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_tm_vbid	pbp_b19b_states_ehc_vbd	pbp_b19b_all_dis_yn	pbp_b19b_cmb_dis_yn	pbp_b19b_lis_vbid	pbp_b19b_enr_tar_vbid	pbp_b19b_enr_eng_vbid	pbp_b19b_states_ehc_ssbci	pbp_b19b_states_ssbci_other1	pbp_b19b_states_ssbci_other2	pbp_b19b_states_ssbci_other3	pbp_b19b_states_ssbci_other4	pbp_b19b_states_ssbci_other5	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_agg_yn	pbp_b19b_agg_amt	pbp_b19b_agg_period	pbp_b19b_agg_nmc_bendesc_cats
H0028	007	0	1	01	01	H0028_007_0	3	2	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H0028	007	0	1	01	01	H0028_007_0	3	1	1	10				01111	1396	1396																	2		13b;13d;13e;13f;14c;		1	13b;13d;13e;13f;14c;	1	2100	3	13b;13d;13e;13f;14c8;
H0028	014	0	1	01	01	H0028_014_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13c;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	1000	3	7b1;7f;10b1;13a;13b;13c;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H0028	015	0	1	02	01	H0028_015_0	3	2	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13c;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13c;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1000	3	7b1;7f;10b1;13a;13b;13c;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H0028	015	0	1	02	01	H0028_015_0	3	1	1	10				01111	7695	7695																	2		13b;13d;13e;13f;14c;	1	1	13b;13d;13e;13f;14c;	1	2100	3	13b;13d;13e;13f;14c8;
H0028	015	0	1	02	01	H0028_015_0	3	3	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	1	13d;	2			
H0028	016	0	1	02	01	H0028_016_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H0028	017	0	1	01	01	H0028_017_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H0028	017	0	1	01	01	H0028_017_0	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H0028	021	0	1	01	01	H0028_021_0	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H0028	023	0	1	01	01	H0028_023_0	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H0028	023	0	1	01	01	H0028_023_0	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H0028	025	1	1	01	01	H0028_025_1	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H0028	025	2	1	01	01	H0028_025_2	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H0028	027	0	1	01	01	H0028_027_0	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H0028	027	0	1	01	01	H0028_027_0	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H0028	028	0	1	01	01	H0028_028_0	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H0028	028	0	1	01	01	H0028_028_0	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H0028	029	0	1	01	01	H0028_029_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H0028	030	0	1	01	01	H0028_030_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H0028	031	0	1	01	01	H0028_031_0	3	1	1	10				01111	2434	2434																	2		13b;13d;13e;13f;14c;		2		1	600	3	13b;13d;13e;13f;14c8;
H0028	031	0	1	01	01	H0028_031_0	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H0028	031	0	1	01	01	H0028_031_0	3	3	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H0028	032	0	1	01	01	H0028_032_0	3	4	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H0028	032	0	1	01	01	H0028_032_0	3	3	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H0028	032	0	1	01	01	H0028_032_0	3	1	1	10				01111	6676	6676																	2		13b;13d;13e;13f;14c;		2		1	900	3	13b;13d;13e;13f;14c8;
H0028	032	0	1	01	01	H0028_032_0	3	2	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H0028	033	0	1	01	01	H0028_033_0	3	4	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H0028	033	0	1	01	01	H0028_033_0	3	3	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H0028	033	0	1	01	01	H0028_033_0	3	2	1	10				01111	3415	1366																	1	010	13b;13d;13e;13f;14c;		2		1	600	3	13b;13d;13e;13f;14c8;
H0028	033	0	1	01	01	H0028_033_0	3	1	1	10				01111	3415	3415																	2		13b;13d;13e;13f;14c;		2		1	900	3	13b;13d;13e;13f;14c8;
H0028	034	0	1	01	01	H0028_034_0	3	1	1	10				01111	811	811																	2		13b;13d;13e;13f;14c;		2		1	1200	3	13b;13d;13e;13f;14c8;
H0028	034	0	1	01	01	H0028_034_0	3	2	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H0028	035	0	1	01	01	H0028_035_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H0028	036	0	1	01	01	H0028_036_0	3	1	1	10				01111	4850	4850																	2		13b;13d;13e;13f;14c;		2		1	1200	3	13b;13d;13e;13f;14c8;
H0028	036	0	1	01	01	H0028_036_0	3	2	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H0028	037	0	1	01	01	H0028_037_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H0028	037	0	1	01	01	H0028_037_0	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H0028	039	0	1	01	01	H0028_039_0	4	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	1600	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H0028	041	0	1	01	01	H0028_041_0	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H0028	041	0	1	01	01	H0028_041_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H0028	042	0	1	01	01	H0028_042_0	4	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H0028	042	0	1	01	01	H0028_042_0	4	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H0028	043	1	1	01	01	H0028_043_1	4	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H0028	043	1	1	01	01	H0028_043_1	4	3	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H0028	043	1	1	01	01	H0028_043_1	4	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H0028	043	2	1	01	01	H0028_043_2	4	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H0028	044	0	1	01	01	H0028_044_0	4	1	1	10				01111	1144	1144																	2		13b;13d;13e;13f;14c;		2		1	900	3	13b;13d;13e;13f;14c8;
H0028	044	0	1	01	01	H0028_044_0	4	2	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H0028	044	0	1	01	01	H0028_044_0	4	3	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H0028	045	0	1	01	01	H0028_045_0	4	2	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H0028	045	0	1	01	01	H0028_045_0	4	1	1	10				01111	795	795																	2		13b;13d;13e;13f;14c;		2		1	1200	3	13b;13d;13e;13f;14c8;
H0028	046	0	1	01	01	H0028_046_0	4	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H0028	047	0	1	01	01	H0028_047_0	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H0028	050	0	1	01	01	H0028_050_0	4	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13c;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	1600	3	7b1;7f;10b1;13a;13b;13c;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;13i-O4;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H0028	050	0	1	01	01	H0028_050_0	4	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H0028	051	0	1	01	01	H0028_051_0	4	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13c;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	1600	3	7b1;7f;10b1;13a;13b;13c;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;13i-O4;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H0028	052	0	1	01	01	H0028_052_0	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H0028	052	0	1	01	01	H0028_052_0	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H0028	053	1	1	01	01	H0028_053_1	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13c;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	1000	3	7b1;7f;10b1;13a;13b;13c;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H0028	053	1	1	01	01	H0028_053_1	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H0028	053	2	1	01	01	H0028_053_2	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13c;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	1000	3	7b1;7f;10b1;13a;13b;13c;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H0028	053	2	1	01	01	H0028_053_2	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H0028	053	3	1	01	01	H0028_053_3	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13c;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	1000	3	7b1;7f;10b1;13a;13b;13c;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H0028	054	1	1	02	01	H0028_054_1	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H0028	054	1	1	02	01	H0028_054_1	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13c;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	2		1	1000	3	7b1;7f;10b1;13a;13b;13c;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H0028	054	2	1	02	01	H0028_054_2	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13c;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	2		1	1000	3	7b1;7f;10b1;13a;13b;13c;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H0028	055	0	1	02	01	H0028_055_0	4	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13c;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	2		1	1600	3	7b1;7f;10b1;13a;13b;13c;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;13i-O4;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H0028	056	0	1	02	01	H0028_056_0	4	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13c;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	2		1	1600	3	7b1;7f;10b1;13a;13b;13c;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;13i-O4;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H0028	057	0	1	01	01	H0028_057_0	4	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H0028	057	0	1	01	01	H0028_057_0	4	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13c;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	1420	3	7b1;7f;10b1;13a;13b;13c;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;13i-O4;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H0028	058	0	1	01	01	H0028_058_0	4	1	1	10				01111	100	100																	2		13b;13d;13e;13f;14c;		1	13b;13d;13e;13f;14c;	1	1500	3	13b;13d;13e;13f;14c8;
H0028	058	0	1	01	01	H0028_058_0	4	2	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H0028	059	0	1	01	01	H0028_059_0	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H0028	059	0	1	01	01	H0028_059_0	3	3	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H0028	059	0	1	01	01	H0028_059_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H0034	001	0	1	01	01	H0034_001_0	10	1	3								11111111111111111111	Arthritis	Hepatitis	Hyperlipidemia	Autism Spectrum Disorder	Osteoporosis											2		13i;		1	13i;	2			
H0034	002	0	1	01	01	H0034_002_0	8	1	3								11111111111111111111	Arthritis	Hepatitis	Hyperlipidemia	Autism Spectrum Disorder	Osteoporosis											2		13i;		1	13i;	2			
H0074	004	0	1	04	01	H0074_004_0	6	2	1	10				01111	366	110																	2		13d;	1	1	13d;	1	300.00	3	13d;
H0074	004	0	1	04	01	H0074_004_0	6	1	3								01111111111111110000																2		13i;	1	1	13i;	2			
H0104	012	0	1	04	01	H0104_012_0	6	1	3								00000001000000001111	COPD	Rheumatoid Arthritis	Vascular Disease	Congestive Heart Failure												2		13c;	1	1	13c;	2			
H0104	014	0	1	04	01	H0104_014_0	5	1	3								00000001000000001111	COPD	Rheumatoid Arthritis	Vascular Disease	Congestive Heart Failure												2		13c;	1	1	13c;	2			
H0104	015	0	1	04	01	H0104_015_0	7	1	3								00000001000000001111	COPD	Rheumatoid Arthritis	Vascular Disease	Congestive Heart Failure												2		13c;	1	1	13c;	2			
H0111	003	0	1	04	01	H0111_003_0	4	1	3								01111111111111110000																2		13i;	1	1	13i;	2			
H0111	004	0	1	04	01	H0111_004_0	5	1	3								01111111111111110000																2		13i;	1	1	13i;	2			
H0111	004	0	1	04	01	H0111_004_0	5	2	1	10				01111	9598	2879																	2		13d;	1	1	13d;	1	300.00	3	13d;
H0154	012	0	1	01	01	H0154_012_0	6	1	1	10				01111	21292	20258																	2		13i;		2		1	360.00	3	13i1;
H0154	019	0	1	01	01	H0154_019_0	6	1	1	10				01111	21292	20258																	2		13i;		2		1	360.00	3	13i1;
H0169	001	0	1	02	01	H0169_001_0	5	1	1	10				01111	18749	15937																	2		13d;	2	1	13d;	2			
H0169	002	0	1	02	01	H0169_002_0	3	1	1	10				01111	27720	23562																	2		13d;	2	1	13d;	2			
H0169	003	0	1	02	01	H0169_003_0	4	1	1	10				01111	8824	7500																	2		13d;	2	1	13d;	2			
H0169	003	0	1	02	01	H0169_003_0	4	2	1	10				01111	8824	882																	2		13e;	2	1	13e;	2			
H0169	004	0	1	02	01	H0169_004_0	3	2	1	10				01111	3805	381																	2		13e;	2	1	13e;	2			
H0169	004	0	1	02	01	H0169_004_0	3	1	1	10				01111	3805	3234																	2		13d;	2	1	13d;	2			
H0169	006	0	1	02	01	H0169_006_0	4	1	1	10				01111	164	139																	2		13d;	2	1	13d;	2			
H0169	008	0	1	02	01	H0169_008_0	5	1	1	10				01111	539	458																	2		13d;	2	1	13d;	2			
H0174	002	0	1	01	01	H0174_002_0	4	1	3								01111111111111110000																2		13i;		1	13i;	1	600	3	13i10;
H0174	004	0	1	01	01	H0174_004_0	5	1	3								01111111111111110000																2		13i;14c;		1	13i;14c;	1	1200	3	13i10;
H0174	004	0	1	01	01	H0174_004_0	5	2	1	10				01111	12044	3613																	2		13d;		1	13d;	1	300.00	3	13d;
H0174	006	0	1	01	01	H0174_006_0	5	1	3								01111111111111110000																2		13i;14c;		1	13i;14c;	1	1500	3	13i10;
H0174	006	0	1	01	01	H0174_006_0	5	2	1	10				01111	12559	4396																	2		13d;		1	13d;	1	600.00	3	13d;
H0174	008	0	1	01	01	H0174_008_0	4	1	3								01111111111111110000																2		13i;14c;		1	13i;14c;	1	600	3	13i10;
H0174	009	0	1	01	01	H0174_009_0	4	1	3								01111111111111110000																2		13i;14c;		1	13i;14c;	1	600	3	13i10;
H0174	010	0	1	01	01	H0174_010_0	4	1	3								01111111111111110000																2		13i;		1	13i;	1	600	3	13i10;
H0174	014	0	1	01	01	H0174_014_0	4	1	3								01111111111111110000																2		13i;		1	13i;	1	600	3	13i10;
H0174	015	0	1	01	01	H0174_015_0	5	1	3								01111111111111110000																2		13i;		1	13i;	1	600	3	13i10;
H0174	016	0	1	01	01	H0174_016_0	4	1	3								01111111111111110000																2		13i;		1	13i;	1	600	3	13i10;
H0251	002	0	1	02	01	H0251_002_0	2	1	1	10				01111	87681	74529																	2		13d;	2	1	13d;	2			
H0251	004	0	1	02	01	H0251_004_0	3	1	1	10				01111	1738	1477																	2		13d;	2	1	13d;	2			
H0270	002	0	1	04	01	H0270_002_0	6	1	1	10				01111	585	176																	2		13d;	1	1	13d;	1	300.00	3	13d;
H0271	005	0	1	04	01	H0271_005_0	3	1	1	10				01111	40858	34729																	2		13d;	1	1	13d;	2			
H0271	006	0	1	04	01	H0271_006_0	2	1	1	10				01111	11479	9757																	2		13d;	1	1	13d;	2			
H0271	013	0	1	04	01	H0271_013_0	3	1	1	10				01111	17907	15221																	2		13d;	1	1	13d;	2			
H0271	014	0	1	04	01	H0271_014_0	2	1	1	10				01111	15098	12833																	2		13d;	1	1	13d;	2			
H0271	016	0	1	04	01	H0271_016_0	2	1	1	10				01111	62872	53441																	2		13d;	1	1	13d;	2			
H0271	020	0	1	04	01	H0271_020_0	2	1	1	10				01111	3874	3293																	2		13d;	1	1	13d;	2			
H0271	023	0	1	04	01	H0271_023_0	2	1	1	10				01111	39435	33520																	2		13d;	1	1	13d;	2			
H0271	024	0	1	04	01	H0271_024_0	2	1	1	10				01111	9724	8265																	2		13d;	1	1	13d;	2			
H0271	025	0	1	04	01	H0271_025_0	2	1	3								00001101000000000000																2		13i;	1	1	13i;	2			
H0271	026	0	1	04	01	H0271_026_0	3	1	3								00001101000000000000																2		13i;	1	1	13i;	2			
H0271	027	0	1	04	01	H0271_027_0	3	1	3								00001101000000000000																2		13i;	1	1	13i;	2			
H0271	028	0	1	04	01	H0271_028_0	2	1	1	10				01111	8742	7431																	2		13d;	1	1	13d;	2			
H0271	029	0	1	04	01	H0271_029_0	3	1	1	10				01111	44881	38149																	2		13d;	1	1	13d;	2			
H0271	030	0	1	04	01	H0271_030_0	2	1	1	10				01111	1113	946																	2		13d;	1	1	13d;	2			
H0271	033	0	1	04	01	H0271_033_0	2	1	3								00001101000000000000																2		13i;	1	1	13i;	2			
H0271	034	0	1	04	01	H0271_034_0	3	1	3								00001101000000000000																2		13i;	1	1	13i;	2			
H0271	035	0	1	04	01	H0271_035_0	2	1	3								00001101000000000000																2		13i;	1	1	13i;	2			
H0271	036	0	1	04	01	H0271_036_0	3	1	3								00001101000000000000																2		13i;	1	1	13i;	2			
H0271	037	0	1	04	01	H0271_037_0	4	1	1	10				01111	2724	2315																	2		13d;	1	1	13d;	2			
H0271	038	0	1	04	01	H0271_038_0	3	1	1	10				01111	9918	8430																	2		13d;	1	1	13d;	2			
H0271	039	0	1	04	01	H0271_039_0	3	1	1	10				01111	479	407																	2		13d;	1	1	13d;	2			
H0271	042	0	1	04	01	H0271_042_0	2	1	1	10				01111	1713	1456																	2		13d;	1	1	13d;	2			
H0271	043	0	1	04	01	H0271_043_0	3	1	3								00001101000000000000																2		13i;	1	1	13i;	2			
H0271	044	0	1	04	01	H0271_044_0	3	1	1	10				01111	2485	2112																	2		13d;	1	1	13d;	2			
H0271	045	0	1	04	01	H0271_045_0	3	1	1	10				01111	173	147																	2		13d;	1	1	13d;	2			
H0271	046	0	1	04	01	H0271_046_0	2	1	1	10				01111	1470	1250																	2		13d;	1	1	13d;	2			
H0271	049	0	1	04	01	H0271_049_0	6	1	3								00001101000000000000																2		13i;	1	1	13i;	2			
H0271	050	0	1	04	01	H0271_050_0	4	1	1	10				01111	439	373																	2		13d;	1	1	13d;	2			
H0271	050	0	1	04	01	H0271_050_0	4	2	1	10				01111	439	44																	2		13e;	1	1	13e;	2			
H0271	052	0	1	04	01	H0271_052_0	3	1	3								00001101000000000000																2		13i;	1	1	13i;	2			
H0271	053	0	1	04	01	H0271_053_0	3	1	1	10				01111	1435	1220																	2		13d;	1	1	13d;	2			
H0271	054	0	1	04	01	H0271_054_0	4	1	1	10				01111	221	188																	2		13d;	1	1	13d;	2			
H0271	055	0	1	04	01	H0271_055_0	5	1	1	10				01111	4996	4247																	2		13d;	1	1	13d;	2			
H0271	056	0	1	04	01	H0271_056_0	3	1	1	10				01111	921	783																	2		13d;	1	1	13d;	2			
H0271	057	0	1	04	01	H0271_057_0	2	1	3								00001101000000000000																2		13i;	1	1	13i;	2			
H0271	058	0	1	04	01	H0271_058_0	3	1	1	10				01111	325	276																	2		13d;	1	1	13d;	2			
H0271	059	0	1	04	01	H0271_059_0	2	1	1	10				01111	37742	32081																	2		13d;	1	1	13d;	2			
H0271	060	1	1	04	01	H0271_060_1	2	1	1	10				01111	3738	3177																	2		13d;	1	1	13d;	2			
H0271	060	2	1	04	01	H0271_060_2	2	1	1	10				01111	8244	7007																	2		13d;	1	1	13d;	2			
H0292	003	0	1	01	01	H0292_003_0	4	1	1	01	1111111111	2	2		2059	2174																	2		13b;13d;13e;13i;14c;		2		1	600	3	13b;13d;13e;13i1;13i3;13i4;13i5;13i6;13i10;14c8;
H0294	027	0	1	04	01	H0294_027_0	4	1	1	10				01111	2486	2113																	2		13d;	1	1	13d;	2			
H0321	002	0	1	02	01	H0321_002_0	3	1	1	10				01111	75564	64229																	2		13d;	2	1	13d;	2			
H0321	002	0	1	02	01	H0321_002_0	3	2	1	10				01111	75564	5667																	2		13f;	2	1	13f;	2			
H0321	004	0	1	02	01	H0321_004_0	3	3	1	10				01111	4913	491																	2		13e;	2	1	13e;	2			
H0321	004	0	1	02	01	H0321_004_0	3	1	1	10				01111	4913	4176																	2		13d;	2	1	13d;	2			
H0321	004	0	1	02	01	H0321_004_0	3	2	1	10				01111	4913	368																	2		13f;	2	1	13f;	2			
H0351	038	0	1	01	01	H0351_038_0	5	1	3								01111111111111110000																2		13i;14c;		1	13i;14c;	2			
H0351	057	0	1	01	01	H0351_057_0	5	1	3								01111111111111110000																2		13i;14c;		1	13i;14c;	2			
H0354	027	0	1	01	01	H0354_027_0	4	1	3								00000001000000000000																2		13i;		2		2			
H0363	001	0	1	01	01	H0363_001_0	10	1	3								01000110010011100000																2		13i;		2		2			
H0363	003	0	1	01	01	H0363_003_0	11	1	3								01000110010011100000																2		13i;		2		2			
H0422	001	0	1	02	01	H0422_001_0	6	1	2														00010000000000										2		13c;	2	2		2			
H0422	003	0	1	02	01	H0422_003_0	7	1	2														00010000000000										2		13c;	2	2		2			
H0423	001	0	1	01	01	H0423_001_0	6	1	3								11111111111111111111	Alzheimer's Disease	Hyperlipidemia	Malnutrition/Undernutrition	Osteoporosis	Kidney Disease											1	001	13i;		1	13i;	2			
H0423	007	0	1	01	01	H0423_007_0	7	1	3								11111111111111111111	Alzheimer's Disease	Hyperlipidemia	Malnutrition/Undernutrition	Osteoporosis	Kidney Disease											1	001	13i;		1	13i;	2			
H0432	009	0	1	02	01	H0432_009_0	2	1	1	10				01111	57856	49178																	2		13d;	2	1	13d;	2			
H0432	013	0	1	02	01	H0432_013_0	2	1	1	10				01111	4115	3498																	2		13d;	2	1	13d;	2			
H0439	002	0	1	01	01	H0439_002_0	5	1	1	10				01111	4821	2909																	2		13i;		2		2			
H0439	012	0	1	01	01	H0439_012_0	4	1	1	10				01111	1411	847																	2		13i;		2		2			
H0473	001	0	1	04	01	H0473_001_0	4	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H0473	001	0	1	04	01	H0473_001_0	4	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H0473	003	0	1	04	01	H0473_003_0	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H0473	004	0	1	04	01	H0473_004_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b2;18a1;18a2;18b1;
H0473	005	0	1	04	01	H0473_005_0	3	3	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H0473	005	0	1	04	01	H0473_005_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H0473	005	0	1	04	01	H0473_005_0	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H0473	006	0	1	04	01	H0473_006_0	3	2	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H0473	006	0	1	04	01	H0473_006_0	3	3	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H0473	006	0	1	04	01	H0473_006_0	3	1	1	10				01111	2389	2389																	2		13b;13d;13e;13f;14c;	1	2		1	600	3	13b;13d;13e;13f;14c8;
