2			1	50.00
H6622	018	0	1	01	01	H6622_018_0	7	1	1	10000000000											2		13d;		1	13d;	2			1	25.00
H6622	018	0	1	01	01	H6622_018_0	7	2	1	00000000001											1	001	13d;		1	13d;	2			1	50.00
H6622	022	0	1	01	01	H6622_022_0	4	1	1	00100000000											1	001	13d;		2		2			2	
H6622	023	0	1	01	01	H6622_023_0	4	1	1	00100000000											1	001	13d;		2		2			2	
H6622	048	0	1	01	01	H6622_048_0	6	1	1	10000000000											2		13d;		1	13d;	2			1	50.00
H6622	048	0	1	01	01	H6622_048_0	6	2	1	00000000001											1	001	13d;		1	13d;	2			1	50.00
H7119	001	0	1	01	01	H7119_001_0	20	1	3												2		13i;		2		2			2	
H7301	002	0	1	04	01	H7301_002_0	6	1	2		00000000001000	Hyperlipidemia									1	001	10b;	1	1	10b;	2			2	
H7301	002	0	1	04	01	H7301_002_0	6	2	2		00000100000000										1	001	10b;13b;	1	1	10b;13b;	2			2	
H7301	006	0	1	04	01	H7301_006_0	5	1	2		00000000001000	Hyperlipidemia									1	001	10b;	1	1	10b;	2			2	
H7301	006	0	1	04	01	H7301_006_0	5	2	2		00000100000000										1	001	10b;13b;	1	1	10b;13b;	2			2	
H7322	001	0	1	01	01	H7322_001_0	5	1	3												1	001	10b;		2		2			2	
H7322	002	0	1	01	01	H7322_002_0	5	1	3												1	001	10b;		2		2			2	
H7326	001	0	1	04	01	H7326_001_0	6	1	1	01000110000											1	100	13d;	2	2		2			1	315.00
H7326	002	0	1	04	01	H7326_002_0	6	1	1	01000110000											1	100	13d;	2	2		2			1	315.00
H7787	001	0	1	04	01	H7787_001_0	8	1	3												1	001	13i;	1	2		2			1	150.00
H7787	002	0	1	04	01	H7787_002_0	8	1	3												1	001	13i;	1	2		2			1	150.00
H7802	001	0	1	01	01	H7802_001_0	8	1	2		00000000001111	Hip Replacement	Knee Replacement	Femur Fracture	Falls or History of Falls		2	2			2		14c;		2		2			2	
H7802	002	0	1	01	01	H7802_002_0	8	1	2		00000000001111	Hip Replacement	Knee Replacement	Femur Fracture	Falls or History of Falls		2	2			2		14c;		2		2			2	
H8067	001	0	1	01	01	H8067_001_0	14	1	3												2		13i;		2		2			2	
H8432	027	0	1	01	01	H8432_027_0	8	1	3												2		13i;13i-O;		2		2			2	
H8432	028	0	1	01	01	H8432_028_0	8	1	3												2		13i;13i-O;		2		2			2	
H8432	034	0	1	01	01	H8432_034_0	8	1	3												2		13i;13i-O;		2		2			2	
H8432	035	0	1	01	01	H8432_035_0	10	1	3												2		13i;13i-O;		2		2			2	
H8457	001	0	1	01	01	H8457_001_0	5	1	2		00000000011100	Behavioral health diagnosis	Documented chronic pain				2	2			2		14c;		2		2			2	
H8783	001	0	1	04	01	H8783_001_0	7	1	2		00010000000000										2		13c;	1	2		2			2	
H8783	002	0	1	04	01	H8783_002_0	6	1	2		00010000000000										2		13c;	1	2		2			2	
H8889	001	0	1	04	01	H8889_001_0	10	1	3												1	001	10b;13c;13d;13i;14c;	1	2		2			2	
H8889	002	0	1	04	01	H8889_002_0	10	1	3												2		13i;	1	2		2			2	
H8889	003	0	1	04	01	H8889_003_0	10	1	3												1	001	10b;13c;13d;13i;14c;	1	2		2			2	