H0482	001	0	1	01	01	H0482_001_0	5	1	3								01111111111111110000																2		13i;		1	13i;	1	600	3	13i10;
H0482	002	0	1	01	01	H0482_002_0	5	1	3								01111111111111110000																2		13i;14c;		1	13i;14c;	1	1500	3	13i10;
H0482	003	0	1	01	01	H0482_003_0	5	1	3								01111111111111110000																2		13i;		1	13i;	1	600	3	13i10;
H0482	004	0	1	01	01	H0482_004_0	5	1	3								01111111111111110000																2		13i;14c;		1	13i;14c;	1	1500	3	13i10;
H0482	005	0	1	01	01	H0482_005_0	5	1	3								01111111111111110000																2		13i;14c;		1	13i;14c;	1	1500	3	13i10;
H0482	006	0	1	01	01	H0482_006_0	6	1	3								01111111111111110000																2		13i;14c;		1	13i;14c;	1	1500	3	13i10;
H0504	037	0	1	01	01	H0504_037_0	5	1	3								00011101000010010000																2		13i-O;		1	13i-O;	2			
H0504	041	0	1	01	01	H0504_041_0	5	1	3								00011101000010010000																2		13i-O;		1	13i-O;	2			
H0504	047	0	1	01	01	H0504_047_0	5	1	3								00011101000010010000																2		13i-O;		1	13i-O;	2			
H0504	048	0	1	01	01	H0504_048_0	5	1	3								00101001000000000000																2		13i;		1	13i;	2			
H0523	801	0	1	01	01	H0523_801_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H0523	805	0	1	01	01	H0523_805_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H0524	008	0	1	01	01	H0524_008_0	10	1	2														00000000001000	Meets clinical criteria for hospital care in home based on health status									2		13d;		2		2			
H0524	033	0	1	01	01	H0524_033_0	10	1	2														00000000001000	Meets clinical criteria for hospital care in home based on health status									2		13d;		2		2			
H0524	061	0	1	01	01	H0524_061_0	10	1	2														00000000001000	Meets clinical criteria for hospital care in home based on health status									2		13d;		2		2			
H0524	063	0	1	01	01	H0524_063_0	10	1	2														00000000001000	Meets clinical criteria for hospital care in home based on health status									2		13d;		2		2			
H0543	239	0	1	01	01	H0543_239_0	2	1	3								00001101000000000000																2		13i;		1	13i;	2			
H0543	240	0	1	01	01	H0543_240_0	2	1	3								00001101000000000000																2		13i;		1	13i;	2			
H0543	241	0	1	01	01	H0543_241_0	2	1	3								00001101000000000000																2		13i;		1	13i;	2			
H0543	242	0	1	01	01	H0543_242_0	2	1	3								00001101000000000000																2		13i;		1	13i;	2			
H0543	243	0	1	01	01	H0543_243_0	3	1	3								00001101000000000000																2		13i;		1	13i;	2			
H0544	002	0	1	01	01	H0544_002_0	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H0544	003	0	1	01	01	H0544_003_0	6	2	1	10				01111	40	40																	2		13i;		2		2			
H0544	003	0	1	01	01	H0544_003_0	6	1	1	10				01111	40	21																	2		13i;		2		2			
H0544	004	0	1	01	01	H0544_004_0	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H0544	007	0	1	01	01	H0544_007_0	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H0544	008	0	1	01	01	H0544_008_0	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H0544	010	0	1	01	01	H0544_010_0	8	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H0544	013	0	1	01	01	H0544_013_0	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H0544	014	0	1	01	01	H0544_014_0	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H0544	015	0	1	01	01	H0544_015_0	8	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H0544	019	0	1	01	01	H0544_019_0	7	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H0544	020	0	1	01	01	H0544_020_0	7	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H0544	027	0	1	01	01	H0544_027_0	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H0544	031	0	1	01	01	H0544_031_0	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H0544	032	0	1	01	01	H0544_032_0	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H0544	036	0	1	01	01	H0544_036_0	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H0544	038	0	1	01	01	H0544_038_0	7	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H0544	052	0	1	01	01	H0544_052_0	5	1	1	10				01111	1180	609																	2		13i;		2		2			
H0544	053	0	1	01	01	H0544_053_0	6	1	1	10				01111	951	491																	2		13i;		2		2			
H0544	055	0	1	01	01	H0544_055_0	5	1	1	10				01111	852	439																	2		13i;		2		2			
H0544	058	0	1	01	01	H0544_058_0	5	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H0544	062	0	1	01	01	H0544_062_0	5	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H0544	066	0	1	01	01	H0544_066_0	5	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H0544	081	0	1	01	01	H0544_081_0	5	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H0544	087	0	1	01	01	H0544_087_0	6	2	1	10				01111	2118	2118																	2		13i;		2		2			
H0544	087	0	1	01	01	H0544_087_0	6	1	1	10				01111	2118	1093																	2		13i;		2		2			
H0544	088	0	1	01	01	H0544_088_0	5	2	1	10				01111	1235	637																	2		13i;		2		2			
H0544	088	0	1	01	01	H0544_088_0	5	1	1	10				01111	1210	624																	2		13i;		2		2			
H0544	090	0	1	01	01	H0544_090_0	5	2	1	10				01111	1131	1131																	2		13i;		2		2			
H0544	090	0	1	01	01	H0544_090_0	5	1	1	10				01111	1131	583																	2		13i;		2		2			
H0544	094	0	1	01	01	H0544_094_0	5	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H0544	095	0	1	01	01	H0544_095_0	5	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H0544	099	0	1	01	01	H0544_099_0	5	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H0544	100	0	1	01	01	H0544_100_0	5	2	1	10				01111	1341	1341																	2		13i;		2		2			
H0544	100	0	1	01	01	H0544_100_0	5	1	1	10				01111	1341	692																	2		13i;		2		2			
H0544	101	0	1	01	01	H0544_101_0	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H0544	102	0	1	01	01	H0544_102_0	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H0544	106	0	1	01	01	H0544_106_0	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H0544	110	0	1	01	01	H0544_110_0	5	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H0544	117	1	1	01	01	H0544_117_1	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H0544	117	2	1	01	01	H0544_117_2	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H0544	118	1	1	01	01	H0544_118_1	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H0544	118	2	1	01	01	H0544_118_2	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H0544	119	1	1	01	01	H0544_119_1	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H0544	119	2	1	01	01	H0544_119_2	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H0544	120	1	1	01	01	H0544_120_1	5	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H0544	120	2	1	01	01	H0544_120_2	5	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H0544	121	1	1	01	01	H0544_121_1	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H0544	121	2	1	01	01	H0544_121_2	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H0544	125	0	1	01	01	H0544_125_0	5	1	1	10				01111	1272	657																	2		13i;		2		2			
H0544	125	0	1	01	01	H0544_125_0	5	2	1	10				01111	1272	1272																	2		13i;		2		2			
H0544	126	0	1	01	01	H0544_126_0	8	1	1	10				01111	471	471																	2		13i;		2		2			
H0544	129	0	1	01	01	H0544_129_0	7	1	1	10				01111	119	62																	2		13i;		2		2			
H0544	129	0	1	01	01	H0544_129_0	7	2	1	10				01111	119	119																	2		13i;		2		2			
H0562	121	0	1	01	01	H0562_121_0	7	2	1	10				01111	13459	4711																	2		13d;		1	13d;	1	600.00	3	13d;
H0562	121	0	1	01	01	H0562_121_0	7	1	3								01111111111111110000																2		13i;		1	13i;	1	900	3	13i10;
H0562	129	0	1	01	01	H0562_129_0	7	1	3								01111111111111110000																2		13i;		1	13i;	1	900	3	13i10;
H0562	129	0	1	01	01	H0562_129_0	7	2	1	10				01111	28240	9884																	2		13d;		1	13d;	1	600.00	3	13d;
H0571	005	0	1	01	01	H0571_005_0	2	1	1	10				01000	3131	2349																	2		13i;		1	13i;	1	28.00	7	13i1;
H0609	037	0	1	02	01	H0609_037_0	2	1	3								00001101000000000000																2		13i;	2	1	13i;	2			
H0609	042	0	1	02	01	H0609_042_0	2	1	3								00001101000000000000																2		13i;	2	1	13i;	2			
H0609	043	0	1	02	01	H0609_043_0	2	1	3								00001101000000000000																2		13i;	2	1	13i;	2			
H0609	047	0	1	02	01	H0609_047_0	2	1	3								00001101000000000000																2		13i;	2	1	13i;	2			
H0609	049	0	1	02	01	H0609_049_0	2	1	3								00001101000000000000																2		13i;	2	1	13i;	2			
H0624	001	0	1	02	01	H0624_001_0	2	1	1	10				01111	35024	29770																	2		13d;	2	1	13d;	2			
H0628	001	0	1	02	01	H0628_001_0	4	1	3								00111111111110111100	Hyperlipidemia	Hypertension														1	001	10b;13b;14c;	2	1	10b;13b;14c;	2			
H0628	005	0	1	02	01	H0628_005_0	4	1	3								00111111111110111100	Hyperlipidemia	Hypertension														1	001	10b;13b;14c;	2	1	10b;13b;14c;	2			
H0628	012	0	1	01	01	H0628_012_0	5	1	1	10				01111	238273	238273																	2		13i;14c;		1	13i;14c;	2			
H0628	013	0	1	01	01	H0628_013_0	6	1	1	10				01111	238273	238273																	2		13i;14c;		1	13i;14c;	2			
H0628	017	0	1	02	01	H0628_017_0	4	1	3								00111111111110111100	Hyperlipidemia	Hypertension														1	001	10b;13b;14c;	2	1	10b;13b;14c;	2			
H0628	801	0	1	01	01	H0628_801_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H0628	802	0	1	01	01	H0628_802_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H0672	009	0	1	01	01	H0672_009_0	5	1	1	10				01111	270	162																	2		13i;		2		2			
H0672	010	0	1	01	01	H0672_010_0	5	1	1	10				01111	106	64																	2		13i;		2		2			
H0672	012	0	1	01	01	H0672_012_0	6	1	1	10				01111	43	26																	2		13i;		2		2			
H0672	012	0	1	01	01	H0672_012_0	6	2	1	10				01111	43	26																	2		13i;		2		2			
H0672	015	0	1	01	01	H0672_015_0	6	1	1	10				01111	42	25																	2		13i;		2		2			
H0672	015	0	1	01	01	H0672_015_0	6	2	1	10				01111	42	25																	2		13i;		2		2			
H0712	005	0	1	01	01	H0712_005_0	5	2	1	10				01111	5590	1677																	2		13d;		1	13d;	1	300.00	3	13d;
H0712	005	0	1	01	01	H0712_005_0	5	1	3								01111111111111110000																2		13i;		1	13i;	1	600	3	13i10;
H0712	025	0	1	01	01	H0712_025_0	5	1	1	10				01111	227	68																	2		13d;		1	13d;	1	300.00	3	13d;
H0712	029	0	1	01	01	H0712_029_0	5	2	1	10				01111	2565	898																	2		13d;		1	13d;	1	600.00	3	13d;
H0712	029	0	1	01	01	H0712_029_0	5	1	3								01111111111111110000																2		13i;		1	13i;	1	600.00	3	13i10;
H0764	001	0	1	04	01	H0764_001_0	3	3	1	10				01111	580	44																	2		13f;	1	1	13f;	2			
H0764	001	0	1	04	01	H0764_001_0	3	1	1	10				01111	580	493																	2		13d;	1	1	13d;	2			
H0764	001	0	1	04	01	H0764_001_0	3	2	1	10				01111	580	58																	2		13e;	1	1	13e;	2			
H0783	002	0	1	01	01	H0783_002_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b2;18a1;18a2;18b1;
H0783	003	0	1	01	01	H0783_003_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H0798	001	0	1	01	01	H0798_001_0	6	1	3								00011111111010110000																2		13i;		2		2			
H0826	001	0	1	01	01	H0826_001_0	4	1	3								00000001010000001000	Chronic Kidney Disease															2		13b;13f;13i;		2		2			
H0826	002	0	1	01	01	H0826_002_0	4	1	3								00000001010000001000	Chronic Kidney Disease															2		10b;13b;13f;13i;		2		2			
H0838	024	0	1	01	01	H0838_024_0	6	1	3								00001111000001001000	Kidney Disease															1	001	13b;13i;		2		2			
H0838	029	0	1	01	01	H0838_029_0	6	1	3								00001111000001000000																1	001	13i;		2		2			
H0838	039	1	1	01	01	H0838_039_1	6	1	3								00001100000000001000	Kidney Disease															1	001	13b;		2		2			
H0838	039	2	1	01	01	H0838_039_2	6	1	3								00001100000000001000	Kidney Disease															1	001	13b;		2		2			
H0838	040	1	1	01	01	H0838_040_1	4	1	3								00001111000001001000	Kidney Disease															1	001	13b;13i;		2		2			
H0838	040	2	1	01	01	H0838_040_2	4	1	3								00001111000001001000	Kidney Disease															1	001	13b;13i;		2		2			
H0838	047	0	1	01	01	H0838_047_0	6	1	3								00001100000000001000	Kidney Disease															1	001	13b;		2		2			
H0838	050	2	1	01	01	H0838_050_2	6	1	3								00001111000001000000																1	001	13i;		2		2			
H0838	051	2	1	01	01	H0838_051_2	7	1	3								00001111000001000000																1	001	13i;		2		2			
H0876	001	0	1	01	01	H0876_001_0	5	1	3								01111111111111110000																2		13i;13i-O;		2		2			
H0885	001	0	1	04	01	H0885_001_0	8	1	3								00001101000000000000																1	001	13i;	1	1	13i;	2			
H0885	002	0	1	04	01	H0885_002_0	8	1	3								00001101000000000000																1	001	13i;	1	1	13i;	2			
H0885	003	0	1	04	01	H0885_003_0	8	1	3								00001101000000000000																1	001	13i;	1	1	13i;	2			
H0885	004	0	1	04	01	H0885_004_0	8	1	3								00001101000000000000																1	001	13i;	1	1	13i;	2			
H0885	005	0	1	04	01	H0885_005_0	8	1	3								00001101000000000000																1	001	13i;	1	1	13i;	2			
H0885	006	0	1	04	01	H0885_006_0	8	1	3								00001101000000000000																1	001	13i;	1	1	13i;	2			
H0907	001	0	1	01	01	H0907_001_0	6	3	1	10				01111	5688	5688																	2		13i;		2		2			
H0907	001	0	1	01	01	H0907_001_0	6	4	1	10				01111	5688	5688																	2		13i-O;		2		2			
H0907	001	0	1	01	01	H0907_001_0	6	2	1	10				01111	5688	5688																	2		13i;		2		2			
H0907	001	0	1	01	01	H0907_001_0	6	1	1	10				01111	5688	2935																	2		13i;		2		2			
H0908	001	0	1	01	01	H0908_001_0	7	1	3								01111111111111110000																2		13i;		1	13i;	1	600	3	13i10;
H0908	001	0	1	01	01	H0908_001_0	7	2	1	10				01111	5769	2019																	2		13d;		1	13d;	1	600.00	3	13d;
H0908	004	0	1	01	01	H0908_004_0	6	1	3								01111111111111110000																2		13i;		1	13i;	1	600	3	13i10;
H0913	013	0	1	01	01	H0913_013_0	5	1	3								01111111111111110000																2		13b;13d;13i;14c;		1	13b;13d;13i;14c;	1	2000	3	13b;13d;13i5;13i10;14c8;
H0913	017	0	1	01	01	H0913_017_0	4	1	3								01111111111111110000																2		13i;		1	13i;	2			
H0969	005	0	1	04	01	H0969_005_0	4	1	3								01111111111111110000																2		13i;	1	1	13i;	1	900	3	13i10;
H0978	002	0	1	01	01	H0978_002_0	8	1	3								00011111010000100000																2		13i;		2		2			
H0978	003	0	1	01	01	H0978_003_0	8	1	3								00011111010000100000																2		13i;		2		2			
H0978	006	0	1	01	01	H0978_006_0	7	1	3								00011111010000100000																2		13i;		2		2			
H0978	007	0	1	01	01	H0978_007_0	7	1	3								00011111010000100000																2		13i;		2		2			
H0982	002	0	1	01	01	H0982_002_0	8	1	1	10				01111	1979	1979																	2		13d;14c;		2		2			
H0982	010	0	1	01	01	H0982_010_0	8	1	1	10				01111	1979	1979																	2		13d;14c;		2		2			
H0982	011	0	1	01	01	H0982_011_0	7	1	3								00000000000001000000																2		13i;14c;		2		2			
H0982	012	0	1	01	01	H0982_012_0	8	1	1	10				01111	1979	1979																	2		13d;14c;		2		2			
H0982	013	0	1	01	01	H0982_013_0	8	1	1	10				01111	1979	1979																	2		13d;14c;		2		2			
H0982	015	0	1	01	01	H0982_015_0	8	1	1	10				01111	1979	1979																	2		13d;14c;		2		2			
H1016	023	0	1	01	01	H1016_023_0	4	1	3								00000101000000001100	Coronary Artery Disease CAD	Chronic Obstructive Pulmonary Disease (COPD)														1	001	13b;13c;		2		2			
H1016	024	0	1	01	01	H1016_024_0	4	1	3								00000101000000001100	Coronary Artery Disease CAD	Chronic Obstructive Pulmonary Disease (COPD)														1	001	13b;13c;		2		2			
H1019	001	0	1	01	01	H1019_001_0	4	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1019	006	0	1	01	01	H1019_006_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1019	023	0	1	01	01	H1019_023_0	4	2	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1019	023	0	1	01	01	H1019_023_0	4	1	1	10				01111	42715	42715																	2		13b;13d;13e;13f;14c;		2		1	3300	3	13b;13d;13e;13f;14c8;
H1019	026	0	1	01	01	H1019_026_0	3	2	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1019	026	0	1	01	01	H1019_026_0	3	1	1	10				01111	34568	34568																	2		13b;13d;13e;13f;14c;		2		1	2100	3	13b;13d;13e;13f;14c8;
H1019	057	0	1	02	01	H1019_057_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	2		1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1019	069	0	1	01	01	H1019_069_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1019	073	0	1	01	01	H1019_073_0	4	1	1	10				01111	6480	6480																	2		13b;13d;13e;13f;14c;		2		1	1800	3	13b;13d;13e;13f;14c8;
H1019	073	0	1	01	01	H1019_073_0	4	2	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1019	098	0	1	01	01	H1019_098_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1019	102	0	1	01	01	H1019_102_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1019	103	1	1	01	01	H1019_103_1	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1019	103	2	1	01	01	H1019_103_2	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1019	105	0	1	01	01	H1019_105_0	4	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1019	106	0	1	01	01	H1019_106_0	4	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1019	107	0	1	01	01	H1019_107_0	4	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1019	108	0	1	01	01	H1019_108_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1019	109	0	1	01	01	H1019_109_0	4	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1019	114	0	1	01	01	H1019_114_0	4	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1019	115	0	1	01	01	H1019_115_0	4	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1019	116	0	1	01	01	H1019_116_0	4	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1019	117	0	1	01	01	H1019_117_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1019	118	0	1	01	01	H1019_118_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1019	121	0	1	01	01	H1019_121_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1019	122	0	1	01	01	H1019_122_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1019	123	0	1	01	01	H1019_123_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1019	124	0	1	01	01	H1019_124_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1019	125	0	1	01	01	H1019_125_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1019	126	0	1	01	01	H1019_126_0	4	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1019	127	0	1	01	01	H1019_127_0	4	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1019	128	0	1	01	01	H1019_128_0	4	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1019	129	0	1	01	01	H1019_129_0	4	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1019	130	0	1	01	01	H1019_130_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1019	141	0	1	02	01	H1019_141_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	2		1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1019	142	0	1	02	01	H1019_142_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	2		1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1032	124	0	1	01	01	H1032_124_0	6	1	3								01111111111111110000																2		13i;14c;		1	13i;14c;	1	600	3	13i10;
H1032	124	0	1	01	01	H1032_124_0	6	2	1	10				01111	20710	6213																	2		13d;		1	13d;	1	300.00	3	13d;
H1032	170	0	1	01	01	H1032_170_0	6	1	3								01111111111111110000																2		13i;14c;		1	13i;14c;	1	600	3	13i10;
H1032	170	0	1	01	01	H1032_170_0	6	2	1	10				01111	630	189																	2		13d;		1	13d;	1	300.00	3	13d;
H1032	175	0	1	01	01	H1032_175_0	6	1	3								01111111111111110000																2		13i;14c;		1	13i;14c;	1	600	3	13i10;
H1032	175	0	1	01	01	H1032_175_0	6	2	1	10				01111	30036	10513																	2		13d;		1	13d;	1	600.00	3	13d;
H1032	176	0	1	01	01	H1032_176_0	6	1	3								01111111111111110000																2		13i;14c;		1	13i;14c;	1	600.00	3	13i10;
H1032	176	0	1	01	01	H1032_176_0	6	2	1	10				01111	1568	549																	2		13d;		1	13d;	1	600.00	3	13d;
H1032	182	0	1	01	01	H1032_182_0	6	1	1	10				01111	2534	760																	2		13d;		1	13d;	1	300.00	3	13d;
H1032	202	0	1	01	01	H1032_202_0	6	1	3								01111111111111110000																2		13i;		1	13i;	2			
H1032	202	0	1	01	01	H1032_202_0	6	2	1	10				01111	1877	563																	2		13d;		1	13d;	1	300.00	3	13d;
H1032	206	0	1	01	01	H1032_206_0	6	1	3								01111111111111110000																2		13i;		1	13i;	2			
H1032	206	0	1	01	01	H1032_206_0	6	2	1	10				01111	184	55																	2		13d;		1	13d;	1	300.00	3	13d;
H1032	214	0	1	01	01	H1032_214_0	6	1	3								01111111111111110000																2		13i;		1	13i;	2			
H1032	214	0	1	01	01	H1032_214_0	6	2	1	10				01111	2758	827																	2		13d;		1	13d;	1	300.00	3	13d;
H1032	217	0	1	01	01	H1032_217_0	6	1	3								01111111111111110000																2		13i;		1	13i;	2			
H1032	217	0	1	01	01	H1032_217_0	6	2	1	10				01111	255	77																	2		13d;		1	13d;	1	300.00	3	13d;
H1032	236	0	1	01	01	H1032_236_0	6	1	1	10				01111	334	100																	2		13d;		1	13d;	1	300.00	3	13d;
H1035	022	0	1	01	01	H1035_022_0	8	1	3								00000101000000001100	Coronary Artery Disease (CAD)	Chronic Obtructive Pulmonary Disease (COPD)														1	001	13b;13i;14c;		1	13b;13i;14c;	2			
H1035	023	0	1	01	01	H1035_023_0	7	1	3								00000101000000001100	Coronary Artery Disease (CAD)	Chronic Obtructive Pulmonary Disease (COPD)														1	001	13b;13i;14c;		1	13b;13i;14c;	2			
H1035	024	0	1	01	01	H1035_024_0	10	1	3								00000101000000001100	Coronary Artery Disease (CAD)	Chronic Obtructive Pulmonary Disease (COPD)														1	001	13b;13i;14c;		1	13b;13i;14c;	2			
H1035	025	0	1	01	01	H1035_025_0	7	1	3								00000101000000001100	Coronary Artery Disease (CAD)	Chronic Obtructive Pulmonary Disease (COPD)														1	001	13b;13i;14c;		1	13b;13i;14c;	2			
H1035	026	0	1	01	01	H1035_026_0	7	1	3								00000101000000001100	Coronary Artery Disease (CAD)	Chronic Obtructive Pulmonary Disease (COPD)														1	001	13b;13i;14c;		1	13b;13i;14c;	2			
H1035	027	0	1	01	01	H1035_027_0	6	1	1	10				01111	1449	1014																	2		13i;		1	13i;	1	51.00	7	13i1;
H1035	028	0	1	01	01	H1035_028_0	6	1	1	10				01111	2277	1594																	2		13i;		1	13i;	1	52.00	7	13i1;
H1035	029	0	1	01	01	H1035_029_0	6	1	1	10				01111	2763	1934																	2		13i;		1	13i;	1	52.00	7	13i1;
H1035	030	0	1	01	01	H1035_030_0	6	1	1	10				01111	2264	1585																	2		13i;		1	13i;	1	52.00	7	13i1;
H1035	031	0	1	01	01	H1035_031_0	6	1	1	10				01111	2504	1753																	2		13i;		1	13i;	1	52.00	7	13i1;
H1035	032	0	1	01	01	H1035_032_0	6	1	1	10				01111	4468	3128																	2		13i;		1	13i;	1	52.00	7	13i1;
H1035	033	0	1	01	01	H1035_033_0	6	1	3								00000101000000001100	Coronary Artery Disease (CAD)	Chronic Obtructive Pulmonary Disease (COPD)														1	001	13b;13i;14c;		1	13b;13i;14c;	2			
H1035	034	0	1	01	01	H1035_034_0	6	1	3								00000101000000001100	Coronary Artery Disease (CAD)	Chronic Obtructive Pulmonary Disease (COPD)														1	001	13b;13i;14c;		1	13b;13i;14c;	2			
H1035	043	0	1	01	01	H1035_043_0	8	1	3								00000101000000001100	Coronary Artery Disease (CAD)	Chronic Obtructive Pulmonary Disease (COPD)														1	001	13i;		1	13i;	2			
H1035	045	0	1	01	01	H1035_045_0	7	1	3								00000101000000001100	Coronary Artery Disease (CAD)	Chronic Obtructive Pulmonary Disease (COPD)														1	001	13b;13i;14c;		1	13b;13i;14c;	2			
H1035	048	0	1	01	01	H1035_048_0	6	1	3								00000101000000001100	Coronary Artery Disease (CAD)	Chronic Obtructive Pulmonary Disease (COPD)														1	001	13b;13i;14c;		1	13b;13i;14c;	2			
H1035	050	0	1	01	01	H1035_050_0	9	1	1	10				01111	514	360																	2		13i;		1	13i;	1	27.00	7	13i1;
H1036	025	0	1	01	01	H1036_025_0	5	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H1036	054	0	1	01	01	H1036_054_0	5	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H1036	054	0	1	01	01	H1036_054_0	5	1	3								01111111111111111110	Chronic Kidney Disease	Peripheral Vascular Disease	Chronic Foot Ulcers													1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1036	062	0	1	01	01	H1036_062_0	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H1036	062	0	1	01	01	H1036_062_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1036	065	0	1	01	01	H1036_065_0	5	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H1036	065	0	1	01	01	H1036_065_0	5	1	3								01111111111111111110	Chronic Kidney Disease	Peripheral Vascular Disease	Chronic Foot Ulcers													1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1036	077	0	1	01	01	H1036_077_0	4	1	1	10				01111	33429	33429																	2		13b;13d;13e;13f;14c;		2		1	2100	3	13b;13d;13e;13f;14c8;
H1036	077	0	1	01	01	H1036_077_0	4	3	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H1036	077	0	1	01	01	H1036_077_0	4	2	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1036	102	0	1	01	01	H1036_102_0	6	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1036	102	0	1	01	01	H1036_102_0	6	2	1	10				01111	22384	22384																	2		13b;13d;13e;13f;14c;		2		1	2100	3	13b;13d;13e;13f;14c8;
H1036	102	0	1	01	01	H1036_102_0	6	3	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H1036	119	0	1	01	01	H1036_119_0	5	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H1036	121	0	1	01	01	H1036_121_0	4	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H1036	121	0	1	01	01	H1036_121_0	4	1	3								01111111111111110000																1	001	13b;13i;13i-O;14c;		2		1	420	3	13b;13i1;13i3;13i4;13i5;13i6;13i10;13i-O1;14c8;
H1036	137	0	1	02	01	H1036_137_0	3	1	3								00000101000011000000																1	001	13c;	2	2		2			
H1036	146	0	1	01	01	H1036_146_0	5	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H1036	156	0	1	01	01	H1036_156_0	6	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1036	160	0	1	01	01	H1036_160_0	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H1036	167	0	1	02	01	H1036_167_0	3	2	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13c;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	2		1	500	3	7b1;7f;10b1;13a;13b;13c;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1036	167	0	1	02	01	H1036_167_0	3	1	1	10				01111	100	100																	2		13b;13d;13e;13f;14c;	1	2		1	2700	3	13b;13d;13e;13f;14c8;
H1036	168	0	1	02	01	H1036_168_0	3	2	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13c;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	2		1	500	3	7b1;7f;10b1;13a;13b;13c;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1036	168	0	1	02	01	H1036_168_0	3	1	1	10				01111	100	100																	2		13b;13d;13e;13f;14c;	1	2		1	2700	3	13b;13d;13e;13f;14c8;
H1036	175	0	1	01	01	H1036_175_0	4	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1036	209	0	1	01	01	H1036_209_0	3	2	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1036	209	0	1	01	01	H1036_209_0	3	1	1	10				01111	7383	7383																	2		13b;13d;13e;13f;14c;		2		1	2100	3	13b;13d;13e;13f;14c8;
H1036	210	0	1	01	01	H1036_210_0	3	1	1	10				01111	6516	6516																	2		13b;13d;13e;13f;14c;		2		1	1800	3	13b;13d;13e;13f;14c8;
H1036	210	0	1	01	01	H1036_210_0	3	2	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1036	213	0	1	01	01	H1036_213_0	3	3	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H1036	213	0	1	01	01	H1036_213_0	3	2	1	10				01111	11301	11301																	2		13b;13d;13e;13f;14c;		2		1	2100	3	13b;13d;13e;13f;14c8;
H1036	213	0	1	01	01	H1036_213_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1036	214	0	1	01	01	H1036_214_0	3	1	1	10				01111	3121	3121																	2		13b;13d;13e;13f;14c;		2		1	1500	3	13b;13d;13e;13f;14c8;
H1036	214	0	1	01	01	H1036_214_0	3	2	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1036	222	0	1	01	01	H1036_222_0	4	1	1	10				01111	12555	12555																	2		13b;13d;13e;13f;14c;		1	13b;13d;13e;13f;14c;	1	2100	3	13b;13d;13e;13f;14c8;
H1036	226	0	1	01	01	H1036_226_0	4	1	1	10				01111	3626	3626																	2		13b;13d;13e;13f;14c;		2		1	1800	3	13b;13d;13e;13f;14c8;
H1036	230	0	1	01	01	H1036_230_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1036	231	0	1	01	01	H1036_231_0	3	1	1	10				01111	3247	3247																	2		13b;13d;13e;13f;14c;		2		1	2100	3	13b;13d;13e;13f;14c8;
H1036	231	0	1	01	01	H1036_231_0	3	2	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1036	233	0	1	02	01	H1036_233_0	3	2	3								00000101000011000000																1	001	13c;	2	2		2			
H1036	233	0	1	02	01	H1036_233_0	3	1	1	01	1111111111	2	2		1765	73																	2		13b;13d;13e;13i;14c;	2	2		1	600	3	13b;13d;13e;13i1;13i3;13i4;13i5;13i6;13i10;14c8;
H1036	234	0	1	01	01	H1036_234_0	4	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	1900	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;13i-O4;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1036	235	0	1	01	01	H1036_235_0	6	1	1	10				01111	1216	1216																	2		13b;13d;13e;13f;14c;		2		1	1800	3	13b;13d;13e;13f;14c8;
H1036	235	0	1	01	01	H1036_235_0	6	2	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1036	236	0	1	01	01	H1036_236_0	4	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1036	261	0	1	01	01	H1036_261_0	4	1	1	10				01111	609	609																	2		13b;13d;13e;13f;14c;		2		1	2100	3	13b;13d;13e;13f;14c8;
H1036	261	0	1	01	01	H1036_261_0	4	2	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1036	265	1	1	01	01	H1036_265_1	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H1036	269	0	1	01	01	H1036_269_0	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H1036	276	0	1	02	01	H1036_276_0	3	1	1	10				01111	100	100																	2		13b;13d;13e;13f;14c;	1	2		1	2700	3	13b;13d;13e;13f;14c8;
H1036	276	0	1	02	01	H1036_276_0	3	2	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13c;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	2		1	500	3	7b1;7f;10b1;13a;13b;13c;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1036	279	0	1	01	01	H1036_279_0	2	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H1036	280	0	1	01	01	H1036_280_0	4	1	1	10				01111	120	120																	2		13b;13d;13e;13f;14c;		2		1	2100	3	13b;13d;13e;13f;14c8;
H1036	284	0	1	01	01	H1036_284_0	3	2	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1036	284	0	1	01	01	H1036_284_0	3	1	1	10				01111	392	392																	2		13b;13d;13e;13f;14c;		2		1	900	3	13b;13d;13e;13f;14c8;
H1036	285	0	1	01	01	H1036_285_0	3	2	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1036	285	0	1	01	01	H1036_285_0	3	1	1	10				01111	1474	1474																	2		13b;13d;13e;13f;14c;		2		1	1800	3	13b;13d;13e;13f;14c8;
H1036	290	0	1	01	01	H1036_290_0	2	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H1036	291	0	1	02	01	H1036_291_0	3	1	3								00000101000011000000																1	001	13c;	2	2		2			
H1036	292	0	1	01	01	H1036_292_0	4	1	3								01111111111111110000																1	001	13b;13i;13i-O;14c;		2		1	420	3	13b;13i1;13i3;13i4;13i5;13i6;13i10;13i-O1;14c8;
H1036	295	0	1	01	01	H1036_295_0	3	2	2														01000000000000										1	010	13d;		2		2			
H1036	295	0	1	01	01	H1036_295_0	3	1	1	01	1111111111	2	2		260	260																	2		13b;13d;13e;13i;14c;		2		1	600	3	13b;13d;13e;13i1;13i3;13i4;13i5;13i6;13i10;14c8;
H1036	296	0	1	01	01	H1036_296_0	4	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;13i-O4;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1036	297	0	1	01	01	H1036_297_0	4	1	3								01111111111111110000																1	001	13b;13i;13i-O;14c;		2		1	420	3	13b;13i1;13i3;13i4;13i5;13i6;13i10;13i-O1;14c8;
H1036	297	0	1	01	01	H1036_297_0	4	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H1036	298	0	1	01	01	H1036_298_0	4	1	3								01111111111111110000																1	001	13b;13i;13i-O;14c;		2		1	420	3	13b;13i1;13i3;13i4;13i5;13i6;13i10;13i-O1;14c8;
H1036	299	0	1	01	01	H1036_299_0	4	1	3								01111111111111110000																1	001	13b;13i;13i-O;14c;		2		1	600	3	13b;13i10;13i-O1;14c8;
H1036	299	0	1	01	01	H1036_299_0	4	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H1036	300	0	1	01	01	H1036_300_0	4	1	3								01111111111111110000																1	001	13b;13i;13i-O;14c;		2		1	600	3	13b;13i3;13i4;13i5;13i6;13i10;13i-O1;14c8;
H1036	300	0	1	01	01	H1036_300_0	4	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H1036	301	0	1	01	01	H1036_301_0	4	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;13i-O4;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1036	302	0	1	01	01	H1036_302_0	4	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;13i-O4;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1036	303	0	1	01	01	H1036_303_0	4	1	3								01111111111111110000																1	001	13b;13i;13i-O;14c;		2		1	600	3	13b;13i4;13i5;13i6;13i10;13i-O1;14c8;
H1036	304	0	1	01	01	H1036_304_0	4	1	1	10				01111	9206	9206																	2		13b;13d;13e;13f;14c;		2		1	3300	3	13b;13d;13e;13f;14c8;
H1036	304	0	1	01	01	H1036_304_0	4	3	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H1036	304	0	1	01	01	H1036_304_0	4	2	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1036	305	0	1	01	01	H1036_305_0	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H1036	306	0	1	01	01	H1036_306_0	4	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13c;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	1600	3	7b1;7f;10b1;13a;13b;13c;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;13i-O4;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1045	012	0	1	01	01	H1045_012_0	2	1	1	10				01111	30892	26258																	2		13d;		1	13d;	2			
H1045	018	0	1	01	01	H1045_018_0	2	1	3								00001101000000000000																2		13i;		1	13i;	2			
H1045	038	0	1	01	01	H1045_038_0	2	1	1	10				01111	2588	2200																	2		13d;		1	13d;	2			
H1045	039	0	1	02	01	H1045_039_0	2	1	1	10				01111	53450	45433																	2		13d;	2	1	13d;	2			
H1045	048	1	1	02	01	H1045_048_1	2	1	3								00001101000000000000																2		13i;	2	1	13i;	2			
H1045	048	2	1	02	01	H1045_048_2	2	1	3								00001101000000000000																2		13i;	2	1	13i;	2			
H1045	048	3	1	02	01	H1045_048_3	2	1	3								00001101000000000000																2		13i;	2	1	13i;	2			
H1045	048	4	1	02	01	H1045_048_4	2	1	3								00001101000000000000																2		13i;	2	1	13i;	2			
H1109	801	0	1	01	01	H1109_801_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H1109	802	0	1	01	01	H1109_802_0	2	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H1112	006	0	1	01	01	H1112_006_0	5	2	1	10				01111	13201	3960																	2		13d;		1	13d;	1	300.00	3	13d;
H1112	006	0	1	01	01	H1112_006_0	5	1	3								01111111111111110000																2		13i;		1	13i;	2			
H1112	033	0	1	01	01	H1112_033_0	5	1	3								01111111111111110000																2		13i;		1	13i;	1	600	3	13i10;
H1112	033	0	1	01	01	H1112_033_0	5	2	1	10				01111	8912	3119																	2		13d;		1	13d;	1	600.00	3	13d;
H1112	043	0	1	01	01	H1112_043_0	4	1	3								01111111111111110000																2		13i;		1	13i;	1	600	3	13i10;
H1170	002	0	1	01	01	H1170_002_0	10	1	2														00000000001000	Meets clinical criteria for hospital care in home based on health status									2		13d;		2		2			
H1170	002	0	1	01	01	H1170_002_0	10	2	3								01111111111111110000																2		13i;		2		2			
H1170	008	0	1	01	01	H1170_008_0	10	1	2														00000000001000	Meets clinical criteria for hospital care in home based on health status									2		13d;		2		2			
H1170	008	0	1	01	01	H1170_008_0	10	2	3								01111111111111110000																2		13i;		2		2			
H1170	009	0	1	01	01	H1170_009_0	10	1	2														00000000001000	Meets clinical criteria for hospital care in home based on health status									2		13d;		2		2			
H1170	009	0	1	01	01	H1170_009_0	10	2	3								01111111111111110000																2		13i;		2		2			
H1170	010	0	1	01	01	H1170_010_0	10	2	3								01111111111111110000																2		13i;		2		2			
H1170	010	0	1	01	01	H1170_010_0	10	1	2														00000000001000	Meets clinical criteria for hospital care in home based on health status									2		13d;		2		2			
H1170	011	0	1	01	01	H1170_011_0	9	1	2														00000000001000	Meets clinical criteria for hospital care in home based on health status									2		13d;		2		2			
H1170	011	0	1	01	01	H1170_011_0	9	2	3								01111111111111110000																2		13i;		2		2			
H1170	012	0	1	01	01	H1170_012_0	9	1	2														00000000001000	Meets clinical criteria for hospital care in home based on health status									2		13d;		2		2			
H1170	012	0	1	01	01	H1170_012_0	9	2	3								01111111111111110000																2		13i;		2		2			
H1170	013	0	1	02	01	H1170_013_0	10	1	2														00000000001000	Meets clinical criteria for hospital care in home based on health status									2		13d;	2	2		2			
H1170	013	0	1	02	01	H1170_013_0	10	2	3								01111111111111110000																2		13i;	2	2		2			
H1170	014	0	1	01	01	H1170_014_0	8	2	3								01111111111111110000																2		13i;		2		2			
H1170	014	0	1	01	01	H1170_014_0	8	1	2														00000000001000	Meets clinical criteria for hospital care in home based on health status									2		13d;		2		2			
H1215	001	0	1	01	01	H1215_001_0	5	2	1	10				01111	800	240																	2		13d;		1	13d;	1	300.00	3	13d;
H1215	001	0	1	01	01	H1215_001_0	5	1	3								01111111111111110000																2		13i;		1	13i;	2			
H1224	001	0	1	01	01	H1224_001_0	12	1	3								01111111111111110000																1	001	13i;		1	13i;	1	60.00	7	13i1;13i10;
H1277	002	0	1	01	01	H1277_002_0	5	1	3								00000010000000000000																2		13i;		1	13i;	2			
H1277	004	0	1	01	01	H1277_004_0	8	1	3								00000000010000000000																2		13c;		1	13c;	2			
H1277	005	0	1	02	01	H1277_005_0	5	1	3								01111111111111110000																2		13i;	2	1	13i;	2			
H1280	001	0	1	01	01	H1280_001_0	6	1	3								00000001000000000000																1	001	13b;13i;		2		1	70.00	5	13b;13i1;
H1280	002	0	1	01	01	H1280_002_0	6	1	3								00000001000000000000																1	001	13b;13i;		2		1	70.00	5	13b;13i1;
H1290	001	0	1	01	01	H1290_001_0	10	1	3								01111111111111111000	Other eligible chronic conditions															2		13i;13i-O;		2		1	540.00	3	13i1;13i-O1;
H1290	002	0	1	01	01	H1290_002_0	10	1	3								01111111111111111000	Other eligible chronic conditions															2		13i;13i-O;		2		1	540.00	7	13i1;13i-O1;
H1290	003	0	1	01	01	H1290_003_0	10	1	3								01111111111111111000	Other eligible chronic conditions															2		13i;13i-O;		2		1	540.00	3	13i1;13i-O1;
H1290	005	0	1	01	01	H1290_005_0	10	1	3								01111111111111111000	Other eligible chronic conditions															2		13i;13i-O;		2		1	540.00	3	13i1;13i-O1;
H1290	019	0	1	01	01	H1290_019_0	9	1	3								01111111111111111000	Other eligible chronic conditions															2		13i;13i-O;		2		1	390.00	3	13i10;13i-O1;
H1290	019	0	1	01	01	H1290_019_0	9	2	1	10				01111	1048	838																	2		13i;		2		1	125.00	7	13i1;
H1290	020	0	1	01	01	H1290_020_0	9	1	3								01111111111111111000	Other eligible chronic conditions															2		13i;13i-O;		2		1	390.00	3	13i10;13i-O1;
H1290	020	0	1	01	01	H1290_020_0	9	2	1	10				01111	974	779																	2		13i;		2		1	125.00	7	13i1;
H1290	021	0	1	01	01	H1290_021_0	9	1	3								01111111111111111000	Other eligible chronic conditions															2		13i;13i-O;		2		1	390.00	3	13i10;13i-O1;
H1290	021	0	1	01	01	H1290_021_0	9	2	1	10				01111	716	573																	2		13i;		2		1	125.00	7	13i1;
H1290	022	0	1	01	01	H1290_022_0	9	1	3								01111111111111111000	Other eligible chronic conditions															2		13i;13i-O;		2		1	390.00	3	13i10;13i-O1;
H1290	022	0	1	01	01	H1290_022_0	9	2	1	10				01111	1775	1420																	2		13i;		2		1	125.00	7	13i1;
H1290	023	0	1	01	01	H1290_023_0	9	1	3								01111111111111111000	Other eligible chronic conditions															2		13i;13i-O;		2		1	390.00	3	13i10;13i-O1;
H1290	023	0	1	01	01	H1290_023_0	9	2	1	10				01111	1463	1170																	2		13i;		2		1	125.00	7	13i1;
H1290	024	0	1	01	01	H1290_024_0	9	1	3								01111111111111111000	Other eligible chronic conditions															2		13i;13i-O;		2		1	390.00	3	13i10;13i-O1;
H1290	024	0	1	01	01	H1290_024_0	9	2	1	10				01111	5308	4246																	2		13i;		2		1	125.00	7	13i1;
H1290	025	0	1	01	01	H1290_025_0	10	1	3								01111111111111111000	Other eligible chronic conditions															2		13i-O;		2		1	240.00	3	13i-O1;
H1290	027	0	1	01	01	H1290_027_0	10	1	3								01111111111111111000	Other eligible chronic conditions															2		13i;13i-O;		2		1	600.00	3	13i1;13i-O1;
H1290	029	0	1	01	01	H1290_029_0	10	1	3								01111111111111111000	Other eligible chronic conditions															2		13i;13i-O;		2		1	600.00	3	13i1;13i-O1;
H1290	033	0	1	01	01	H1290_033_0	9	1	3								01111111111111111000	Other eligible chronic conditions															2		13i;13i-O;		2		1	390.00	3	13i10;13i-O1;
H1290	033	0	1	01	01	H1290_033_0	9	2	1	10				01111	565	452																	2		13i;		2		1	125.00	7	13i1;
H1290	034	0	1	01	01	H1290_034_0	9	2	1	10				01111	120	96																	2		13i;		2		1	125.00	7	13i1;
H1290	034	0	1	01	01	H1290_034_0	9	1	3								01111111111111111000	Other eligible chronic conditions															2		13i;13i-O;		2		1	390.00	3	13i10;13i-O1;
H1290	036	1	1	01	01	H1290_036_1	10	1	3								01111111111111111000	Other eligible chronic conditions															2		13i;13i-O;		2		1	540.00	3	13i1;13i-O1;
H1290	036	2	1	01	01	H1290_036_2	12	1	3								01111111111111111000	Other eligible chronic conditions															2		13i;13i-O;		2		1	540.00	3	13i1;13i-O1;
H1290	037	1	1	01	01	H1290_037_1	10	1	3								01111111111111111000	Other Eligible Chronic Conditions															2		13i-O;		2		1	240.00	3	13i-O1;
H1290	037	2	1	01	01	H1290_037_2	10	1	3								01111111111111111000	Other Eligible Chronic Conditions															2		13i-O;		2		1	240.00	3	13i-O1;