H8889	004	0	1	04	01	H8889_004_0	10	1	3												2		13i;	1	2		2			2	
H9065	001	0	1	01	01	H9065_001_0	7	1	3												2		13i;13i-O;		2		2			2	
H9065	002	0	1	02	01	H9065_002_0	8	1	3												2		13i;13i-O;	2	2		2			2	
H9065	003	0	1	02	01	H9065_003_0	7	1	3												2		13i;13i-O;	2	2		2			2	
H9095	001	0	1	01	01	H9095_001_0	5	1	2		00000000011100	Behavioral health diagnosis	Documented chronic pain				2	2			2		14c;		2		2			2	
H9408	001	0	1	04	01	H9408_001_0	5	1	3												2		13i;	1	2		2			2	
H9408	005	0	1	04	01	H9408_005_0	4	1	3												2		13i;	1	2		2			2	
H9455	001	0	1	01	01	H9455_001_0	6	1	3												2		10b;13i;14c;		1	10b;13i;14c;	2			2	
H9525	003	0	1	01	01	H9525_003_0	8	1	3												2		13i;13i-O;		2		2			2	
H9525	004	0	1	01	01	H9525_004_0	7	1	3												2		13i;13i-O;		2		2			2	
H9525	006	0	1	01	01	H9525_006_0	7	1	3												2		13i;13i-O;		2		2			2	
H9525	007	0	1	01	01	H9525_007_0	7	1	3												2		13i;13i-O;		2		2			2	
H9525	008	0	1	01	01	H9525_008_0	7	1	3												2		13i;13i-O;		2		2			2	
H9590	001	0	1	01	01	H9590_001_0	5	1	2		00000000011100	Behavioral health diagnosis	Documented chronic pain				2	2			2		14c;		2		2			2	
H9615	007	0	1	04	01	H9615_007_0	12	1	2		00000100000000										2		13b;	1	1	13b;	2			2	
H9615	007	0	1	04	01	H9615_007_0	12	2	2		00001000000000										2		14c;	1	1	14c;	2			1	250.00
H9615	008	0	1	04	01	H9615_008_0	12	1	2		00000100000000										2		13b;	1	1	13b;	2			2	
H9615	008	0	1	04	01	H9615_008_0	12	2	2		00001000000000										2		14c;	1	1	14c;	2			1	250.00
H9615	009	0	1	04	01	H9615_009_0	12	1	2		00000100000000										2		13b;	1	1	13b;	2			2	
H9615	009	0	1	04	01	H9615_009_0	12	2	2		00001000000000										2		14c;	1	1	14c;	2			1	250.00
H9615	010	0	1	04	01	H9615_010_0	12	1	2		00000100000000										2		13b;	1	1	13b;	2			2	
H9615	010	0	1	04	01	H9615_010_0	12	2	2		00001000000000										2		14c;	1	1	14c;	2			1	250.00
H9615	012	0	1	04	01	H9615_012_0	12	1	2		00000100000000										2		13b;	1	1	13b;	2			2	
H9615	012	0	1	04	01	H9615_012_0	12	2	2		00001000000000										2		14c;	1	1	14c;	2			1	250.00
H9942	001	0	1	04	01	H9942_001_0	6	1	2		00000000011100	Behavioral health diagnosis	Documented chronic pain				2	2			2		14c;	1	2		2			2	
R0802	001	0	1	31	11	R0802_001_0	7	1	2		00000000001100	Opioid Use Disorder	Chronic Pain Syndrome				2	2			1	001	13a;14c;	1	2		1	1		1	200.00
R0802	001	0	1	31	11	R0802_001_0	7	2	2		01000000000000										1	001	14c;	1	2		2			2	
R0802	001	0	1	31	11	R0802_001_0	7	3	2		00000000001100	History of Falls	Hip Fracture				2	2			1	001	14c;	1	2		1	1		1	250.00
R0802	001	0	1	31	11	R0802_001_0	7	4	3												1	001	13c;13i;	1	2		2			2	