H1290	037	3	1	01	01	H1290_037_3	10	1	3								01111111111111111000	Other Eligible Chronic Conditions															2		13i-O;		2		1	240.00	3	13i-O1;
H1290	037	4	1	01	01	H1290_037_4	10	1	3								01111111111111111000	Other Eligible Chronic Conditions															2		13i-O;		2		1	240.00	3	13i-O1;
H1290	037	5	1	01	01	H1290_037_5	10	1	3								01111111111111111000	Other Eligible Chronic Conditions															2		13i-O;		2		1	240.00	3	13i-O1;
H1290	039	0	1	01	01	H1290_039_0	9	2	3								01111111111111111000	Other eligible chronic conditions															2		13i;		2		1	150.00	3	13i10;
H1290	039	0	1	01	01	H1290_039_0	9	1	1	10				01111	91	73																	2		13i;		2		1	125.00	7	13i1;
H1290	041	0	1	01	01	H1290_041_0	9	1	1	10				01111	86	69																	2		13i;		2		1	125.00	7	13i1;
H1290	041	0	1	01	01	H1290_041_0	9	2	3								01111111111111111000	Other eligible chronic conditions															2		13i;		2		1	150.00	3	13i10;
H1290	042	0	1	01	01	H1290_042_0	10	1	1	10				01111	54	43																	2		13i;		2		1	200.00	7	13i1;
H1290	043	0	1	01	01	H1290_043_0	10	1	1	10				01111	29	23																	2		13i;		2		1	140.00	7	13i1;
H1290	044	1	1	01	01	H1290_044_1	13	1	3								01111111111111111000	Other eligible chronic conditions															2		13i-O;		2		1	240.00	3	13i-O1;
H1290	044	2	1	01	01	H1290_044_2	13	1	3								01111111111111111000	Other eligible chronic conditions															2		13i-O;		2		1	240.00	3	13i-O1;
H1290	044	3	1	01	01	H1290_044_3	13	1	3								01111111111111111000	Other eligible chronic conditions															2		13i-O;		2		1	240.00	3	13i-O1;
H1290	046	0	1	01	01	H1290_046_0	10	1	3								01111111111111111000	Other Eligible Chronic Conditions															2		13i;		2		1	25.00	7	13i1;
H1290	050	0	1	01	01	H1290_050_0	10	1	3								01111111111111111000	Other Eligible Chronic Conditions															2		13i;		2		1	25.00	7	13i1;
H1304	001	0	1	04	01	H1304_001_0	6	1	2														01000000000000										2		7f;	1	2		2			
H1304	001	0	1	04	01	H1304_001_0	6	2	2														00000000001000	Pre-diabetes									2		14c;	1	2		2			
H1304	001	0	1	04	01	H1304_001_0	6	3	3								01111111111111110000																1	001	13i;	1	2		2			
H1304	004	0	1	04	01	H1304_004_0	8	3	3								01111111111111110000																1	001	13i;	1	2		2			
H1304	004	0	1	04	01	H1304_004_0	8	1	2														01000000000000										2		7f;	1	2		2			
H1304	004	0	1	04	01	H1304_004_0	8	2	2														00000000001000	Pre-diabetes									2		14c;	1	2		2			
H1304	011	1	1	04	01	H1304_011_1	9	2	2														00000000001000	Pre-diabetes									2		14c;	1	2		2			
H1304	011	1	1	04	01	H1304_011_1	9	1	2														01000000000000										2		7f;	1	2		2			
H1304	011	1	1	04	01	H1304_011_1	9	3	3								01111111111111110000																1	001	13i;	1	2		2			
H1304	011	2	1	04	01	H1304_011_2	9	3	3								01111111111111110000																1	001	13i;	1	2		2			
H1304	011	2	1	04	01	H1304_011_2	9	1	2														01000000000000										2		7f;	1	2		2			
H1304	011	2	1	04	01	H1304_011_2	9	2	2														00000000001000	Pre-diabetes									2		14c;	1	2		2			
H1304	012	1	1	04	01	H1304_012_1	8	2	2														00000000001000	Pre-diabetes									2		14c;	1	2		2			
H1304	012	1	1	04	01	H1304_012_1	8	1	2														01000000000000										2		7f;	1	2		2			
H1304	012	1	1	04	01	H1304_012_1	8	3	3								01111111111111110000																1	001	13i;	1	2		2			
H1304	012	2	1	04	01	H1304_012_2	8	3	3								01111111111111110000																1	001	13i;	1	2		2			
H1304	012	2	1	04	01	H1304_012_2	8	1	2														01000000000000										2		7f;	1	2		2			
H1304	012	2	1	04	01	H1304_012_2	8	2	2														00000000001000	Pre-diabetes									2		14c;	1	2		2			
H1304	803	0	1	04	01	H1304_803_0	1	1	2														01000000000000										2		7f;	1	2		2			
H1304	803	0	1	04	01	H1304_803_0	1	2	2														00000000001000	Pre-diabetes									2		14c;	1	2		2			
H1304	803	0	1	04	01	H1304_803_0	1	3	3								01111111111111110000																1	001	13i;	1	2		2			
H1304	804	0	1	04	01	H1304_804_0	1	3	3								01111111111111110000																1	001	13i;	1	2		2			
H1304	804	0	1	04	01	H1304_804_0	1	1	2														01000000000000										2		7f;	1	2		2			
H1304	804	0	1	04	01	H1304_804_0	1	2	2														00000000001000	Pre-diabetes									2		14c;	1	2		2			
H1304	805	0	1	04	01	H1304_805_0	1	3	3								01111111111111110000																1	001	13i;	1	2		2			
H1304	805	0	1	04	01	H1304_805_0	1	1	2														01000000000000										2		7f;	1	2		2			
H1304	805	0	1	04	01	H1304_805_0	1	2	2														00000000001000	Pre-diabetes									2		14c;	1	2		2			
H1304	806	0	1	04	01	H1304_806_0	1	1	2														01000000000000										2		7f;	1	2		2			
H1304	806	0	1	04	01	H1304_806_0	1	2	2														00000000001000	Pre-diabetes									2		14c;	1	2		2			
H1304	806	0	1	04	01	H1304_806_0	1	3	3								01111111111111110000																1	001	13i;	1	2		2			
H1347	001	0	1	04	01	H1347_001_0	3	1	3								00000001000000001111	COPD	Rheumatoid Arthritis	Vascular Disease	Congestive Heart Failure												2		13c;	1	1	13c;	2			
H1352	003	0	1	01	01	H1352_003_0	6	2	2														00000000001000	Neuropathy and other circulatory diseases									1	010	7f;		2		2			
H1352	003	0	1	01	01	H1352_003_0	6	1	3								01111111111111110000																1	011	13i;		2		2			
H1352	004	0	1	01	01	H1352_004_0	6	1	2														00000000001000	Neuropathy and other circulatory diseases									1	010	7f;		2		2			
H1353	002	0	1	01	01	H1353_002_0	5	2	1	10				01111	282	85																	2		13d;		1	13d;	1	300.00	3	13d;
H1353	002	0	1	01	01	H1353_002_0	5	1	3								01111111111111110000																2		13i;		1	13i;	1	600	3	13i10;
H1353	004	0	1	01	01	H1353_004_0	5	2	1	10				01111	1304	391																	2		13d;		1	13d;	1	300.00	3	13d;
H1353	004	0	1	01	01	H1353_004_0	5	1	3								01111111111111110000																2		13i;		1	13i;	1	900	3	13i10;
H1353	005	0	1	01	01	H1353_005_0	4	1	3								01111111111111110000																2		13i;		1	13i;	2			
H1353	006	0	1	01	01	H1353_006_0	4	1	3								01111111111111110000																2		13i;		1	13i;	2			
H1353	007	0	1	01	01	H1353_007_0	4	1	3								01111111111111110000																2		13i;		1	13i;	2			
H1360	001	0	1	02	01	H1360_001_0	3	1	1	10				01111	9136	7766																	2		13d;	2	1	13d;	2			
H1360	001	0	1	02	01	H1360_001_0	3	2	1	10				01111	9136	914																	2		13e;	2	1	13e;	2			
H1365	001	0	1	04	01	H1365_001_0	6	3	2														00000000001100	History of Falls	Hip Fracture				2	2			2		14c;	1	2		1	250.00	3	14c1;14c8;
H1365	001	0	1	04	01	H1365_001_0	6	1	2														00000000001100	Opiate Use DIsorder	Chronic Pain Syndrome				2	2			2		13a;14c;	1	2		1	200.00	3	13a;14c18;
H1365	001	0	1	04	01	H1365_001_0	6	2	3								00000100010000000000																2		13i;	1	2		2			
H1365	004	1	1	04	01	H1365_004_1	5	3	2														00000000001100	History of Falls	Hip Fracture				2	2			2		14c;	1	2		1	250.00	3	14c1;14c8;
H1365	004	1	1	04	01	H1365_004_1	5	2	3								00000100010000000000																2		13i;	1	2		2			
H1365	004	1	1	04	01	H1365_004_1	5	1	2														00000000001100	Opiate Use DIsorder	Chronic Pain Syndrome				2	2			2		13a;14c;	1	2		1	200.00	3	13a;14c18;
H1365	004	2	1	04	01	H1365_004_2	5	3	2														00000000001100	History of Falls	Hip Fracture				2	2			2		14c;	1	2		1	250.00	3	14c1;14c8;
H1365	004	2	1	04	01	H1365_004_2	5	2	3								00000100010000000000																2		13i;	1	2		2			
H1365	004	2	1	04	01	H1365_004_2	5	1	2														00000000001100	Opiate Use DIsorder	Chronic Pain Syndrome				2	2			2		13a;14c;	1	2		1	200.00	3	13a;14c18;
H1375	001	0	1	02	01	H1375_001_0	2	1	1	10				01111	2713	2306																	2		13d;	2	1	13d;	2			
H1375	002	0	1	02	01	H1375_002_0	3	1	1	10				01111	4062	3453																	2		13d;	2	1	13d;	2			
H1395	001	0	1	04	01	H1395_001_0	5	1	1	10				01111	616	185																	2		13d;	1	1	13d;	1	300.00	3	13d;
H1395	003	0	1	04	01	H1395_003_0	4	1	3								01111111111111110000																2		13i;	1	1	13i;	2			
H1416	009	0	1	02	01	H1416_009_0	4	1	3								01111111111111110000																2		13i;	1	1	13i;	2			
H1416	023	0	1	01	01	H1416_023_0	4	1	3								01111111111111110000																2		13i;		1	13i;	2			
H1416	033	0	1	02	01	H1416_033_0	6	1	1	10				01111	1641	492																	2		13d;	1	1	13d;	1	300.00	3	13d;
H1416	034	0	1	01	01	H1416_034_0	6	2	1	10				01111	9074	2722																	2		13d;		1	13d;	1	300.00	3	13d;
H1416	034	0	1	01	01	H1416_034_0	6	1	3								01111111111111110000																2		13i;		1	13i;	2			
H1416	035	0	1	01	01	H1416_035_0	5	2	1	10				01111	10186	3565																	2		13d;		1	13d;	1	600.00	3	13d;
H1416	035	0	1	01	01	H1416_035_0	5	1	3								01111111111111110000																2		13i;14c;		1	13i;14c;	2			
H1416	036	0	1	01	01	H1416_036_0	7	1	3								01111111111111110000																2		13b;13d;13i;14c;		1	13b;13d;13i;14c;	1	400	3	13b;13d;13i5;14c8;
H1416	036	0	1	01	01	H1416_036_0	7	2	1	10				01111	4183	1255																	2		13d;		1	13d;	1	300.00	3	13d;
H1416	043	0	1	02	01	H1416_043_0	6	1	1	10				01111	1743	523																	2		13d;	1	1	13d;	1	300.00	3	13d;
H1416	044	0	1	01	01	H1416_044_0	6	1	3								01111111111111110000																2		13i;		1	13i;	1	600	3	13i10;
H1416	044	0	1	01	01	H1416_044_0	6	2	1	10				01111	8778	3072																	2		13d;		1	13d;	1	600.00	3	13d;
H1416	068	0	1	01	01	H1416_068_0	5	1	3								01111111111111110000																2		13i;		1	13i;	2			
H1423	001	0	1	01	01	H1423_001_0	5	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimer's	Pre-diabetes, Chronic Obstruction Pulmonary Disease, Systic Fibrosis	Ceberal Palsy, Tramadic brain injury, Obesity	Crohn's disease, Ankylosig Spondylitis, Osteoarthritis	Osteoporosis, Schronic back pain, Blindness											2		13i;		2		2			
H1423	002	0	1	01	01	H1423_002_0	5	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H1423	003	0	1	01	01	H1423_003_0	5	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H1423	004	0	1	01	01	H1423_004_0	5	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H1423	005	0	1	01	01	H1423_005_0	5	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H1423	009	0	1	01	01	H1423_009_0	5	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H1468	007	0	1	01	01	H1468_007_0	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H1468	017	0	1	01	01	H1468_017_0	4	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	1600	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1468	019	0	1	02	01	H1468_019_0	4	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1468	020	0	1	02	01	H1468_020_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H1608	027	0	1	04	01	H1608_027_0	2	1	1	01	0001000000				10756	5382																	1	001	13b;13c;13d;13i;	1	1	13b;13c;13d;13i;	2			
H1608	062	0	1	04	01	H1608_062_0	3	1	1	10				01111	238273	238273																	2		10b;13i;13i-O;14c;	1	1	10b;13i;13i-O;14c;	1	210.00	5	10b2;13i1;13i4;13i-O1;
H1608	801	0	1	04	01	H1608_801_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H1608	802	0	1	04	01	H1608_802_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H1609	016	0	1	01	01	H1609_016_0	4	1	3								01111111111111111100	Hyperlipidemia	Hypertension														2		13i;		1	13i;	1	100.00	5	13i1;
H1609	017	0	1	01	01	H1609_017_0	4	1	1	10				01111	238273	238273																	2		10b;13i;13i-O;14c;		1	10b;13i;13i-O;14c;	1	75.00	5	10b2;13i1;13i4;13i-O1;
H1609	018	0	1	01	01	H1609_018_0	4	1	3								01111111111111111100	Hyperlipidemia	Hypertension														2		13i;		1	13i;	1	100.00	5	13i1;
H1609	019	0	1	01	01	H1609_019_0	4	1	1	10				01111	238273	238273																	2		10b;13i;13i-O;14c;		1	10b;13i;13i-O;14c;	1	75.00	5	10b2;13i1;13i4;13i-O1;
H1609	020	0	1	01	01	H1609_020_0	4	1	3								01111111111111111100	Hyperlipidemia	Hypertension														2		13i;		1	13i;	1	75.00	5	13i1;
H1609	021	0	1	01	01	H1609_021_0	4	1	3								01111111111111111100	Hyperlipidemia	Hypertension														2		13i;		1	13i;	1	75.00	5	13i1;
H1609	022	0	1	01	01	H1609_022_0	4	1	3								01111111111111111100	Hyperlipidemia	Hypertension														2		13i;		1	13i;	1	75.00	5	13i1;
H1609	043	0	1	01	01	H1609_043_0	4	1	1	10				01111	238273	238273																	2		10b;13i;13i-O;14c;		1	10b;13i;13i-O;14c;	1	500.00	5	10b2;13i1;13i4;13i-O1;
H1609	044	0	1	01	01	H1609_044_0	4	1	1	10				01111	238273	238273																	2		10b;13i;13i-O;14c;		1	10b;13i;13i-O;14c;	1	500.00	5	10b2;13i1;13i4;13i-O1;
H1609	045	0	1	01	01	H1609_045_0	4	1	1	10				01111	238273	238273																	2		10b;13i;13i-O;14c;		1	10b;13i;13i-O;14c;	1	480.00	5	10b2;13i1;13i4;13i-O1;
H1609	046	0	1	01	01	H1609_046_0	4	1	1	10				01111	238273	238273																	2		10b;13i;13i-O;14c;		1	10b;13i;13i-O;14c;	1	480.00	5	10b2;13i1;13i4;13i-O1;
H1609	047	0	1	01	01	H1609_047_0	4	1	1	10				01111	238273	238273																	2		10b;13i;13i-O;14c;		1	10b;13i;13i-O;14c;	1	500.00	5	10b2;13i1;13i4;13i-O1;
H1609	048	0	1	01	01	H1609_048_0	4	1	1	10				01111	238273	238273																	2		10b;13i;13i-O;14c;		1	10b;13i;13i-O;14c;	1	500.00	5	10b2;13i1;13i4;13i-O1;
H1609	049	0	1	01	01	H1609_049_0	5	1	1	10				01111	238273	238273																	2		10b;13i;13i-O;14c;		1	10b;13i;13i-O;14c;	1	500.00	5	10b2;13i1;13i4;13i-O1;
H1609	055	0	1	01	01	H1609_055_0	5	1	1	10				01111	238273	238273																	2		10b;13i;13i-O;14c;		1	10b;13i;13i-O;14c;	1	480.00	5	10b2;13i1;13i4;13i-O1;
H1609	056	0	1	01	01	H1609_056_0	4	1	1	10				01111	238273	238273																	2		10b;13i;13i-O;14c;		1	10b;13i;13i-O;14c;	1	500.00	5	10b2;13i1;13i4;13i-O1;
H1609	061	0	1	01	01	H1609_061_0	4	1	1	10				01111	238273	238273																	2		10b;13i;13i-O;14c;		1	10b;13i;13i-O;14c;	1	480.00	5	10b2;13i1;13i4;13i-O1;
H1609	062	0	1	01	01	H1609_062_0	4	1	1	10				01111	238273	238273																	2		10b;13i;13i-O;14c;		1	10b;13i;13i-O;14c;	1	480.00	5	10b2;13i1;13i4;13i-O1;
H1609	801	0	1	01	01	H1609_801_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H1609	807	0	1	01	01	H1609_807_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H1610	001	0	1	01	01	H1610_001_0	4	1	1	10				01111	238273	238273																	2		10b;13i;13i-O;14c;		1	10b;13i;13i-O;14c;	1	750.00	5	10b2;13i1;13i4;13i-O1;
H1610	002	0	1	01	01	H1610_002_0	3	1	1	10				01111	238273	238273																	2		10b;13i;13i-O;14c;		1	10b;13i;13i-O;14c;	1	500.00	5	10b2;13i1;13i4;13i-O1;
H1610	003	0	1	01	01	H1610_003_0	3	1	1	10				01111	238273	238273																	2		10b;13i;13i-O;14c;		1	10b;13i;13i-O;14c;	1	500.00	5	10b2;13i1;13i4;13i-O1;
H1644	001	0	1	01	01	H1644_001_0	5	1	3								00000110010011101000	Chronic alcohol and other drug dependence															2		13i;		2		2			
H1664	005	0	1	01	01	H1664_005_0	5	2	1	10				01111	398	119																	2		13d;		1	13d;	1	300.00	3	13d;
H1664	005	0	1	01	01	H1664_005_0	5	1	3								01111111111111110000																2		13i;		1	13i;	2			
H1692	005	0	1	01	01	H1692_005_0	2	1	1	10				01111	238273	238273																	2		10b;13b;13i;13i-O;14c;		1	10b;13b;13i;13i-O;14c;	1	300.00	5	10b2;13b;13i1;13i4;13i-O1;
H1692	801	0	1	01	01	H1692_801_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H1692	802	0	1	01	01	H1692_802_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H1732	001	0	1	01	01	H1732_001_0	6	2	1	10				01111	191	191																	2		13i-O;		2		2			
H1732	001	0	1	01	01	H1732_001_0	6	1	1	10				01111	191	191																	2		13i;		2		2			
H1732	003	0	1	01	01	H1732_003_0	5	2	1	10				01111	11915	11915																	2		13i;		2		2			
H1732	003	0	1	01	01	H1732_003_0	5	5	1	10				01111	11767	11767																	2		13i;		2		2			
H1732	003	0	1	01	01	H1732_003_0	5	4	1	10				01111	11915	11915																	2		13i-O;		2		2			
H1732	003	0	1	01	01	H1732_003_0	5	3	1	10				01111	11915	11915																	2		13i;		2		2			
H1732	003	0	1	01	01	H1732_003_0	5	1	1	10				01111	11915	6198																	2		13i;		2		2			
H1732	004	0	1	01	01	H1732_004_0	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H1732	007	0	1	01	01	H1732_007_0	7	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;13i-O;		2		2			
H1748	001	0	1	01	01	H1748_001_0	6	1	3								01111111111111110000																2		13i;		2		1	55.00	7	13i1;
H1748	003	0	1	01	01	H1748_003_0	6	1	3								01111111111111110000																2		13i;		2		1	52.00	7	13i1;
H1748	004	0	1	01	01	H1748_004_0	6	1	3								01111111111111110000																2		13i;		2		1	52.00	7	13i1;
H1748	005	0	1	01	01	H1748_005_0	6	1	3								01111111111111110000																2		13i;		2		1	60.00	7	13i1;
H1799	001	0	1	01	01	H1799_001_0	8	1	3								01111111111111110000																1	001	13d;13e;13i;13i-O;		2		1	1020.00	3	13d;13e;13i1;13i3;13i-O1;
H1799	002	0	1	01	01	H1799_002_0	7	1	3								01111111111111110000																1	001	13d;13e;13i;13i-O;		2		1	1020.00	3	13d;13e;13i1;13i3;13i-O1;
H1822	002	0	1	01	01	H1822_002_0	8	1	3								00011111010000100000																2		13i;		2		2			
H1822	003	0	1	01	01	H1822_003_0	8	1	3								00011111010000100000																2		13i;		2		2			
H1822	005	0	1	01	01	H1822_005_0	9	1	3								00011111010000100000																2		13d;13i;		2		2			
H1848	003	0	1	04	01	H1848_003_0	5	1	1	10				01111	999	300																	2		13d;	1	1	13d;	1	300.00	3	13d;
H1889	002	1	1	04	01	H1889_002_1	2	1	1	10				01111	116152	98729																	2		13d;	1	1	13d;	2			
H1889	002	2	1	04	01	H1889_002_2	2	1	1	10				01111	34854	29626																	2		13d;	1	1	13d;	2			
H1889	005	0	1	04	01	H1889_005_0	3	1	1	10				01111	77204	65623																	2		13d;	1	1	13d;	2			
H1889	006	0	1	04	01	H1889_006_0	3	1	1	10				01111	18041	15335																	2		13d;	1	1	13d;	2			
H1889	007	0	1	04	01	H1889_007_0	3	2	1	10				01111	5793	434																	2		13f;	1	1	13f;	2			
H1889	007	0	1	04	01	H1889_007_0	3	1	1	10				01111	5793	4924																	2		13d;	1	1	13d;	2			
H1889	008	0	1	04	01	H1889_008_0	2	1	1	10				01111	2895	2461																	2		13d;	1	1	13d;	2			
H1889	009	0	1	04	01	H1889_009_0	3	1	1	10				01111	1609	1368																	2		13d;	1	1	13d;	2			
H1889	010	0	1	04	01	H1889_010_0	2	1	1	10				01111	2894	2460																	2		13d;	1	1	13d;	2			
H1889	011	0	1	04	01	H1889_011_0	2	1	1	10				01111	1996	1697																	2		13d;	1	1	13d;	2			
H1894	001	0	1	01	01	H1894_001_0	7	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H1894	002	0	1	01	01	H1894_002_0	6	3	1	10				01111	3317	3317																	2		13i;		2		2			
H1894	002	0	1	01	01	H1894_002_0	6	2	1	10				01111	3317	3317																	2		13i;		2		2			
H1894	002	0	1	01	01	H1894_002_0	6	1	1	10				01111	3317	1711																	2		13i;		2		2			
H1894	002	0	1	01	01	H1894_002_0	6	4	1	10				01111	3317	3317																	2		13i;		2		2			
H1894	008	0	1	01	01	H1894_008_0	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H1914	006	0	1	04	01	H1914_006_0	5	1	1	10				01111	276	83																	2		13d;	1	1	13d;	1	300.00	3	13d;
H1947	001	0	1	01	01	H1947_001_0	6	2	1	10				01111	4979	4979																	2		13i;		2		2			
H1947	001	0	1	01	01	H1947_001_0	6	3	1	10				01111	4979	4979																	2		13i;		2		2			
H1947	001	0	1	01	01	H1947_001_0	6	1	1	10				01111	4979	2569																	2		13i;		2		2			
H1947	001	0	1	01	01	H1947_001_0	6	4	1	10				01111	4979	4979																	2		13i-O;		2		2			
H1947	003	0	1	01	01	H1947_003_0	7	2	1	10				01111	172	172																	2		13i;		2		2			
H1947	003	0	1	01	01	H1947_003_0	7	1	1	10				01111	172	89																	2		13i;		2		2			
H1951	032	0	1	01	01	H1951_032_0	5	1	1	10				01111	7238	7238																	2		13b;13d;13e;13f;14c;		1	13b;13d;13e;13f;14c;	1	1200	3	13b;13d;13e;13f;14c8;
H1951	033	0	1	01	01	H1951_033_0	6	1	1	10				01111	11955	11955																	2		13b;13d;13e;13f;14c;		1	13b;13d;13e;13f;14c;	1	1200	3	13b;13d;13e;13f;14c8;
H1951	034	0	1	01	01	H1951_034_0	4	1	1	10				01111	2227	2227																	2		13b;13d;13e;13f;14c;		1	13b;13d;13e;13f;14c;	1	900	3	13b;13d;13e;13f;14c8;
H1951	038	0	1	01	01	H1951_038_0	5	1	3								00000101000000000000																1	001	13c;		2		2			
H1951	039	0	1	01	01	H1951_039_0	5	1	3								00000101000000000000																1	001	13c;		2		2			
H1951	041	0	1	01	01	H1951_041_0	5	1	1	10				01111	22484	22484																	2		13b;13d;13e;13f;14c;		1	13b;13d;13e;13f;14c;	1	900	3	13b;13d;13e;13f;14c8;
H1951	044	0	1	01	01	H1951_044_0	7	1	3								01111111111111110000																1	001	13b;13i;13i-O;14c;		2		1	900	3	13b;13i1;13i3;13i4;13i5;13i6;13i10;13i-O1;14c8;
H1951	056	0	1	01	01	H1951_056_0	4	1	1	10				01111	10966	10966																	2		13b;13d;13e;13f;14c;		2		1	1200	3	13b;13d;13e;13f;14c8;
H1951	057	0	1	01	01	H1951_057_0	4	1	1	10				01111	12636	12636																	2		13b;13d;13e;13f;14c;		1	13b;13d;13e;13f;14c;	1	2700	3	13b;13d;13e;13f;14c8;
H1961	003	0	1	02	01	H1961_003_0	3	2	2														00000000010000										2		14c;	2	1	14c;	2			
H1961	003	0	1	02	01	H1961_003_0	3	1	1	10				01111	22118	18800																	2		13d;	2	1	13d;	2			
H1961	014	1	1	02	01	H1961_014_1	3	1	2														00000000010000										2		14c;	2	1	14c;	2			
H1961	014	2	1	02	01	H1961_014_2	3	1	2														00000000010000										2		14c;	2	1	14c;	2			
H1961	014	3	1	02	01	H1961_014_3	3	1	2														00000000010000										2		14c;	2	1	14c;	2			
H1961	014	4	1	02	01	H1961_014_4	4	1	2														00000000010000										2		14c;	2	1	14c;	2			
H1961	017	0	1	02	01	H1961_017_0	3	1	2														00000000010000										2		14c;	2	1	14c;	2			
H1961	019	0	1	02	01	H1961_019_0	3	1	1	10				01111	22224	18890																	2		13d;	2	1	13d;	2			
H1961	019	0	1	02	01	H1961_019_0	3	2	2														00000000010000										2		14c;	2	1	14c;	2			
H1969	002	0	1	01	01	H1969_002_0	8	3	3								01111111111111110000																1	001	13i;		2		2			
H1969	002	0	1	01	01	H1969_002_0	8	2	2														00000000001000	Pre-diabetes									2		14c;		2		2			
H1969	002	0	1	01	01	H1969_002_0	8	1	2														01000000000000										2		7f;		2		2			
H1969	006	0	1	01	01	H1969_006_0	6	1	2														01000000000000										2		7f;		2		2			
H1969	006	0	1	01	01	H1969_006_0	6	3	3								01111111111111110000																1	001	13i;		2		2			
H1969	006	0	1	01	01	H1969_006_0	6	2	2														00000000001000	Pre-diabetes									2		14c;		2		2			
H1969	007	3	1	01	01	H1969_007_3	9	2	2														00000000001000	Pre-diabetes									2		14c;		2		2			
H1969	007	3	1	01	01	H1969_007_3	9	1	2														01000000000000										2		7f;		2		2			
H1969	007	3	1	01	01	H1969_007_3	9	3	3								01111111111111110000																1	001	13i;		2		2			
H1969	007	4	1	01	01	H1969_007_4	9	1	2														01000000000000										2		7f;		2		2			
H1969	007	4	1	01	01	H1969_007_4	9	2	2														00000000001000	Pre-diabetes									2		14c;		2		2			
H1969	007	4	1	01	01	H1969_007_4	9	3	3								01111111111111110000																1	001	13i;		2		2			
H1993	003	0	1	01	01	H1993_003_0	11	1	3								01111111111111111000	Hypertension															2		13i;13i-O;		2		1	100.00	5	13i6;13i7;13i-O1;
H1993	007	0	1	01	01	H1993_007_0	11	1	3								01111111111111111000	Hypertension															2		13i;13i-O;		2		1	330.00	6	13i1;13i6;13i7;13i-O1;
H1993	008	0	1	01	01	H1993_008_0	11	1	3								01111111111111111000	Hypertension															2		13i;13i-O;		2		1	360.00	6	13i1;13i6;13i7;13i-O1;
H1994	001	0	1	01	01	H1994_001_0	9	1	2														00110000001111	COPD/Asthma, Community Acquired pneumonia, Covid-19 Pneumonia	Venous Thromboembolism (VTE) or Pulmonary Embolism (PE)	Cellulitis, Diverticulitis, Gastroenteritis, Neutropenic fever	Pyelonephritis/UTI, Dehydration and Acute Kidney Injury, Electrolyte def		2	2			2		13d;		2		2			
H1994	002	0	1	01	01	H1994_002_0	14	1	2														00110000001111	COPD/Asthma, Community Acquired pneumonia, Covid-19 Pneumonia	Venous Thromboembolism (VTE) or Pulmonary Embolism (PE)	Cellulitis, Diverticulitis, Gastroenteritis, Neutropenic fever	Pyelonephritis/UTI, Dehydration and Acute Kidney Injury, Electrolyte def		2	2			2		13d;		2		2			
H1994	007	0	1	01	01	H1994_007_0	9	1	2														00110000001111	COPD/Asthma, Community Acquired pneumonia, Covid-19 Pneumonia	Venous Thromboembolism (VTE) or Pulmonary Embolism (PE)	Cellulitis, Diverticulitis, Gastroenteritis, Neutropenic fever	Pyelonephritis/UTI, Dehydration and Acute Kidney Injury, Electrolyte def		2	2			2		13d;		2		2			
H1994	015	0	1	01	01	H1994_015_0	9	1	2														00110000001111	COPD/Asthma, Community Acquired pneumonia, Covid-19 Pneumonia	Venous Thromboembolism (VTE) or Pulmonary Embolism (PE)	Cellulitis, Diverticulitis, Gastroenteritis, Neutropenic fever, identifi	Pyelonephritis/UTI, Dehydration and Acute Kidney Injury, Electrolyte def		2	2			2		13d;		2		2			
H1994	016	0	1	01	01	H1994_016_0	6	1	2														00110000001111	COPD/Asthma, Community Acquired pneumonia, Covid-19 Pneumonia	Venous Thromboembolism (VTE) or Pulmonary Embolism (PE)	Cellulitis, Diverticulitis, Gastroenteritis, Neutropenic fever	Pyelonephritis/UTI, Dehydration and Acute Kidney Injury, Electrolyte def		2	2			2		13d;		2		2			
H1994	017	0	1	01	01	H1994_017_0	9	1	2														00110000001111	COPD/Asthma, Community Acquired pneumonia, Covid-19 Pneumonia	Venous Thromboembolism (VTE) or Pulmonary Embolism (PE)	Cellulitis, Diverticulitis, Gastroenteritis, Neutropenic fever	Pyelonephritis/UTI, Dehydration and Acute Kidney Injury, Electrolyte def		2	2			2		13d;		2		2			
H1997	002	0	1	01	01	H1997_002_0	8	2	2														00000000001000	Pre-diabetes									2		14c;		2		2			
H1997	002	0	1	01	01	H1997_002_0	8	3	3								01111111111111110000																1	001	13i;		2		2			
H1997	002	0	1	01	01	H1997_002_0	8	1	2														01000000000000										2		7f;		2		2			
H1997	008	0	1	01	01	H1997_008_0	6	1	2														01000000000000										2		7f;		2		2			
H1997	008	0	1	01	01	H1997_008_0	6	3	3								01111111111111110000																1	001	13i;		2		2			
H1997	008	0	1	01	01	H1997_008_0	6	2	2														00000000001000	Pre-diabetes									2		14c;		2		2			
H1997	009	0	1	01	01	H1997_009_0	10	2	2														00000000001000	Pre-diabetes									2		14c;		2		2			
H1997	009	0	1	01	01	H1997_009_0	10	1	2														01000000000000										2		7f;		2		2			
H1997	009	0	1	01	01	H1997_009_0	10	3	3								01111111111111110000																1	001	13i;		2		2			
H2056	801	0	1	01	01	H2056_801_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H2056	802	0	1	01	01	H2056_802_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H2108	001	0	1	01	01	H2108_001_0	4	1	1	10				01111	3876	2326																	2		13i;		2		2			
H2108	039	0	1	01	01	H2108_039_0	5	1	1	10				01111	275	165																	2		13i;		2		2			
H2117	002	0	1	04	01	H2117_002_0	7	2	1	10				01111	6689	2007																	2		13d;	1	1	13d;	1	300.00	3	13d;
H2117	002	0	1	04	01	H2117_002_0	7	1	3								01111111111111110000																2		13i;	1	1	13i;	1	600.00	3	13i10;
H2128	005	0	1	04	01	H2128_005_0	6	2	1	10				01111	828	248																	2		13d;	1	1	13d;	1	300.00	3	13d;
H2128	005	0	1	04	01	H2128_005_0	6	1	3								01111111111111110000																2		13i;	1	1	13i;	2			
H2134	001	0	1	01	01	H2134_001_0	6	1	3								01111111111111110000																2		13i;		1	13i;	1	900	3	13i10;
H2134	001	0	1	01	01	H2134_001_0	6	2	1	10				01111	5184	1555																	2		13d;		1	13d;	1	300.00	3	13d;
H2134	003	0	1	01	01	H2134_003_0	7	1	3								01111111111111110000																2		13i;		1	13i;	1	600	3	13i10;
H2134	003	0	1	01	01	H2134_003_0	7	2	1	10				01111	3067	920																	2		13d;		1	13d;	1	300.00	3	13d;
H2134	004	0	1	01	01	H2134_004_0	4	1	3								01111111111111110000																2		13i;		1	13i;	2			
H2134	006	0	1	01	01	H2134_006_0	4	1	3								01111111111111110000																2		13i;		1	13i;	2			
H2168	001	0	1	01	01	H2168_001_0	6	1	3								01111111111111111111	Osteoporosis	Inflammatory disorders	Eye disorders	Gastrointestinal disorders												1	001	13i;		1	13i;	1	0.00	6	13i1;
H2168	002	0	1	01	01	H2168_002_0	6	1	3								01111111111111111111	Osteoporosis	Inflammatory disorders	Eye disorders	Gastrointestinal disorders												1	001	13i;		1	13i;	1	0.00	6	13i1;
H2168	003	0	1	01	01	H2168_003_0	6	1	3								01111111111111111111	Osteoporosis	Inflammatory disorders	Eye disorders	Gastrointestinal disorders												1	001	13i;		1	13i;	1	0.00	6	13i1;
H2171	001	0	1	01	01	H2171_001_0	5	1	2														10100000001111	Simple pneumonia & pleurisy	Bronchitis & asthma & other respiratory system diagnoses	Heart Failure & Shock	Cellulitis	Kidney & urinary tract infections	2	2			2		13d;		2		2			
H2171	003	0	1	01	01	H2171_003_0	5	1	2														10100000001111	Simple pneumonia & pleurisy	Bronchitis & asthma & other respiratory system diagnoses	Heart Failure & Shock	Cellulitis	Kidney & urinary tract infections	2	2			2		13d;		2		2			
H2171	801	0	1	01	01	H2171_801_0	4	1	2														10100000001111	Simple pneumonia & pleurisy	Bronchitis & asthma & other respiratory system diagnoses	Heart Failure & Shock	Cellulitis	Kidney & urinary tract infections	2	2			2		13d;		2		2			
H2171	802	0	1	01	01	H2171_802_0	4	1	2														10100000001111	Simple pneumonia & pleurisy	Bronchitis & asthma & other respiratory system diagnoses	Heart Failure & Shock	Cellulitis	Kidney & urinary tract infections	2	2			2		13d;		2		2			
H2171	803	0	1	01	01	H2171_803_0	4	1	2														10100000001111	Simple pneumonia & pleurisy	Bronchitis & asthma & other respiratory system diagnoses	Heart Failure & Shock	Cellulitis	Kidney & urinary tract infections	2	2			2		13d;		2		2			
H2171	804	0	1	01	01	H2171_804_0	4	1	2														10100000001111	Simple pneumonia & pleurisy	Bronchitis & asthma & other respiratory system diagnoses	Heart Failure & Shock	Cellulitis	Kidney & urinary tract infections	2	2			2		13d;		2		2			
H2174	001	0	1	01	01	H2174_001_0	6	2	1	10				01111	1347	404																	2		13d;		1	13d;	1	300.00	3	13d;
H2174	001	0	1	01	01	H2174_001_0	6	1	3								01111111111111110000																2		13b;13d;13i;14c;		1	13b;13d;13i;14c;	1	1700	3	13b;13d;13i5;13i10;14c8;
H2224	001	0	1	01	01	H2224_001_0	8	1	3								01111111111111110000																1	001	13i;		2		1	500.00	3	13i1;13i4;
H2224	003	0	1	01	01	H2224_003_0	9	1	3								01111111111111110000																1	001	13i;		2		1	500.00	3	13i1;13i4;
H2225	001	0	1	01	01	H2225_001_0	6	1	3								01111111111111110000																2		13i;13i-O;		2		2			
H2226	001	0	1	01	01	H2226_001_0	2	1	1	10				01111	15699	13344																	2		13d;		1	13d;	2			
H2226	003	0	1	01	01	H2226_003_0	2	1	1	10				01111	10168	8643																	2		13d;		1	13d;	2			
H2228	041	0	1	04	01	H2228_041_0	3	1	1	10				01111	21318	18120																	2		13d;	1	1	13d;	2			
H2228	043	0	1	04	01	H2228_043_0	4	1	1	10				01111	24781	21064																	2		13d;	1	1	13d;	2			
H2228	044	0	1	04	01	H2228_044_0	2	1	1	10				01111	4090	3477																	2		13d;	1	1	13d;	2			
H2228	045	0	1	04	01	H2228_045_0	2	1	1	10				01111	10384	8826																	2		13d;	1	1	13d;	2			
H2228	128	0	1	04	01	H2228_128_0	3	1	1	10				01111	5686	4833																	2		13d;	1	1	13d;	2			
H2235	001	0	1	01	01	H2235_001_0	4	1	3								00000001000000000000																2		7f;13b;14c;		2		2			
H2235	003	0	1	01	01	H2235_003_0	4	1	3								00000001000000000000																2		7f;13b;14c;		2		2			
H2237	001	0	1	01	01	H2237_001_0	6	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	500.00	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H2237	001	0	1	01	01	H2237_001_0	6	2	1	10				01111	8827	8827																	2		13b;13d;13e;13f;14c;		1	13b;13d;13e;13f;14c;	1	1800	3	13b;13d;13e;13f;14c8;
H2237	007	0	1	01	01	H2237_007_0	5	1	1	10				01111	908	908																	2		13b;13d;13e;13f;14c;		1	13b;13d;13e;13f;14c;	1	1800	3	13b;13d;13e;13f;14c8;
H2246	018	0	1	04	01	H2246_018_0	12	1	2														00110000001111	COPD/Asthma, Community Acquired pneumonia, Covid-19 Pneumonia	Venous Thromboembolism (VTE) or Pulmonary Embolism (PE)	Cellulitis, Diverticulitis, Gastroenteritis, Neutropenic fever	Pyelonephritis/UTI, Dehydration and Acute Kidney Injury, Electrolyte def		2	2			2		13d;	1	2		2			
H2247	001	0	1	02	01	H2247_001_0	2	1	1	10				01111	29401	24991																	2		13d;	2	1	13d;	2			
H2247	003	0	1	02	01	H2247_003_0	2	1	1	10				01111	1959	1665																	2		13d;	2	1	13d;	2			
H2256	001	1	1	01	01	H2256_001_1	8	1	2														00110000001100	Pneumonia	Cellulitis				2	2			2		13d;14c;		2		2			
H2256	001	2	1	01	01	H2256_001_2	8	1	2														00110000001100	Pneumonia	Cellulitis				2	2			2		13d;14c;		2		2			
H2256	001	6	1	01	01	H2256_001_6	8	1	2														00110000001100	Pneumonia	Cellulitis				2	2			2		13d;14c;		2		2			
H2256	015	1	1	01	01	H2256_015_1	8	1	2														00110000001100	Pneumonia	Cellulitis				2	2			2		13d;14c;		2		2			
H2256	015	2	1	01	01	H2256_015_2	8	1	2														00110000001100	Pneumonia	Cellulitis				2	2			2		13d;14c;		2		2			
H2256	015	6	1	01	01	H2256_015_6	8	1	2														00110000001100	Pneumonia	Cellulitis				2	2			2		13d;14c;		2		2			
H2256	016	1	1	01	01	H2256_016_1	6	1	2														00110000001100	Pneumonia	Cellulitis				2	2			2		13d;14c;		2		2			
H2256	016	2	1	01	01	H2256_016_2	6	1	2														00110000001100	Pneumonia	Cellulitis				2	2			2		13d;14c;		2		2			
H2256	018	1	1	01	01	H2256_018_1	8	1	2														00110000001100	Pneumonia	Cellulitis				2	2			2		13d;14c;		2		2			
H2256	018	7	1	01	01	H2256_018_7	8	1	2														00110000001100	Pneumonia	Cellulitis				2	2			2		13d;14c;		2		2			
H2256	018	8	1	01	01	H2256_018_8	8	1	2														00110000001100	Pneumonia	Cellulitis				2	2			2		13d;14c;		2		2			
H2256	019	1	1	01	01	H2256_019_1	6	1	2														00110000001100	Pneumonia	Cellulitis				2	2			2		13d;14c;		2		2			
H2256	019	7	1	01	01	H2256_019_7	6	1	2														00110000001100	Pneumonia	Cellulitis				2	2			2		13d;14c;		2		2			
H2256	026	1	1	01	01	H2256_026_1	8	1	2														00110000001100	Pneumonia	Cellulitis				2	2			2		13d;14c;		2		2			
H2256	026	2	1	01	01	H2256_026_2	8	1	2														00110000001100	Pneumonia	Cellulitis				2	2			2		13d;14c;		2		2			
H2256	026	3	1	01	01	H2256_026_3	8	1	2														00110000001100	Pneumonia	Cellulitis				2	2			2		13d;14c;		2		2			
H2256	028	0	1	01	01	H2256_028_0	8	1	2														00110000001100	Pneumonia	Cellulitis				2	2			2		13d;14c;		2		2			
H2256	033	0	1	01	01	H2256_033_0	8	1	2														00110000001100	Pneumonia	Cellulitis				2	2			2		13d;14c;		2		2			
H2256	034	0	1	01	01	H2256_034_0	8	1	2														00110000001100	Pneumonia	Cellulitis				2	2			2		13d;14c;		2		2			
H2256	036	0	1	01	01	H2256_036_0	8	1	2														00110000001100	Pneumonia	Cellulitis				2	2			2		13d;14c;		2		2			
H2256	039	0	1	01	01	H2256_039_0	6	1	2														00110000001100	Pneumonia	Cellulitis				2	2			2		13d;14c;		2		2			
H2256	040	0	1	01	01	H2256_040_0	6	1	2														00110000001100	Pneumonia	Cellulitis				2	2			2		13d;14c;		2		2			
H2256	041	0	1	01	01	H2256_041_0	6	1	2														00110000001100	Pneumonia	Cellulitis				2	2			2		13d;14c;		2		2			
H2256	042	0	1	01	01	H2256_042_0	6	1	2														00110000001100	Pneumonia	Cellulitis				2	2			2		13d;14c;		2		2			
H2256	046	0	1	01	01	H2256_046_0	8	1	2														00110000001100	Pneumonia	Cellulitis				2	2			2		13d;14c;		2		2			
H2272	001	0	1	02	01	H2272_001_0	2	2	1	10				01111	176	18																	2		13e;	2	1	13e;	2			
H2272	001	0	1	02	01	H2272_001_0	2	1	1	10				01111	176	150																	2		13d;	2	1	13d;	2			
H2293	001	0	1	04	01	H2293_001_0	2	1	1	10				01111	238273	238273																	2		13b;13i;	1	1	13b;13i;	1	75.00	5	13b;13i1;
H2293	002	0	1	04	01	H2293_002_0	2	1	1	10				01111	238273	238273																	2		13b;13i;14c;	1	1	13b;13i;14c;	1	300.00	5	13b;13i1;
H2293	003	0	1	04	01	H2293_003_0	3	1	1	10				01111	238273	238273																	2		13b;13i;14c;	1	1	13b;13i;14c;	1	150.00	5	13b;13i1;
H2293	004	0	1	04	01	H2293_004_0	3	1	1	10				01111	238273	238273																	2		13b;13i;14c;	1	1	13b;13i;14c;	1	150.00	5	13b;13i1;
H2293	005	0	1	04	01	H2293_005_0	4	1	1	10				01111	238273	238273																	2		13b;13i;14c;	1	1	13b;13i;14c;	1	300.00	5	13b;13i1;
H2293	006	0	1	04	01	H2293_006_0	3	1	3								01111111111111111100	Hyperlipidemia	Hypertension														2		13b;13i;	1	1	13b;13i;	1	60.00	5	13b;13i1;
H2293	007	0	1	04	01	H2293_007_0	3	1	3								01111111111111111100	Hyperlipidemia	Hypertension														2		13b;13i;	1	1	13b;13i;	1	75.00	5	13b;13i1;
H2293	008	0	1	04	01	H2293_008_0	3	1	3								01111111111111111100	Hyperlipidemia	Hypertension														2		13b;13i;	1	1	13b;13i;	1	75.00	5	13b;13i1;
H2293	009	0	1	04	01	H2293_009_0	3	1	3								01111111111111111100	Hyperlipidemia	Hypertension														2		13b;13i;	1	1	13b;13i;	1	75.00	5	13b;13i1;
H2293	011	0	1	04	01	H2293_011_0	3	1	1	10				01111	238273	238273																	2		13b;13i;	1	1	13b;13i;	1	90.00	5	13b;13i1;
H2293	011	0	1	04	01	H2293_011_0	3	2	3								01111111111111111100	Hyperlipidemia	Hypertension														2		13i;	1	1	13i;	2			
H2320	030	1	1	02	01	H2320_030_1	12	1	3								01111111111111110000																2		13i;	1	1	13i;	2			
H2320	030	2	1	02	01	H2320_030_2	12	1	3								01111111111111110000																2		13i;	1	1	13i;	2			
H2334	005	0	1	04	01	H2334_005_0	5	1	3								00001101000011000000																2		13i;	1	2		1	55.00	7	13i1;
H2354	025	0	1	01	01	H2354_025_0	7	1	3								00000100000011000000																2		13i;		1	13i;	1	525.00	3	13i1;13i9;
H2392	003	0	1	01	01	H2392_003_0	5	1	3								01111111111111110000																1	001	13i;		1	13i;	2			
H2416	001	0	1	01	01	H2416_001_0	15	1	3								00000001000000000000																1	001	13i;		2		2			
H2422	002	0	1	01	01	H2422_002_0	7	1	3								11111111111111111111	Chronic Kidney Disease	Spinal Cord Injury or Paralysis	Morbid Obesity	Chronic liver disease or cirrhosis	Neuromuscular Disorders											1	001	13i;14c;		2		2			
H2425	001	0	1	01	01	H2425_001_0	6	1	3								00011111110110010000																2		13b;13i;		1	13b;13i;	2			
H2456	002	0	1	01	01	H2456_002_0	8	3	3								01000011000001001110	Congestive Heart Failure	Ischemic Heart Disease	Hypertension													2		10b;13i;13i-O;14c;		1	10b;13i;13i-O;14c;	2			
H2456	002	0	1	01	01	H2456_002_0	8	2	2														00000000001000	Nursing home level of care									2		14c;		1	14c;	2			
H2456	002	0	1	01	01	H2456_002_0	8	1	2														00000000001000	History or Risk of falls									2		14c;		1	14c;	2			
H2456	002	0	1	01	01	H2456_002_0	8	4	2														10001000011111	Renal failure	Parkinsons	Cognitive Impairment	Chronic Kidney Disease	Primary Organ and blood cancers	2	2			2		14c;		1	14c;	2			
H2456	002	0	1	01	01	H2456_002_0	8	5	2														00000100000000										2		14c;		1	14c;	2			
H2458	002	0	1	01	01	H2458_002_0	6	1	3								00001101000000000000																2		13i;14c;		2		2			
H2459	021	1	1	02	01	H2459_021_1	4	1	2														00010000001000	Post Hospitalization					1				2		13c;	2	1	13c;	2			
H2459	021	2	1	02	01	H2459_021_2	4	1	2														00010000001000	Post Hospitalization					1				2		13c;	2	1	13c;	2			
H2459	021	3	1	02	01	H2459_021_3	4	1	2														00010000001000	Post Hospitalization					1				2		13c;	2	1	13c;	2			
H2459	031	0	1	01	01	H2459_031_0	5	1	3								00000000000000001100	COPD	Congestive heart failure														2		13b;		2		2			
H2459	032	0	1	01	01	H2459_032_0	5	1	3								00000000000000001100	COPD	Congestive heart failure														2		13b;		2		2			
H2463	001	0	1	01	01	H2463_001_0	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H2463	003	0	1	01	01	H2463_003_0	3	3	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H2463	003	0	1	01	01	H2463_003_0	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H2463	003	0	1	01	01	H2463_003_0	3	1	1	01	1111111111	2	2		343	343																	2		13b;13d;13e;13i;14c;		2		1	900	3	13b;13d;13e;13i1;13i3;13i4;13i5;13i6;13i10;14c8;
H2478	001	0	1	01	01	H2478_001_0	8	1	3								01111111111111110000																1	001	13d;13e;13i;13i-O;		2		1	1020.00	3	13d;13e;13i1;13i3;13i-O1;
H2478	002	0	1	01	01	H2478_002_0	9	1	3								01111111111111110000																1	001	13d;13e;13i;13i-O;		2		1	960.00	3	13d;13e;13i1;13i3;13i-O1;
H2486	003	0	1	01	01	H2486_003_0	4	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H2486	005	0	1	01	01	H2486_005_0	4	1	3								00000001000000001110	Obesity	Chronic Kidney Disease (CKD)	Depression													1	001	14c;		2		2			
H2486	006	0	1	01	01	H2486_006_0	4	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H2486	006	0	1	01	01	H2486_006_0	4	1	3								00000100000010000000																1	001	10b;13i;14c;		2		2			
H2486	007	0	1	01	01	H2486_007_0	2	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H2486	008	0	1	01	01	H2486_008_0	3	1	3								00000001000000001110	Obesity	Chronic Kidney Disease (CKD)	Depression													1	001	14c;		2		2			
H2491	004	0	1	01	01	H2491_004_0	6	1	1	10				01111	5355	1607																	2		13d;		1	13d;	1	300.00	3	13d;
H2491	007	0	1	01	01	H2491_007_0	4	1	3								01111111111111110000																2		13i;		1	13i;	1	600	3	13i10;
H2491	010	0	1	01	01	H2491_010_0	4	1	3								01111111111111110000																2		13i;		1	13i;	1	900	3	13i10;
H2491	011	0	1	01	01	H2491_011_0	5	2	1	10				01111	4523	1357																	2		13d;		1	13d;	1	300.00	3	13d;
H2491	011	0	1	01	01	H2491_011_0	5	1	3								01111111111111110000																2		13i;		1	13i;	1	900	3	13i10;
H2491	012	0	1	01	01	H2491_012_0	5	1	3								01111111111111110000																2		13i;		1	13i;	1	1200	3	13i10;
H2491	012	0	1	01	01	H2491_012_0	5	2	1	10				01111	8771	3070																	2		13d;		1	13d;	1	600.00	3	13d;
H2491	022	0	1	01	01	H2491_022_0	5	2	1	10				01111	116	35																	2		13d;		1	13d;	1	300.00	3	13d;
H2491	022	0	1	01	01	H2491_022_0	5	1	3								01111111111111110000																2		13i;		1	13i;	1	600	3	13i10;
H2509	001	0	1	02	01	H2509_001_0	3	1	1	10				01111	770	655																	2		13d;	2	1	13d;	2			
H2563	004	0	1	01	01	H2563_004_0	10	1	3								01111111111111110000																2		13i;		2		2			
H2563	005	1	1	01	01	H2563_005_1	9	1	1	01	1000000000				80	20																	2		13d;		1	13d;	2			
H2563	005	2	1	01	01	H2563_005_2	9	1	1	01	1000000000				80	20																	2		13d;		1	13d;	2			
H2563	008	0	1	01	01	H2563_008_0	9	1	3								01111111111111110000																2		13i;		2		2			
H2563	009	0	1	01	01	H2563_009_0	10	1	3								01111111111111110000																2		13i;		2		2			
H2563	014	0	1	01	01	H2563_014_0	8	1	3								01111111111111110000																2		13i;		2		2			
H2563	015	0	1	01	01	H2563_015_0	9	1	3								01111111111111110000																2		13i;		2		2			
H2563	016	0	1	01	01	H2563_016_0	9	1	3								01111111111111110000																2		13i;		2		2			
H2563	017	1	1	01	01	H2563_017_1	9	1	1	01	1000000000				1081	270																	2		13d;		1	13d;	2			
H2563	017	1	1	01	01	H2563_017_1	9	2	3								01111111111111110000																2		13i;		2		2			
H2563	017	2	1	01	01	H2563_017_2	9	2	3								01111111111111110000																2		13i;		2		2			
H2563	017	2	1	01	01	H2563_017_2	9	1	1	01	1000000000				1081	270																	2		13d;		1	13d;	2			
H2563	018	0	1	01	01	H2563_018_0	8	1	1	01	1000000000				1081	270																	2		13d;		1	13d;	2			
H2563	018	0	1	01	01	H2563_018_0	8	2	3								01111111111111110000																2		13i;		2		2			
H2582	002	0	1	02	01	H2582_002_0	2	1	1	10				01111	5239	4453																	2		13d;	2	1	13d;	2			
H2593	001	0	1	01	01	H2593_001_0	5	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Crohns disease, Ankylosing spondylitis, Osteoarthritis											2		13i;		2		2			
H2593	005	0	1	01	01	H2593_005_0	5	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H2593	006	0	1	01	01	H2593_006_0	5	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H2593	013	0	1	01	01	H2593_013_0	5	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H2593	022	0	1	01	01	H2593_022_0	8	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H2593	031	0	1	02	01	H2593_031_0	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;	2	2		2			
H2593	032	0	1	01	01	H2593_032_0	5	1	1	10				01111	4079	2105																	2		13i;		2		2			
H2593	032	0	1	01	01	H2593_032_0	5	2	1	10				01111	4079	4079																	2		13i;		2		2			
H2593	032	0	1	01	01	H2593_032_0	5	4	1	10				01111	4079	4079																	2		13i;		2		2			
H2593	032	0	1	01	01	H2593_032_0	5	3	1	10				01111	4079	4079																	2		13i;		2		2			
H2593	040	0	1	01	01	H2593_040_0	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H2593	041	0	1	01	01	H2593_041_0	5	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H2593	043	0	1	01	01	H2593_043_0	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H2610	005	0	1	01	01	H2610_005_0	4	1	3								00000001000000000000																2		13b;		2		1	50.00	5	13b;
H2610	006	0	1	01	01	H2610_006_0	5	1	3								00000001000000000000																2		13b;		2		1	50.00	5	13b;
H2610	017	0	1	01	01	H2610_017_0	7	1	3								01111111111111110000																2		13i;		2		2			
H2663	002	0	1	01	01	H2663_002_0	4	1	3								01111111111111111100	Hyperlipidemia	Hypertension														2		13i;		1	13i;	2			
H2663	805	0	1	01	01	H2663_805_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H2663	810	0	1	01	01	H2663_810_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H2686	002	0	1	04	01	H2686_002_0	9	1	3								01111111111111111000	Other Eligible Chronic Conditions															2		13i;	1	2		1	30.00	7	13i1;
H2694	001	0	1	04	01	H2694_001_0	7	1	3								00000001000000000000																1	001	13b;13i;	1	2		1	70.00	5	13b;13i1;
H2697	001	0	1	01	01	H2697_001_0	10	1	3								01111111111111111000	Other Eligible Chronic Conditions															2		13i;13i-O;		2		1	540.00	3	13i1;13i-O1;
H2697	002	0	1	01	01	H2697_002_0	10	1	3								01111111111111111000	Other Eligible Chronic Conditions:															2		13i-O;		2		1	240.00	3	13i-O1;
H2697	004	0	1	01	01	H2697_004_0	10	1	3								01111111111111111000	Other Eligible Chronic Conditions															2		13i;		2		1	25.00	7	13i1;
H2697	010	0	1	01	01	H2697_010_0	10	2	1	10				01111	338	270																	2		13i;		1	13i;	1	150.00	7	13i1;
H2697	010	0	1	01	01	H2697_010_0	10	1	3								01111111111111111000	Other eligible chronic conditions															2		13i-O;		1	13i-O;	1	240.00	3	13i-O1;
H2697	011	0	1	01	01	H2697_011_0	11	1	3								01111111111111111000	Other eligible chronic conditions															2		13i-O;		2		1	240.00	3	13i-O1;
H2697	011	0	1	01	01	H2697_011_0	11	2	1	10				01111	229	183																	2		13i;		2		1	75.00	7	13i1;
H2715	001	0	1	01	01	H2715_001_0	7	1	3								01111111111111110000																1	001	13d;13e;13i;13i-O;		2		1	960.00	3	13d;13e;13i1;13i3;13i-O1;
H2722	003	0	1	02	01	H2722_003_0	9	1	1	10				01111	235	176																	2		13d;	1	1	13d;	1	100.00	7	13d;
H2752	002	0	1	01	01	H2752_002_0	4	1	1	10				01111	78	47																	2		13i;		2		2			
H2752	003	0	1	01	01	H2752_003_0	4	1	1	10				01111	163	98																	2		13i;		2		2			
H2775	112	0	1	04	01	H2775_112_0	5	1	3								01111111111111110000																2		13i;	1	1	13i;	1	600.00	3	13i10;
H2775	112	0	1	04	01	H2775_112_0	5	2	1	10				01111	25154	7546																	2		13d;	1	1	13d;	1	300.00	3	13d;
H2775	114	0	1	04	01	H2775_114_0	4	1	3								01111111111111110000																2		13i;	1	1	13i;	1	600	3	13i10;
H2775	115	0	1	04	01	H2775_115_0	5	2	1	10				01111	1014	304																	2		13d;	1	1	13d;	1	300.00	3	13d;
H2775	115	0	1	04	01	H2775_115_0	5	1	3								01111111111111110000																2		13i;	1	1	13i;	1	600	3	13i10;
H2802	044	0	1	02	01	H2802_044_0	2	1	1	10				01111	22101	18786																	2		13d;	2	1	13d;	2			
H2802	053	0	1	02	01	H2802_053_0	4	1	1	10				01111	7025	5971																	2		13d;	2	1	13d;	2			
H2802	053	0	1	02	01	H2802_053_0	4	2	1	10				01111	7025	703																	2		13e;	2	1	13e;	2			
H2853	001	0	1	01	01	H2853_001_0	5	1	3								01111111111111110000																2		13i;		1	13i;	1	600	3	13i10;
H2853	002	0	1	01	01	H2853_002_0	5	1	3								01111111111111110000																2		13i;14c;		1	13i;14c;	1	1500	3	13i10;
H2879	001	0	1	01	01	H2879_001_0	7	1	3								01111111111111110000																1	001	13d;13e;13i;13i-O;		2		1	1140.00	3	13d;13e;13i1;13i-O1;
H2879	002	0	1	01	01	H2879_002_0	7	1	3								01111111111111110000																1	001	13d;13e;13i;13i-O;		2		1	960.00	3	13d;13e;13i1;13i3;13i-O1;
H2879	003	0	1	01	01	H2879_003_0	7	1	3								01111111111111110000																1	001	13d;13e;13i;13i-O;		2		1	1140.00	3	13d;13e;13i1;13i3;13i-O1;
H2879	005	0	1	01	01	H2879_005_0	8	1	3								01111111111111110000																1	001	13d;13e;13i;13i-O;		2		1	1080.00	3	13d;13e;13i1;13i3;13i-O1;
H2915	002	0	1	01	01	H2915_002_0	5	2	1	10				01111	12626	3788																	2		13d;		1	13d;	1	300.00	3	13d;
H2915	002	0	1	01	01	H2915_002_0	5	1	3								01111111111111110000																2		13i;		1	13i;	1	600	3	13i10;
H2915	007	0	1	01	01	H2915_007_0	5	2	1	10				01111	5715	1715																	2		13d;		1	13d;	1	300.00	3	13d;
H2915	007	0	1	01	01	H2915_007_0	5	1	3								01111111111111110000																2		13i;		1	13i;	1	1500	3	13i10;
H2923	001	0	1	01	01	H2923_001_0	10	1	3								01111111111111111000	Other Eligible Chronic Conditions															2		13i;		2		1	30.00	7	13i1;
H2926	001	0	1	01	01	H2926_001_0	16	1	3								00000001000000000000																1	001	13i;		2		2			
H2962	019	1	1	01	01	H2962_019_1	7	1	3								01111111111111110000																2		13i;		2		2			
H2962	019	2	1	01	01	H2962_019_2	7	1	3								01111111111111110000																2		13i;		2		2			
H2962	021	0	1	01	01	H2962_021_0	8	1	3								01111111111111110000																2		13i;		2		2			
H2962	022	0	1	01	01	H2962_022_0	7	1	3								01111111111111110000																2		13i;		2		2			
H2962	023	0	1	01	01	H2962_023_0	7	1	3								01111111111111110000																2		13i;		2		2			
H2962	024	0	1	01	01	H2962_024_0	7	1	3								01111111111111110000																2		13i;		2		2			
H2962	025	0	1	01	01	H2962_025_0	8	1	3								01111111111111110000																2		13i;		2		2			
H2962	026	0	1	01	01	H2962_026_0	8	1	3								01111111111111110000																2		13i;		2		2			
H2962	029	0	1	01	01	H2962_029_0	8	1	3								01111111111111110000																2		13i;		2		2			
H2962	033	0	1	01	01	H2962_033_0	7	1	3								01111111111111110000																2		13i;		2		2			
H2962	034	0	1	01	01	H2962_034_0	7	1	3								01111111111111110000																2		13i;		2		2			
H2962	035	0	1	01	01	H2962_035_0	7	1	1	10				01111	500	500																	2		13i;		2		2			
H2962	036	0	1	01	01	H2962_036_0	7	1	1	10				01111	500	500																	2		13i;		2		2			
H2962	050	0	1	01	01	H2962_050_0	10	1	3								01111111111111110000																2		13i;		2		2			
H2962	051	0	1	01	01	H2962_051_0	10	1	3								01111111111111110000																2		13i;		2		2			
H2962	052	0	1	01	01	H2962_052_0	10	1	3								01111111111111110000																2		13i;		2		2			
H3015	001	0	1	01	01	H3015_001_0	5	2	3								01111111111111111111	Disabled Members	Members with Obesity	Members with Joint and Spine Conditions	Members with Endocrine disorder												2		13i;		2		1	150.00	5	13i10;
H3015	001	0	1	01	01	H3015_001_0	5	1	1	11	1000000000			01111	3554	3554																	2		13i;		2		1	0.00	5	13i1;
H3041	001	0	1	01	01	H3041_001_0	10	1	3								01111111111111111000	Other Eligible Chronic Conditions															2		13i;		2		1	30.00	7	13i1;
H3071	002	0	1	01	01	H3071_002_0	5	1	3								00001101000011000000																2		13i;		2		1	55.00	7	13i1;
H3080	003	0	1	01	01	H3080_003_0	9	1	1	10				01111	178	142																	2		13i;		2		1	200.00	7	13i1;
H3080	004	0	1	01	01	H3080_004_0	9	1	1	10				01111	96	77																	2		13i;		2		1	140.00	7	13i1;
H3080	006	0	1	01	01	H3080_006_0	9	1	1	10				01111	18	14																	2		13i;		1	13i;	1	200.00	7	13i1;
H3080	007	0	1	01	01	H3080_007_0	9	1	1	10				01111	10	8																	2		13i;		2		1	140.00	7	13i1;
H3113	005	0	1	01	01	H3113_005_0	3	1	1	10				01111	40998	34848																	2		13d;		1	13d;	2			
H3113	005	0	1	01	01	H3113_005_0	3	2	1	10				01111	40998	3075																	2		13f;		1	13f;	2			
H3113	009	0	1	02	01	H3113_009_0	2	1	1	10				01111	34291	29147																	2		13d;	2	1	13d;	2			
H3113	010	0	1	02	01	H3113_010_0	2	2	1	10				01111	11301	1130																	2		13e;	2	1	13e;	2			
H3113	010	0	1	02	01	H3113_010_0	2	1	1	10				01111	11301	9606																	2		13d;	2	1	13d;	2			
H3113	011	0	1	02	01	H3113_011_0	2	1	1	10				01111	5629	4785																	2		13d;	2	1	13d;	2			
H3113	013	0	1	02	01	H3113_013_0	2	1	1	10				01111	989	841																	2		13d;	2	1	13d;	2			
H3113	014	0	1	02	01	H3113_014_0	2	1	1	10				01111	1021	868																	2		13d;	2	1	13d;	2			
H3132	001	0	1	01	01	H3132_001_0	5	1	2														00000000001000	AIDS-Related Neuropathy									2		14c;		2		2			
H3146	001	0	1	02	01	H3146_001_0	2	1	2														00000100001000	Hyperlipidemia					2	2			2		10b;13b;	2	1	10b;13b;	2			
H3146	002	0	1	01	01	H3146_002_0	2	1	1	10				01111	238273	238273																	2		13i;14c;		1	13i;14c;	1	360.00	5	13i1;
H3146	003	0	1	01	01	H3146_003_0	2	1	1	10				01111	238273	238273																	2		13i;14c;		1	13i;14c;	1	500.00	5	13i1;
H3146	004	0	1	02	01	H3146_004_0	2	1	2														00000100001000	Hyperlipidemia					2	2			2		10b;13b;	2	1	10b;13b;	2			
H3146	006	0	1	01	01	H3146_006_0	2	2	1	10				01111	238273	238273																	2		13i;		1	13i;	2			
H3146	006	0	1	01	01	H3146_006_0	2	1	2														00000100001000	Hyperlipidemia					2	2			2		10b;13b;		1	10b;13b;	2			
H3146	007	0	1	02	01	H3146_007_0	3	1	2														00000100001000	Hyperlipidemia					2	2			2		10b;13b;	2	1	10b;13b;	2			
H3146	008	0	1	01	01	H3146_008_0	3	1	1	10				01111	238273	238273																	2		13i;14c;		1	13i;14c;	1	500.00	5	13i1;
H3146	009	0	1	01	01	H3146_009_0	2	2	3								01111111111111111100	Hyperlipidemia	Hypertension														2		13i;		1	13i;	2			
H3146	009	0	1	01	01	H3146_009_0	2	1	1	10				01111	238273	238273																	2		10b;13i;13i-O;14c;		1	10b;13i;13i-O;14c;	1	550.00	5	10b2;13i1;13i4;13i-O1;
H3146	011	0	1	01	01	H3146_011_0	2	1	2														00000100001000	Hyperlipidemia					2	2			2		10b;13b;		1	10b;13b;	2			
H3146	011	0	1	01	01	H3146_011_0	2	2	1	10				01111	238273	238273																	2		13i;		1	13i;	2			
H3146	012	0	1	01	01	H3146_012_0	2	2	1	10				01111	238273	238273																	2		13i;		1	13i;	2			
H3146	012	0	1	01	01	H3146_012_0	2	1	2														00000100001000	Hyperlipidemia					2	2			2		10b;13b;		1	10b;13b;	2			
H3146	013	0	1	01	01	H3146_013_0	2	1	2														00000100001000	Hyperlipidemia					2	2			2		10b;13b;		1	10b;13b;	2			
H3146	013	0	1	01	01	H3146_013_0	2	2	1	10				01111	238273	238273																	2		13i;		1	13i;	2			
H3146	014	0	1	02	01	H3146_014_0	2	1	2														00000100001000	Hyperlipidemia					2	2			2		10b;13b;	2	1	10b;13b;	2			
H3146	015	0	1	01	01	H3146_015_0	2	1	1	10				01111	238273	238273																	2		13i;14c;		1	13i;14c;	1	500.00	5	13i1;
H3146	016	0	1	01	01	H3146_016_0	2	1	1	10				01111	238273	238273																	2		13i;14c;		1	13i;14c;	1	550.00	5	13i1;
H3146	017	0	1	01	01	H3146_017_0	2	1	1	10				01111	238273	238273																	2		13i;14c;		1	13i;14c;	1	400.00	5	13i1;
H3146	801	0	1	01	01	H3146_801_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H3146	802	0	1	01	01	H3146_802_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H3152	801	0	1	01	01	H3152_801_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H3152	804	0	1	01	01	H3152_804_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H3186	001	0	1	04	01	H3186_001_0	5	1	3								00000101010000000000																2		13c;	1	2		2			
H3186	002	0	1	04	01	H3186_002_0	5	1	3								00000101010000000000																2		13c;	1	2		2			
H3192	007	0	1	01	01	H3192_007_0	3	1	1	10				01111	238273	238273																	2		10b;13i;13i-O;14c;		1	10b;13i;13i-O;14c;	1	180.00	5	10b2;13i1;13i4;13i-O1;
H3192	008	0	1	01	01	H3192_008_0	2	1	1	10				01111	238273	238273																	2		13i;14c;		1	13i;14c;	2			
H3192	009	0	1	01	01	H3192_009_0	2	1	1	10				01111	238273	238273																	2		13i;14c;		1	13i;14c;	2			
H3192	801	0	1	01	01	H3192_801_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H3192	802	0	1	01	01	H3192_802_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H3219	801	0	1	04	01	H3219_801_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H3219	802	0	1	04	01	H3219_802_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H3239	001	0	1	01	01	H3239_001_0	3	1	1	10				01111	238273	238273																	2		13b;13i;14c;		1	13b;13i;14c;	1	300.00	5	13b;13i1;
H3239	002	0	1	01	01	H3239_002_0	3	1	1	10				01111	238273	238273																	2		13b;13i;14c;		1	13b;13i;14c;	1	300.00	5	13b;13i1;
H3239	003	0	1	01	01	H3239_003_0	3	1	1	10				01111	238273	238273																	2		13b;13i;14c;		1	13b;13i;14c;	1	300.00	5	13b;13i1;
H3239	005	0	1	01	01	H3239_005_0	3	1	1	10				01111	238273	238273																	2		13b;13i;14c;		1	13b;13i;14c;	1	300.00	5	13b;13i1;
H3239	006	0	1	01	01	H3239_006_0	3	1	1	10				01111	238273	238273																	2		13b;13i;14c;		1	13b;13i;14c;	1	300.00	5	13b;13i1;
H3239	007	0	1	01	01	H3239_007_0	4	1	1	10				01111	238273	238273																	2		13b;13i;14c;		1	13b;13i;14c;	1	300.00	5	13b;13i1;
H3239	008	0	1	01	01	H3239_008_0	3	1	1	10				01111	238273	238273																	2		13b;13i;14c;		1	13b;13i;14c;	1	300.00	5	13b;13i1;
H3239	010	0	1	01	01	H3239_010_0	3	1	1	10				01111	238273	238273																	2		13b;13i;14c;		1	13b;13i;14c;	1	150.00	5	13b;13i1;
H3239	011	0	1	01	01	H3239_011_0	3	1	1	10				01111	238273	238273																	2		13b;13i;14c;		1	13b;13i;14c;	1	150.00	5	13b;13i1;
H3239	012	0	1	01	01	H3239_012_0	3	1	1	10				01111	238273	238273																	2		13b;13i;14c;		1	13b;13i;14c;	1	150.00	5	13b;13i1;
H3239	013	0	1	01	01	H3239_013_0	4	1	1	10				01111	238273	238273																	2		13b;13i;14c;		1	13b;13i;14c;	1	300.00	5	13b;13i1;
H3240	013	0	1	01	01	H3240_013_0	7	1	1	10				01111	18205	18205																	2		13i;		2		2			
H3240	013	0	1	01	01	H3240_013_0	7	2	1	10				01111	18205	18205																	2		13i;		2		2			
H3240	013	0	1	01	01	H3240_013_0	7	3	1	10				01111	18205	18205																	2		13i;		2		2			
H3240	013	0	1	01	01	H3240_013_0	7	4	1	10				01111	18205	18205																	2		13i;		2		2			
H3240	017	0	1	02	01	H3240_017_0	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;	2	2		2			
H3240	024	0	1	02	01	H3240_024_0	6	5	1	10				01111	941	941																	2		13i;	2	2		2			
H3240	024	0	1	02	01	H3240_024_0	6	4	1	10				01111	941	941																	2		13i;	2	2		2			
H3240	024	0	1	02	01	H3240_024_0	6	3	1	10				01111	941	941																	2		13i;	2	2		2			
H3240	024	0	1	02	01	H3240_024_0	6	2	1	10				01111	941	941																	2		13i;	2	2		2			
H3240	024	0	1	02	01	H3240_024_0	6	1	1	10				01111	941	941																	2		13i;	2	2		2			
H3256	001	0	1	04	01	H3256_001_0	2	1	1	10				01111	58437	49671																	2		13d;	1	1	13d;	2			
H3256	002	0	1	04	01	H3256_002_0	2	1	1	10				01111	8901	7566																	2		13d;	1	1	13d;	2			
H3259	001	0	1	01	01	H3259_001_0	3	1	3								01111111111111111111	Disabled Members	Members with Obesity	Members with Joint and Spine Conditions	Members with Endocrine Disorders												2		13i;		2		2			
H3259	002	0	1	01	01	H3259_002_0	3	1	3								01111111111111111111	Disabled Members	Members with Obesity	Members with Joint and Spine Conditions	Members with Endocrine Disorders												2		13i;		2		2			
H3259	003	0	1	01	01	H3259_003_0	3	1	3								01111111111111111111	Disabled Members	Members with Obesity	Members with Joint and Spine Conditions	Members with Endocrine Disorders												2		13i;		2		2			
H3274	001	0	1	01	01	H3274_001_0	6	1	3								01111111111111110000																2		13i;		1	13i;	2			
H3274	002	0	1	01	01	H3274_002_0	5	1	3								01111111111111110000																2		13i;		1	13i;	2			
H3274	003	0	1	01	01	H3274_003_0	5	1	3								00000010000000000000																2		13i;		1	13i;	2			
H3274	004	0	1	01	01	H3274_004_0	6	1	3								00000000010000000000																2		13c;		1	13c;	2			
H3276	001	0	1	01	01	H3276_001_0	10	1	1	10				01111	1807	1717																	2		13b;		2		1	60.00	7	13b;
H3288	047	0	1	04	01	H3288_047_0	2	1	2														00000100001000	Hyperlipidemia					2	2			2		10b;13b;	1	1	10b;13b;	2			
H3288	801	0	1	04	01	H3288_801_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H3288	802	0	1	04	01	H3288_802_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H3291	002	0	1	01	01	H3291_002_0	7	1	3								10001011010011011111	Alzheimer's Dieases or related dementia	Intellectual disabilities and related conditions	Hypertention	Obesity	Malnutrition including failure to thrive											2		13i;		2		2			
H3305	007	0	1	02	01	H3305_007_0	7	3	2														00000000101000	Osteoarthritis					2	2			2		14c;	2	1	14c;	2			
H3305	007	0	1	02	01	H3305_007_0	7	1	2														00000100000000										2		13b;	2	1	13b;	2			
H3305	007	0	1	02	01	H3305_007_0	7	2	2														00001000000000										2		14c;	2	1	14c;	1	250.00	3	14c8;
H3305	015	0	1	02	01	H3305_015_0	8	2	2														00001000000000										2		14c;	2	1	14c;	1	250.00	3	14c8;
H3305	015	0	1	02	01	H3305_015_0	8	3	2														00000000101000	Osteoarthritis					2	2			2		14c;	2	1	14c;	2			
H3305	015	0	1	02	01	H3305_015_0	8	1	2														00000100000000										2		13b;	2	1	13b;	2			
H3305	020	0	1	02	01	H3305_020_0	6	3	2														00000000101000	Osteoarthritis					2	2			2		14c;	2	1	14c;	2			
H3305	020	0	1	02	01	H3305_020_0	6	1	2														00000100000000										2		13b;	2	1	13b;	2			
H3305	020	0	1	02	01	H3305_020_0	6	2	2														00001000000000										2		14c;	2	1	14c;	1	250.00	3	14c8;
H3305	021	0	1	02	01	H3305_021_0	8	2	2														00001000000000										2		14c;	2	1	14c;	1	250.00	3	14c8;
H3305	021	0	1	02	01	H3305_021_0	8	1	2														00000100000000										2		13b;	2	1	13b;	2			
H3305	021	0	1	02	01	H3305_021_0	8	3	2														00000000101000	Osteoarthritis					2	2			2		14c;	2	1	14c;	2			
H3305	022	0	1	02	01	H3305_022_0	8	2	2														00001000000000										2		14c;	2	1	14c;	1	250.00	3	14c8;
H3305	022	0	1	02	01	H3305_022_0	8	3	2														00000000101000	Osteoarthritis					2	2			2		14c;	2	1	14c;	2			
H3305	022	0	1	02	01	H3305_022_0	8	1	2														00000100000000										2		13b;	2	1	13b;	2			
H3305	030	0	1	02	01	H3305_030_0	8	3	2														00000000101000	Osteoarthritis					2	2			2		14c;	2	1	14c;	2			
H3305	030	0	1	02	01	H3305_030_0	8	1	2														00000100000000										2		13b;	2	1	13b;	2			
H3305	030	0	1	02	01	H3305_030_0	8	2	2														00001000000000										2		14c;	2	1	14c;	1	250.00	3	14c8;
H3305	032	0	1	02	01	H3305_032_0	8	3	2														00000000101000	Osteoarthritis					2	2			2		14c;	2	1	14c;	2			
H3305	032	0	1	02	01	H3305_032_0	8	1	2														00000100000000										2		13b;	2	1	13b;	2			
H3305	032	0	1	02	01	H3305_032_0	8	2	2														00001000000000										2		14c;	2	1	14c;	1	250.00	3	14c8;
H3305	033	0	1	01	01	H3305_033_0	8	1	2														00000000101000	Osteoarthritis					2	2			2		14c;		1	14c;	2			
H3305	033	0	1	01	01	H3305_033_0	8	2	3								11111111111111111111	Osteoarthritis	Overweight/Obesity	Hypertension/Hypercholesterolemia	Liver and Kidney Disease	Prediabetes											2		13i;		1	13i;	1	50.00	7	13i1;
H3305	034	0	1	01	01	H3305_034_0	8	2	3								11111111111111111111	Osteoarthritis	Overweight/Obesity	Hypertension/Hypercholesterolemia	Liver and Kidney Disease	Prediabetes											2		13i;		1	13i;	1	50.00	7	13i1;
H3305	034	0	1	01	01	H3305_034_0	8	1	2														00000000101000	Osteoarthritis					2	2			2		14c;		1	14c;	2			
H3305	035	0	1	01	01	H3305_035_0	8	1	2														00000000101000	Osteoarthritis					2	2			2		14c;		1	14c;	2			
H3305	035	0	1	01	01	H3305_035_0	8	2	3								11111111111111111111	Osteoarthritis	Overweight/Obesity	Hypertension/Hypercholesterolemia	Liver and Kidney Disease	Prediabetes											2		13i;		1	13i;	1	50.00	7	13i1;
H3312	069	0	1	01	01	H3312_069_0	2	1	1	10				01111	238273	238273																	2		13i;14c;		1	13i;14c;	2			
H3312	070	0	1	01	01	H3312_070_0	2	1	1	10				01111	137895	137895																	2		13i;14c;		1	13i;14c;	2			
H3312	073	0	1	01	01	H3312_073_0	3	1	1	10				01111	238273	238273																	2		13i;		1	13i;	2			
H3312	801	0	1	01	01	H3312_801_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H3312	804	0	1	01	01	H3312_804_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H3330	042	1	1	01	01	H3330_042_1	11	1	1	10				01111	9753	9265																	2		13b;		2		1	130.00	7	13b;
H3330	042	2	1	01	01	H3330_042_2	11	1	1	10				01111	805	765																	2		13b;		2		1	60.00	7	13b;
H3330	042	3	1	01	01	H3330_042_3	11	1	1	10				01111	2785	2646																	2		13b;		2		1	110.00	7	13b;
H3344	005	0	1	04	01	H3344_005_0	5	1	3								00111111111110110000																1	001	14c;	2	2		2			
H3344	010	0	1	04	01	H3344_010_0	5	1	3								00111111111110110000																1	001	14c;	2	2		2			
H3347	002	0	1	01	01	H3347_002_0	3	1	3								11111111111111111111	Chronic Kidney Disease, Eating Disorders	Hepatitis B and C, Cystic Fibrosis	Osteoporosis, Obesity, Arthritis	RSD (Reflex Sympathetic Dystrophy)	Chronic conditions related to Tobacco use											2		13i;		2		2			
H3347	007	0	1	01	01	H3347_007_0	3	1	3								11111111111111111111	Chronic Kidney Disease, Eating Disorders	Hepatitis B and C, Cystic Fibrosis	Osteoporosis, Obesity, Arthritis	RSD  (Reflex Sympathetic Dystrophy)	Chronic conditions related to Tobacco use											2		13i;		2		2			
H3347	009	0	1	01	01	H3347_009_0	3	1	3								11111111111111111111	Chronic Kidney Disease, Eating Disorders	Hepatitis B and C, Cystic Fibrosis	Osteoporosis, Obesity, Arthritis	RSD  (Reflex Sympathetic Dystrophy)	Chronic conditions related to Tobacco use											2		13i;		2		2			
H3347	016	0	1	01	01	H3347_016_0	4	1	3								11111111111111111111	Chronic Kidney Disease, Eating Disorders	Hepatitis B and C, Cystic Fibrosis	Osteoporosis, Obesity, Arthritis	RSD  (Reflex Sympathetic Dystrophy)	Chronic conditions related to Tobacco use											2		13i;		2		2			
H3359	019	0	1	01	01	H3359_019_0	9	1	1	10				01111	25200	5140																	2		13d;13e;		1	13d;13e;	1	100.00	5	13d;13e;
H3359	021	0	1	01	01	H3359_021_0	9	1	1	10				01111	188000	38346																	2		13d;13e;		1	13d;13e;	1	475.00	5	13d;13e;
H3359	034	0	1	01	01	H3359_034_0	10	1	3								11111111111111111111	Alzheimer's Disease, ALS, arthritis (including rheumatoid arthritis)	heart disease, eating disorder, Hepatitis B, Hepatitis C, hypertension	COPD, cystic fibrosis, obesity, osteoporosis	Parkinson's Disease, reflex sympathetic dystrophy (RSD) syndrome	Emphysema and chronic conditions related to tobacco use											2		13i;		1	13i;	1	0.00	6	13i1;13i10;
H3359	038	0	1	01	01	H3359_038_0	10	1	1	10				01111	4800	979																	2		13d;13e;		1	13d;13e;	1	270.00	5	13d;13e;
H3362	038	0	1	01	01	H3362_038_0	5	1	3								00111111111110110000																1	001	14c;		2		2			
H3362	039	0	1	01	01	H3362_039_0	5	1	3								00111111111110110000																1	001	14c;		2		2			
H3387	013	0	1	01	01	H3387_013_0	2	1	1	10				01111	23	20																	2		13d;		1	13d;	2			
H3387	014	1	1	02	01	H3387_014_1	2	1	1	10				01111	51375	43669																	2		13d;	2	1	13d;	2			
H3387	014	2	1	02	01	H3387_014_2	2	1	1	10				01111	80558	68474																	2		13d;	2	1	13d;	2			
H3387	015	1	1	02	01	H3387_015_1	2	1	1	10				01111	5351	4548																	2		13d;	2	1	13d;	2			
H3387	015	2	1	02	01	H3387_015_2	2	1	1	10				01111	3761	3197																	2		13d;	2	1	13d;	2			
H3388	001	0	1	01	01	H3388_001_0	12	1	3								01111111111111110000																1	011	14c;		2		2			
H3388	002	0	1	01	01	H3388_002_0	13	1	3								01111111111111110000																1	011	14c;		2		2			
H3388	004	0	1	01	01	H3388_004_0	13	1	3								01111111111111110000																1	011	14c;		2		2			
H3388	013	0	1	01	01	H3388_013_0	12	1	3								01111111111111110000																1	011	14c;		2		2			
H3388	014	0	1	01	01	H3388_014_0	12	1	3								01111111111111110000																1	011	14c;		2		2			
H3388	019	0	1	01	01	H3388_019_0	12	1	3								01111111111111111110	Obesity	Hyperlipidemia	hypertension													1	001	13i;		1	13i;	1	50.00	7	13i1;
H3407	001	0	1	01	01	H3407_001_0	7	1	3								00000011000000000000																2		13i;		1	13i;	2			
H3419	003	0	1	01	01	H3419_003_0	4	1	3								01111111111111110000																2		13i;		1	13i;	2			
H3443	001	0	1	01	01	H3443_001_0	5	2	1	10				01111	4557	1367																	2		10b;13b;13i;13i-O;16b;17b;18b;		2		2			
H3443	001	0	1	01	01	H3443_001_0	5	3	1	01	1111111011	2	2		5924	2962																	2		13i;		2		2			
H3443	001	0	1	01	01	H3443_001_0	5	1	3								01111111111111110000																2		13i;13i-O;		2		2			
H3443	002	0	1	01	01	H3443_002_0	5	3	1	01	1111111011	2	2		5924	2962																	2		13i;		2		2			
H3443	002	0	1	01	01	H3443_002_0	5	1	3								01111111111111110000																2		13i;13i-O;		2		2			
H3443	002	0	1	01	01	H3443_002_0	5	2	1	10				01111	4557	1367																	2		10b;13b;13i;13i-O;16b;17b;18b;		2		2			
H3443	003	0	1	01	01	H3443_003_0	6	1	3								01111111111111110000																2		13i;13i-O;		2		2			
H3447	011	0	1	01	01	H3447_011_0	7	4	1	10				01111	25500	25500																	2		13i;		2		2			
H3447	011	0	1	01	01	H3447_011_0	7	5	1	10				01111	25500	25500																	2		13i-O;		2		2			
H3447	011	0	1	01	01	H3447_011_0	7	3	1	10				01111	25500	25500																	2		13i;		2		2			
H3447	011	0	1	01	01	H3447_011_0	7	2	1	10				01111	25500	25500																	2		13i;		2		2			
H3447	011	0	1	01	01	H3447_011_0	7	1	1	10				01111	25500	13158																	2		13i;		2		2			
H3447	013	0	1	01	01	H3447_013_0	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;13i-O;		2		2			
H3447	018	0	1	01	01	H3447_018_0	6	2	1	10				01111	13597	13597																	2		13i;		2		2			
H3447	018	0	1	01	01	H3447_018_0	6	3	1	10				01111	13597	13597																	2		13i;		2		2			
H3447	018	0	1	01	01	H3447_018_0	6	4	1	10				01111	13597	13597																	2		13i-O;		2		2			
H3447	018	0	1	01	01	H3447_018_0	6	1	1	10				01111	13597	7016																	2		13i;		2		2			
H3447	020	0	1	01	01	H3447_020_0	5	1	1	10				01111	46253	23866																	2		13i;		2		2			
H3447	020	0	1	01	01	H3447_020_0	5	2	1	10				01111	46253	46253																	2		13i;		2		2			
H3447	020	0	1	01	01	H3447_020_0	5	3	1	10				01111	46253	46253																	2		13i;		2		2			
H3447	020	0	1	01	01	H3447_020_0	5	4	1	10				01111	46253	46253																	2		13i-O;		2		2			
H3447	024	0	1	01	01	H3447_024_0	5	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;13i-O;		2		2			
H3447	025	0	1	01	01	H3447_025_0	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;13i-O;		2		2			
H3447	027	0	1	01	01	H3447_027_0	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;13i-O;		2		2			
H3447	028	0	1	01	01	H3447_028_0	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;13i-O;		2		2			
H3447	030	0	1	01	01	H3447_030_0	6	5	1	10				01111	4749	4749																	2		13i-O;		2		2			
H3447	030	0	1	01	01	H3447_030_0	6	1	1	10				01111	4749	2451																	2		13i;		2		2			
H3447	030	0	1	01	01	H3447_030_0	6	3	1	10				01111	4749	4749																	2		13i;		2		2			
H3447	030	0	1	01	01	H3447_030_0	6	2	1	10				01111	4749	4749																	2		13i;		2		2			
H3447	030	0	1	01	01	H3447_030_0	6	4	1	10				01111	4749	4749																	2		13i;		2		2			
H3447	033	0	1	01	01	H3447_033_0	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;13i-O;		2		2			
H3447	037	0	1	01	01	H3447_037_0	5	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;13i-O;		2		2			
H3447	038	1	1	01	01	H3447_038_1	5	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;13i-O;		2		2			
H3447	038	2	1	01	01	H3447_038_2	5	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;13i-O;		2		2			
H3447	039	0	1	01	01	H3447_039_0	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H3447	042	1	1	01	01	H3447_042_1	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;13i-O;		2		2			
H3447	042	2	1	01	01	H3447_042_2	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;13i-O;		2		2			
H3447	042	3	1	01	01	H3447_042_3	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;13i-O;		2		2			
H3447	042	4	1	01	01	H3447_042_4	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;13i-O;		2		2			
H3499	005	0	1	01	01	H3499_005_0	5	2	1	10				01111	5047	1514																	2		13d;		1	13d;	1	300.00	3	13d;
H3499	005	0	1	01	01	H3499_005_0	5	1	3								01111111111111110000																2		13i;		1	13i;	1	600.00	3	13i10;
H3499	008	0	1	01	01	H3499_008_0	5	1	3								01111111111111110000																2		13i;		1	13i;	1	600	3	13i10;
H3533	002	0	1	01	01	H3533_002_0	2	1	1	10				01111	6646	6646																	2		13b;13d;13e;13f;14c;		1	13b;13d;13e;13f;14c;	1	1800	3	13b;13d;13e;13f;14c8;
H3533	006	0	1	01	01	H3533_006_0	2	1	3								00000001000000000000																1	001	13c;		2		2			
H3533	010	0	1	01	01	H3533_010_0	2	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		1	13d;	2			
H3533	013	0	1	01	01	H3533_013_0	2	1	3								00000001000000000000																1	001	13c;		2		2			
H3533	027	0	1	01	01	H3533_027_0	2	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		1	13d;	2			
H3533	032	1	1	01	01	H3533_032_1	2	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		1	13d;	2			
H3533	032	2	1	01	01	H3533_032_2	2	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		1	13d;	2			
H3533	033	0	1	01	01	H3533_033_0	2	1	3								00000101000010001000	Depression															1	001	13c;		2		2			
H3533	033	0	1	01	01	H3533_033_0	2	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H3533	034	1	1	01	01	H3533_034_1	2	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		1	13d;	2			
H3533	034	1	1	01	01	H3533_034_1	2	1	1	10				01111	6673	6673																	2		13b;13d;13e;13f;14c;		1	13b;13d;13e;13f;14c;	1	1800	3	13b;13d;13e;13f;14c8;
H3533	034	2	1	01	01	H3533_034_2	2	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		1	13d;	2			
H3533	034	2	1	01	01	H3533_034_2	2	1	1	10				01111	6673	6673																	2		13b;13d;13e;13f;14c;		1	13b;13d;13e;13f;14c;	1	1800	3	13b;13d;13e;13f;14c8;
H3536	004	0	1	01	01	H3536_004_0	5	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H3536	006	0	1	01	01	H3536_006_0	5	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;13i-O;		2		2			
H3554	002	0	1	04	01	H3554_002_0	5	1	3								00010001000000011100	Coronary artery disease	Sjgrens Syndrome														2		16a;16b;	1	2		2			
H3554	004	0	1	04	01	H3554_004_0	5	1	3								00010001000000011100	Coronary artery disease	Sjgrens Syndrome														2		16a;16b;	1	2		2			
H3554	007	0	1	04	01	H3554_007_0	5	1	3								00010001000000011100	Coronary artery disease	Sjgrens Syndrome														2		16a;16b;	1	2		2			
H3554	011	0	1	04	01	H3554_011_0	3	1	3								00010001000000011100	Coronary artery disease	Sjgrens Syndrome														2		16a;16b;	1	2		2			
H3557	001	0	1	04	01	H3557_001_0	11	1	3								00001001000000000000																2		16b;	1	2		2			
H3561	001	0	1	01	01	H3561_001_0	6	1	3								01111111111111110000																2		13i;		1	13i;	1	900	3	13i10;
H3561	001	0	1	01	01	H3561_001_0	6	2	1	10				01111	5272	1582																	2		13d;		1	13d;	1	300.00	3	13d;
H3597	011	0	1	02	01	H3597_011_0	7	1	1	10				01111	238273	238273																	2		10b;13i;13i-O;14c;	2	1	10b;13i;13i-O;14c;	1	150.00	5	10b2;13i1;13i4;13i-O1;
H3597	801	0	1	01	01	H3597_801_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H3597	802	0	1	01	01	H3597_802_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H3632	001	0	1	04	01	H3632_001_0	7	1	3								00011111111010110000																2		13i;	1	2		2			
H3655	033	0	1	01	01	H3655_033_0	5	3	1	10				01111	41511	41511																	2		13i;		2		2			
H3655	033	0	1	01	01	H3655_033_0	5	2	1	10				01111	41511	41511																	2		13i;		2		2			
H3655	033	0	1	01	01	H3655_033_0	5	1	1	10				01111	41511	21420																	2		13i;		2		2			
H3655	033	0	1	01	01	H3655_033_0	5	4	1	10				01111	41511	41511																	2		13i-O;		2		2			
H3655	034	0	1	01	01	H3655_034_0	5	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;13i-O;		2		2			
H3655	038	0	1	01	01	H3655_038_0	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;13i-O;		2		2			
H3655	041	0	1	01	01	H3655_041_0	5	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;13i-O;		2		2			
H3655	042	0	1	01	01	H3655_042_0	5	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;13i-O;		2		2			
H3655	044	0	1	01	01	H3655_044_0	5	4	1	10				01111	4271	4271																	2		13i;		2		2			
H3655	044	0	1	01	01	H3655_044_0	5	2	1	10				01111	4271	4271																	2		13i;		2		2			
H3655	044	0	1	01	01	H3655_044_0	5	3	1	10				01111	4271	4271																	2		13i;		2		2			
H3655	044	0	1	01	01	H3655_044_0	5	1	1	10				01111	4271	2204																	2		13i;		2		2			
H3655	045	1	1	01	01	H3655_045_1	7	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;13i-O;		2		2			
H3655	045	2	1	01	01	H3655_045_2	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;13i-O;		2		2			
H3655	045	3	1	01	01	H3655_045_3	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;13i-O;		2		2			
H3655	045	4	1	01	01	H3655_045_4	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;13i-O;		2		2			
H3660	028	0	1	02	01	H3660_028_0	7	1	2														00000000001111	Hip Replacement	Knee Replacement	Femur Fracture	Falls or History of Falls		2	2			2		14c;	2	2		2			
H3660	028	0	1	02	01	H3660_028_0	7	2	2														00000000001000	High A1C (over 8) Levels									2		13c;	2	2		2			
H3660	029	0	1	02	01	H3660_029_0	7	1	2														00000000001111	Hip Replacement	Knee Replacement	Femur Fracture	Falls or History of Falls		2	2			2		14c;	2	2		2			
H3660	029	0	1	02	01	H3660_029_0	7	2	2														00000000001000	High A1C (over 8) Levels									2		13c;	2	2		2			
H3660	044	0	1	01	01	H3660_044_0	7	1	2														00000000001111	Hip Replacement	Knee Replacement	Femur Fracture	Falls or History of Falls		2	2			2		14c;		2		2			
H3660	044	0	1	01	01	H3660_044_0	7	2	2														00000000001000	High A1C (over 8) Levels									2		13c;		2		2			
H3660	050	0	1	01	01	H3660_050_0	7	1	2														00000000001111	Hip Replacement	Knee Replacement	Femur Fracture	Falls or History of Falls		2	2			2		14c;		2		2			
H3660	050	0	1	01	01	H3660_050_0	7	2	2														00000000001000	High A1C (over 8) Levels									2		13c;		2		2			
H3660	052	1	1	01	01	H3660_052_1	7	1	2														00000000001111	Hip Replacement	Knee Replacement	Femur Fracture	Falls or History of Falls		2	2			2		14c;		2		2			
H3660	052	1	1	01	01	H3660_052_1	7	2	2														00000000001000	High A1C (over 8) Level									2		13c;		2		2			
H3660	052	2	1	01	01	H3660_052_2	7	2	2														00000000001000	High A1C (over 8) Level									2		13c;		2		2			
H3660	052	2	1	01	01	H3660_052_2	7	1	2														00000000001111	Hip Replacement	Knee Replacement	Femur Fracture	Falls or History of Falls		2	2			2		14c;		2		2			
H3660	053	1	1	01	01	H3660_053_1	7	2	2														00000000001000	High A1C (over 8) Level									2		13c;		2		2			
H3660	053	1	1	01	01	H3660_053_1	7	1	2														00000000001111	Hip Replacement	Knee Replacement	Femur Fracture	Falls or History of Falls		2	2			2		14c;		2		2			
H3660	053	2	1	01	01	H3660_053_2	7	2	2														00000000001000	High A1C (over 8) Level									2		13c;		2		2			
H3660	053	2	1	01	01	H3660_053_2	7	1	2														00000000001111	Hip Replacement	Knee Replacement	Femur Fracture	Falls or History of Falls		2	2			2		14c;		2		2			
H3660	056	1	1	01	01	H3660_056_1	8	1	3								00000101000010000000																1	001	13c;13i;		2		2			
H3660	056	2	1	01	01	H3660_056_2	8	1	3								00000101000010000000																1	001	13c;13i;		2		2			
H3660	801	0	1	01	01	H3660_801_0	4	2	2														00000000001000	High A1C (over 8) Levels									2		13c;		2		2			
H3660	801	0	1	01	01	H3660_801_0	4	1	2														00000000001111	Hip Replacement	Knee Replacement	Femur Fracture	Falls or History of Falls		2	2			2		14c;		2		2			
H3660	805	0	1	02	01	H3660_805_0	4	2	2														00000000001000	High A1C (over 8) Levels									2		13c;	2	2		2			
H3660	805	0	1	02	01	H3660_805_0	4	1	2														00000000001111	Hip Replacement	Knee Replacement	Femur Fracture	Falls or History of Falls		2	2			2		14c;	2	2		2			
H3672	019	0	1	01	01	H3672_019_0	7	3	1	10				01111	3019	906																	2		13i-O;		1	13i-O;	1	0.00	3	13i-O3;
H3672	019	0	1	01	01	H3672_019_0	7	1	1	10				01111	3019	2415																	2		13i-O;		1	13i-O;	1	65.00	7	13i-O1;
H3672	019	0	1	01	01	H3672_019_0	7	2	1	10				01111	3019	2113																	2		13i-O;		1	13i-O;	1	25.00	7	13i-O2;
H3706	024	0	1	01	01	H3706_024_0	8	1	3								00001101000000000000																2		13b;13i;		2		2			
H3706	025	0	1	01	01	H3706_025_0	8	1	3								00001101000000000000																2		13b;13i;		2		2			
H3706	028	0	1	01	01	H3706_028_0	9	1	1	10				01111	100	60																	2		13b;13i;		2		1	150.00	7	13b;13i1;13i10;
H3706	028	0	1	01	01	H3706_028_0	9	2	1	10				01111	100	60																	2		13c;		2		2			
H3706	029	0	1	01	01	H3706_029_0	8	1	1	10				01111	100	60																	2		13b;13i;		2		1	150.00	7	13b;13i1;13i10;
H3706	029	0	1	01	01	H3706_029_0	8	2	1	10				01111	100	60																	2		13c;		2		2			
H3748	801	0	1	01	01	H3748_801_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H3748	802	0	1	01	01	H3748_802_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H3794	002	0	1	02	01	H3794_002_0	2	1	1	10				01111	43339	36838																	2		13d;	2	1	13d;	2			
H3794	004	0	1	02	01	H3794_004_0	2	1	1	10				01111	177	150																	2		13d;	2	1	13d;	2			
H3815	001	0	1	01	01	H3815_001_0	9	1	3								01111111111111110000																2		13i;13i-O;		2		2			
H3815	007	0	1	01	01	H3815_007_0	9	2	1	10				01111	6163	1849																	2		7b;10b;13a;13b;13i;13i-O;16b;17b;18b;		2		2			
H3815	007	0	1	01	01	H3815_007_0	9	3	1	01	1111111011	2	2		6163	2157																	2		13i;		2		2			
H3815	007	0	1	01	01	H3815_007_0	9	1	3								01111111111111110000																2		13i-O;		2		2			
H3815	008	0	1	01	01	H3815_008_0	9	1	3								01111111111111110000																2		13i;13i-O;		2		2			
H3815	010	0	1	01	01	H3815_010_0	7	1	3								01111111111111110000																2		13i;13i-O;		2		2			
H3815	011	0	1	01	01	H3815_011_0	7	1	3								01111111111111110000																2		13i;13i-O;		2		2			
H3815	015	0	1	01	01	H3815_015_0	6	1	3								01111111111111110000																2		13i;13i-O;		2		2			
H3815	016	0	1	01	01	H3815_016_0	7	1	3								01111111111111110000																2		13i;13i-O;		2		2			
H3815	026	0	1	02	01	H3815_026_0	7	1	3								01111111111111110000																2		13i;13i-O;	2	2		2			
H3815	028	0	1	01	01	H3815_028_0	5	1	3								01111111111111110000																2		13i-O;		2		2			
H3815	029	0	1	01	01	H3815_029_0	5	1	3								01111111111111110000																2		13i-O;		2		2			
H3815	030	0	1	01	01	H3815_030_0	6	1	3								01111111111111110000																2		13i;13i-O;		2		2			
H3815	031	0	1	01	01	H3815_031_0	10	1	3								01111111111111110000																2		13i;13i-O;		2		2			
H3815	033	0	1	01	01	H3815_033_0	8	1	3								01111111111111110000																2		13i;13i-O;		2		2			
H3815	035	0	1	01	01	H3815_035_0	6	1	3								01111111111111110000																2		13i;13i-O;		2		2			
H3815	036	0	1	01	01	H3815_036_0	7	1	3								01111111111111110000																2		13i;		2		2			
H3817	008	1	1	04	01	H3817_008_1	8	1	2														01000000000000										2		7f;	1	2		2			
H3817	008	1	1	04	01	H3817_008_1	8	2	2														00000000001000	Pre-diabetes									2		14c;	1	2		2			
H3817	008	1	1	04	01	H3817_008_1	8	3	3								01111111111111110000																1	001	13i;	1	2		2			
H3817	008	2	1	04	01	H3817_008_2	8	2	2														00000000001000	Pre-diabetes									2		14c;	1	2		2			
H3817	008	2	1	04	01	H3817_008_2	8	1	2														01000000000000										2		7f;	1	2		2			
H3817	008	2	1	04	01	H3817_008_2	8	3	3								01111111111111110000																1	001	13i;	1	2		2			
H3817	009	1	1	04	01	H3817_009_1	8	1	2														01000000000000										2		7f;	1	2		2			
H3817	009	1	1	04	01	H3817_009_1	8	3	3								01111111111111110000																1	001	13i;	1	2		2			
H3817	009	1	1	04	01	H3817_009_1	8	2	2														00000000001000	Pre-diabetes									2		14c;	1	2		2			
H3817	009	2	1	04	01	H3817_009_2	8	1	2														01000000000000										2		7f;	1	2		2			
H3817	009	2	1	04	01	H3817_009_2	8	2	2														00000000001000	Pre-diabetes									2		14c;	1	2		2			
H3817	009	2	1	04	01	H3817_009_2	8	3	3								01111111111111110000																1	001	13i;	1	2		2			
H3817	010	0	1	04	01	H3817_010_0	6	3	3								01111111111111110000																1	001	13i;	1	2		2			
H3817	010	0	1	04	01	H3817_010_0	6	2	2														00000000001000	Pre-diabetes									2		14c;	1	2		2			
H3817	010	0	1	04	01	H3817_010_0	6	1	2														01000000000000										2		7f;	1	2		2			
H3817	011	1	1	04	01	H3817_011_1	9	1	2														01000000000000										2		7f;	1	2		2			
H3817	011	1	1	04	01	H3817_011_1	9	3	3								01111111111111110000																1	001	13i;	1	2		2			
H3817	011	1	1	04	01	H3817_011_1	9	2	2														00000000001000	Pre-diabetes									2		14c;	1	2		2			
H3817	011	2	1	04	01	H3817_011_2	9	3	3								01111111111111110000																1	001	13i;	1	2		2			
H3817	011	2	1	04	01	H3817_011_2	9	1	2														01000000000000										2		7f;	1	2		2			
H3817	011	2	1	04	01	H3817_011_2	9	2	2														00000000001000	Pre-diabetes									2		14c;	1	2		2			
H3817	801	0	1	04	01	H3817_801_0	1	2	2														00000000001000	Pre-diabetes									2		14c;	1	2		2			
H3817	801	0	1	04	01	H3817_801_0	1	1	2														01000000000000										2		7f;	1	2		2			
H3817	801	0	1	04	01	H3817_801_0	1	3	3								01111111111111110000																1	001	13i;	1	2		2			
H3817	802	0	1	04	01	H3817_802_0	1	2	2														00000000001000	Pre-diabetes									2		14c;	1	2		2			
H3817	802	0	1	04	01	H3817_802_0	1	1	2														01000000000000										2		7f;	1	2		2			
H3817	802	0	1	04	01	H3817_802_0	1	3	3								01111111111111110000																1	001	13i;	1	2		2			
H3817	803	0	1	04	01	H3817_803_0	1	1	2														01000000000000										2		7f;	1	2		2			
H3817	803	0	1	04	01	H3817_803_0	1	2	2														00000000001000	Pre-diabetes									2		14c;	1	2		2			
H3817	803	0	1	04	01	H3817_803_0	1	3	3								01111111111111110000																1	001	13i;	1	2		2			
H3817	804	0	1	04	01	H3817_804_0	1	3	3								01111111111111110000																1	001	13i;	1	2		2			
H3817	804	0	1	04	01	H3817_804_0	1	1	2														01000000000000										2		7f;	1	2		2			
H3817	804	0	1	04	01	H3817_804_0	1	2	2														00000000001000	Pre-diabetes									2		14c;	1	2		2			
H3832	007	0	1	04	01	H3832_007_0	6	2	2														00000000001110	Oral Cancer	Sjorgens	Head and Neck Cancer			2	2			2		16a;16b;	1	2		2			
H3832	007	0	1	04	01	H3832_007_0	6	1	2														01101010001110	Pregnancy	End Stage Renal Disease (ESRD)	Metabolic Syndrome			2	2			2		16a;	1	2		2			
H3832	008	0	1	04	01	H3832_008_0	6	1	2														01101010001110	Pregnancy	End Stage Renal Disease (ESRD)	Metabolic Syndrome			2	2			2		16a;	1	2		2			
H3832	008	0	1	04	01	H3832_008_0	6	2	2														00000000001110	Oral Cancer	Sjorgens	Head and Neck Cancer			2	2			2		16a;16b;	1	2		2			
H3832	009	0	1	04	01	H3832_009_0	6	2	2														00000000001110	Oral Cancer	Sjorgens	Head and Neck Cancer			2	2			2		16a;16b;	1	2		2			
H3832	009	0	1	04	01	H3832_009_0	6	1	2														01101010001110	Pregnancy	End Stage Renal Disease (ESRD)	Metabolic Syndrome			2	2			2		16a;	1	2		2			
H3832	010	0	1	04	01	H3832_010_0	6	1	2														01101010001110	Pregnancy	End Stage Renal Disease (ESRD)	Metabolic Syndrome			2	2			2		16a;	1	2		2			
H3832	010	0	1	04	01	H3832_010_0	6	2	2														00000000001110	Oral Cancer	Sjorgens	Head and Neck Cancer			2	2			2		16a;16b;	1	2		2			
H3864	043	0	1	01	01	H3864_043_0	6	1	3								00001101000010000000																2		13i;		2		2			
H3907	002	0	1	01	01	H3907_002_0	7	1	2														01110000000000						1				2		13c;		1	13c;	2			
H3907	006	0	1	01	01	H3907_006_0	10	1	2														01110000000000						1				2		13c;		1	13c;	2			
H3907	029	0	1	01	01	H3907_029_0	8	1	2														01110000000000						1				2		13c;		1	13c;	2			
H3907	037	0	1	01	01	H3907_037_0	8	1	2														01110000000000						1				2		13c;		1	13c;	2			
H3907	046	0	1	01	01	H3907_046_0	8	1	2														01110000000000						1				2		13c;		1	13c;	2			
H3907	049	0	1	01	01	H3907_049_0	8	1	2														01110000000000						1				2		13c;		1	13c;	2			
H3907	050	0	1	01	01	H3907_050_0	8	1	2														01110000000000						1				2		13c;		1	13c;	2			
H3907	052	0	1	01	01	H3907_052_0	8	1	2														01110000000000						1				2		13c;		1	13c;	2			
H3909	001	0	1	04	01	H3909_001_0	4	1	3								00000001000000001000	Depression / Depressive Disorders															2		13i;	1	2		2			
H3909	001	0	1	04	01	H3909_001_0	4	2	2														01010000000000						1				2		10b;	1	2		2			
H3909	007	0	1	04	01	H3909_007_0	3	1	3								00000001000000001000	Depression / Depressive Disorders															2		13i;	1	2		2			
H3909	007	0	1	04	01	H3909_007_0	3	2	2														01010000000000						1				2		10b;	1	2		2			
H3909	009	0	1	04	01	H3909_009_0	3	1	3								00000001000000001000	Depression / Depressive Disorders															2		13i;	1	2		2			
H3909	009	0	1	04	01	H3909_009_0	3	2	2														01010000000000						1				2		10b;	1	2		2			
H3909	014	0	1	04	01	H3909_014_0	3	1	3								00000001000000001000	Depression / Depressive Disorders															2		13i;	1	2		2			
H3909	014	0	1	04	01	H3909_014_0	3	2	2														01010000000000						1				2		10b;	1	2		2			
H3909	015	0	1	04	01	H3909_015_0	4	2	2														01010000000000						1				2		10b;	1	2		2			
H3909	015	0	1	04	01	H3909_015_0	4	1	3								00000001000000001000	Depression / Depressive Disorders															2		13i;	1	2		2			
H3909	017	0	1	04	01	H3909_017_0	3	1	3								00000001000000001000	Depression, Depressive Disorders															2		13i;	1	2		2			
H3909	017	0	1	04	01	H3909_017_0	3	2	2														01010000000000						1				2		10b;	1	2		2			
H3916	001	0	1	04	01	H3916_001_0	7	1	3								00011110010010010000																2		14c;	1	2		2			
H3916	005	0	1	04	01	H3916_005_0	7	1	3								00001101000010000000																2		13d;	1	2		2			
H3916	012	0	1	04	01	H3916_012_0	5	1	3								00000001000000000000																2		13d;	1	2		2			
H3916	015	0	1	04	01	H3916_015_0	7	1	3								00001101000010000000																2		13d;	1	2		2			
H3916	022	0	1	04	01	H3916_022_0	7	1	3								00011110010010010000																2		14c;	1	2		2			
H3923	013	0	1	04	01	H3923_013_0	3	1	3								00001101000010000000																2		13i;	1	2		1	60.00	1	13i1;
H3923	017	0	1	04	01	H3923_017_0	3	1	3								00001101000010000000																2		13i;	1	2		1	60.00	1	13i1;
H3923	028	0	1	04	01	H3923_028_0	3	1	3								00001101000010000000																2		13i;	1	2		1	60.00	5	13i1;
H3923	029	0	1	04	01	H3923_029_0	4	1	3								00001101000010000000																2		13i;	1	2		1	60.00	1	13i1;
H3923	030	0	1	04	01	H3923_030_0	4	1	3								00001101000010000000																2		13i;	1	2		1	60.00	1	13i1;
H3923	034	0	1	04	01	H3923_034_0	3	1	3								00001101000010000000																2		13i;	1	2		1	60.00	5	13i1;
H3923	035	0	1	04	01	H3923_035_0	3	1	3								00001101000010000000																2		13i;	1	2		1	60.00	5	13i1;
H3923	037	0	1	04	01	H3923_037_0	3	1	3								00001101000010000000																2		13i;	1	2		1	60.00	5	13i1;
H3924	059	21	1	04	01	H3924_059_21	5	1	3								01111111111111110000																1	001	13c;13i;14c;	1	2		1	1000.00	3	13c;13i5;13i9;13i10;14c21;
H3924	059	22	1	04	01	H3924_059_22	5	1	3								01111111111111110000																1	001	13c;13i;14c;	1	2		1	1000.00	3	13c;13i5;13i9;13i10;14c21;
H3924	062	21	1	04	01	H3924_062_21	4	1	3								01111111111111110000																1	001	13c;13i;14c;	1	2		1	1000.00	3	13c;13i5;13i9;13i10;14c21;
H3924	062	22	1	04	01	H3924_062_22	4	1	3								01111111111111110000																1	001	13c;13i;14c;	1	2		1	1000.00	3	13c;13i5;13i9;13i10;14c21;
H3924	062	23	1	04	01	H3924_062_23	4	1	3								01111111111111110000																1	001	13c;13i;14c;	1	2		1	1000.00	3	13c;13i5;13i9;13i10;14c21;
H3924	065	0	1	04	01	H3924_065_0	5	1	3								01111111111111110000																1	001	13c;13i;14c;	1	2		1	1000.00	3	13c;13i5;13i9;13i10;14c21;
H3924	066	0	1	04	01	H3924_066_0	4	1	3								01111111111111110000																1	001	13c;13i;14c;	1	2		1	1000.00	3	13c;13i5;13i9;13i10;14c21;
H3928	001	0	1	01	01	H3928_001_0	7	1	3								01111111111111111100	Hyperlipidemia	Hypertension														2		13b;13i;		1	13b;13i;	1	90.00	5	13b;13i1;
H3928	801	0	1	01	01	H3928_801_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H3928	803	0	1	01	01	H3928_803_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H3931	004	0	1	02	01	H3931_004_0	2	1	1	01	0001000000				10756	5382																	1	001	10b;13b;13c;13d;13i;	2	1	10b;13b;13c;13d;13i;	2			
H3931	099	0	1	02	01	H3931_099_0	4	1	1	10				01111	238273	238273																	2		13i;	2	1	13i;	2			
H3931	801	0	1	01	01	H3931_801_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H3931	804	0	1	01	01	H3931_804_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H3949	009	0	1	01	01	H3949_009_0	4	1	1	10				01111	17790	10674																	2		13i;		2		2			
H3952	008	0	1	01	01	H3952_008_0	3	2	2														01010000000000						1				2		10b;		2		2			
H3952	008	0	1	01	01	H3952_008_0	3	1	3								00010001000000001100	Depression / Depressive Disorders	Congestive Heart Failure														1	001	13i;		2		2			
H3952	020	0	1	01	01	H3952_020_0	4	1	3								00010001000000001100	Depression / Depressive Disorders	Congestive Heart Failure														1	001	13i;		2		2			
H3952	020	0	1	01	01	H3952_020_0	4	2	2														01010000000000						1				2		10b;		2		2			
H3952	044	0	1	01	01	H3952_044_0	3	2	2														01010000000000						1				2		10b;		2		2			
H3952	044	0	1	01	01	H3952_044_0	3	1	3								00010001000000001100	Depression / Depressive Disorders	Congestive Heart Failure														1	001	13i;		2		2			
H3952	045	0	1	01	01	H3952_045_0	4	1	3								00010001000000001100	Depression / Depressive Disorders	Congestive Heart Failure														1	001	13i;		2		2			
H3952	045	0	1	01	01	H3952_045_0	4	2	2														01010000000000						1				2		10b;		2		2			
H3952	048	0	1	01	01	H3952_048_0	2	2	2														01010000000000						1				2		10b;		2		2			
H3952	048	0	1	01	01	H3952_048_0	2	1	3								00010001000000001100	Depression / Depressive Disorders	Congestive Heart Failure														1	001	13i;		2		2			
H3952	049	0	1	01	01	H3952_049_0	4	1	3								00010001000000001100	Depression / Depressive Disorders	Congestive Heart Failure														1	001	13i;		2		2			
H3952	049	0	1	01	01	H3952_049_0	4	2	2														01010000000000						1				2		10b;		2		2			
H3952	050	0	1	01	01	H3952_050_0	3	2	2														01010000000000						1				2		10b;		2		2			
H3952	050	0	1	01	01	H3952_050_0	3	1	3								00010001000000001100	Depression / Depressive Disorders	Congestive Heart Failure														1	001	13i;		2		2			
H3952	051	0	1	01	01	H3952_051_0	3	2	2														01010000000000						1				2		10b;		2		2			
H3952	051	0	1	01	01	H3952_051_0	3	1	3								00010001000000001100	Depression / Depressive Disorders	Congestive Heart Failure														1	001	13i;		2		2			
H3952	053	0	1	02	01	H3952_053_0	3	3	2														01010000000000						1				2		10b;	2	2		2			
H3952	053	0	1	02	01	H3952_053_0	3	2	2														01000000000000										2		13b;	2	2		2			
H3952	053	0	1	02	01	H3952_053_0	3	1	3								00010001000000001100	Depression/Depressive Disorders	Congestive Heart Failure														1	001	13i;	2	2		2			
H3952	054	0	1	02	01	H3952_054_0	3	3	2														01010000000000						1				2		10b;	2	2		2			
H3952	054	0	1	02	01	H3952_054_0	3	2	2														01000000000000										2		13b;	2	2		2			
H3952	054	0	1	02	01	H3952_054_0	3	1	3								00010001000000001100	Depression/Depressive Disorders	Congestive Heart Failure														1	001	13i;	2	2		2			
H3952	055	0	1	01	01	H3952_055_0	4	1	3								00010001000000001100	Depression / Depressive Disorders	Congestive Heart Failure														1	001	13i;		2		2			
H3952	055	0	1	01	01	H3952_055_0	4	2	2														01010000000000						1				2		10b;		2		2			
H3952	056	0	1	01	01	H3952_056_0	3	1	3								00010001000000001100	Depression / Depressive Disorders	Congestive Heart Failure														1	001	13i;		2		2			
H3952	056	0	1	01	01	H3952_056_0	3	2	2														01010000000000						1				2		10b;		2		2			
H3954	097	0	1	01	01	H3954_097_0	4	1	3								01111111111111110000																1	001	13c;13i;14c;		2		1	3000.00	3	13c;13i1;13i2;13i5;13i9;13i10;
H3954	157	21	1	01	01	H3954_157_21	5	1	3								01111111111111110000																1	001	13c;13i;14c;		2		1	1000.00	3	14c21;
H3954	157	22	1	01	01	H3954_157_22	5	1	3								01111111111111110000																1	001	13c;13i;14c;		2		1	1000.00	3	14c21;
H3954	157	23	1	01	01	H3954_157_23	5	1	3								01111111111111110000																1	001	13c;13i;14c;		2		1	1000.00	3	14c21;
H3954	158	13	1	01	01	H3954_158_13	4	1	3								01111111111111110000																1	001	13c;13i;14c;		2		1	1000.00	3	13c;13i5;13i9;13i10;14c21;
H3954	158	14	1	01	01	H3954_158_14	4	1	3								01111111111111110000																1	001	13c;13i;14c;		2		1	1000.00	3	13c;13i5;13i9;13i10;14c21;
H3954	160	0	1	01	01	H3954_160_0	4	1	3								01111111111111110000																1	001	13c;13i;14c;		2		1	1000.00	3	13c;13i5;13i9;13i10;14c21;
H3954	161	0	1	01	01	H3954_161_0	4	1	3								01111111111111110000																1	001	13c;13i;14c;		2		1	1000.00	3	13c;13i5;13i9;13i10;14c21;
H3954	162	0	1	01	01	H3954_162_0	3	1	3								01111111111111110000																1	001	13c;13i;14c;		2		1	1000.00	3	13c;13i5;13i9;13i10;14c21;
H3957	031	0	1	02	01	H3957_031_0	12	1	3								00000001000010000000																2		10b;16b;	2	2		2			
H3957	042	1	1	01	01	H3957_042_1	10	1	3								00000001000000000000																2		13d;		2		2			
H3957	042	2	1	01	01	H3957_042_2	10	1	3								00000001000000000000																2		13d;		2		2			
H3957	042	4	1	01	01	H3957_042_4	10	1	3								00000001000000000000																2		13d;		2		2			
H3957	042	5	1	01	01	H3957_042_5	10	1	3								00000001000000000000																2		13d;		2		2			
H3957	043	1	1	02	01	H3957_043_1	8	1	3								00001101000010000000																2		13d;	2	2		2			
H3957	043	2	1	02	01	H3957_043_2	8	1	3								00001101000010000000																2		13d;	2	2		2			
H3957	044	1	1	02	01	H3957_044_1	10	1	3								00001101000010000000																2		13d;	2	2		2			
H3957	045	1	1	02	01	H3957_045_1	10	1	3								00011111010010010000																2		13d;14c;	2	2		2			
H3957	045	2	1	02	01	H3957_045_2	10	1	3								00001101000010000000																2		13d;	2	2		2			
H3957	046	1	1	02	01	H3957_046_1	10	1	3								00011111010010010000																2		13d;14c;	2	2		2			
H3957	046	2	1	02	01	H3957_046_2	10	1	3								00001101000010000000																2		13d;	2	2		2			
H3959	001	0	1	01	01	H3959_001_0	2	1	1	01	0001000000				10756	5382																	1	001	10b;13b;13c;13d;13i;		1	10b;13b;13c;13d;13i;	2			
H3959	002	0	1	01	01	H3959_002_0	2	1	1	01	0001000000				10756	5382																	1	001	10b;13b;13c;13d;13i;		1	10b;13b;13c;13d;13i;	2			
H3959	010	0	1	02	01	H3959_010_0	3	1	2														00000100001000	Hyperlipidemia					2	2			2		10b;13b;	2	1	10b;13b;	2			
H3959	011	0	1	02	01	H3959_011_0	3	1	3								01111111111111111100	Hyperlipidemia	Hypertension														2		13i;	2	1	13i;	2			
H3959	032	0	1	02	01	H3959_032_0	3	2	3								01111111111111111100	Hyperlipidemia	Hypertension														2		13i;	2	1	13i;	2			
H3959	032	0	1	02	01	H3959_032_0	3	1	2														00000100001000	Hyperlipidemia					2	2			2		10b;13b;	2	1	10b;13b;	2			
H3959	035	0	1	01	01	H3959_035_0	2	1	1	10				01111	238273	238273																	2		10b;13b;13i;13i-O;14c;		1	10b;13b;13i;13i-O;14c;	1	360.00	5	10b2;13b;13i1;13i4;13i-O1;
H3959	036	0	1	01	01	H3959_036_0	2	1	1	10				01111	238273	238273																	2		10b;13b;13i;13i-O;14c;		1	10b;13b;13i;13i-O;14c;	1	360.00	5	10b2;13b;13i1;13i4;13i-O1;
H3959	036	0	1	01	01	H3959_036_0	2	2	3								01111111111111111100	Hyperlipidemia	Hypertension														2		13i;		1	13i;	2			
H3959	039	0	1	02	01	H3959_039_0	2	1	1	01	0001000000				10756	5382																	1	001	10b;13b;13c;13d;13i;	2	1	10b;13b;13c;13d;13i;	2			
H3959	041	0	1	01	01	H3959_041_0	1	1	3								01111111111111111100	Hyperlipidemia	Hypertension														2		13i;		1	13i;	2			
H3959	046	0	1	01	01	H3959_046_0	2	1	2														00000100001000	Hyperlipidemia					2	2			2		10b;13b;		1	10b;13b;	2			
H3959	046	0	1	01	01	H3959_046_0	2	2	3								00111111111110111100	Hyperlipidemia	Hypertension														1	001	10b;13b;14c;		1	10b;13b;14c;	2			
H3959	047	0	1	01	01	H3959_047_0	2	2	3								00111111111110111100	Hyperlipidemia	Hypertension														1	001	10b;13b;14c;		1	10b;13b;14c;	2			
H3959	047	0	1	01	01	H3959_047_0	2	1	2														00000100001000	Hyperlipidemia					2	2			2		10b;13b;		1	10b;13b;	2			
H3959	049	0	1	02	01	H3959_049_0	2	2	3								00111111111110111100	Hyperlipidemia	Hypertension														1	001	10b;13b;14c;	2	1	10b;13b;14c;	2			
H3959	049	0	1	02	01	H3959_049_0	2	1	2														00000100001000	Hyperlipidemia					2	2			2		10b;13b;	2	1	10b;13b;	2			
H3959	051	0	1	01	01	H3959_051_0	2	1	3								00111111111110111100	Hyperlipidemia	Hypertension														1	001	10b;13b;14c;		1	10b;13b;14c;	2			
H3959	053	0	1	01	01	H3959_053_0	2	1	3								01111111111111111100	Hyperlipidemia	Hypertension														2		13i;		1	13i;	2			
H3959	063	0	1	01	01	H3959_063_0	3	1	1	10				01111	238273	238273																	2		10b;13b;13i;13i-O;14c;		1	10b;13b;13i;13i-O;14c;	1	300.00	5	10b2;13b;13i1;13i4;13i-O1;
H3959	066	0	1	01	01	H3959_066_0	4	1	3								01000110010011100000																2		13i;		1	13i;	2			
H3959	803	0	1	01	01	H3959_803_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H3959	804	0	1	01	01	H3959_804_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H3962	001	0	1	01	01	H3962_001_0	3	1	3								00001101000010000000																2		13i;		2		1	60.00	5	13i1;
H3962	004	0	1	01	01	H3962_004_0	3	1	3								00001101000010000000																2		13i;		2		1	60.00	5	13i1;
H3962	007	0	1	01	01	H3962_007_0	3	1	3								00001101000010000000																2		13i;		2		1	60.00	5	13i1;
H3962	021	0	1	01	01	H3962_021_0	3	1	3								00001101000010000000																2		13i;		2		1	60.00	5	13i1;
H3975	002	0	1	04	01	H3975_002_0	4	1	3								01111111111111110000																2		13i;	1	1	13i;	2			
H3975	004	0	1	04	01	H3975_004_0	6	2	1	10				01111	1400	420																	2		13d;	1	1	13d;	1	300.00	3	13d;
H3975	004	0	1	04	01	H3975_004_0	6	1	3								01111111111111110000																2		13i;	1	1	13i;	1	600	3	13i10;
H4003	009	0	1	01	01	H4003_009_0	8	2	1	01	0100000000				705	146																	2		13d;		2		2			
H4003	009	0	1	01	01	H4003_009_0	8	1	1	01	1111111111	2	2		9132	9132																	2		13b;13i;13i-O;14c;		2		1	80.00	7	13b;13i1;13i2;13i3;13i6;13i10;13i-O1;14c4;14c8;14c17;
H4003	017	0	1	01	01	H4003_017_0	8	2	1	01	0100000000				5092	1052																	2		13d;		2		2			
H4003	017	0	1	01	01	H4003_017_0	8	1	1	10				10000	73337	73337																	2		13b;13i;13i-O;14c;		2		1	145.00	7	13b;13i1;13i2;13i3;13i6;13i10;13i-O1;14c4;14c8;14c17;
H4003	019	0	1	02	01	H4003_019_0	9	1	1	01	1111111111	2	2		1506	1506																	2		13b;13i;13i-O;14c;	2	2		1	35.00	7	13b;13i1;13i2;13i3;13i6;13i10;13i-O1;14c4;14c8;14c17;
H4003	034	0	1	02	01	H4003_034_0	8	1	1	01	1111111111	2	2		47330	47330																	2		13b;13i;13i-O;14c;	2	2		1	30.00	7	13b;13i1;13i2;13i3;13i6;13i10;13i-O1;14c4;14c8;14c17;
H4003	047	0	1	01	01	H4003_047_0	8	2	1	10				10000	18873	1887																	2		13i-O;		2		2			
H4003	047	0	1	01	01	H4003_047_0	8	1	1	01	0100000000				1310	271																	2		13d;		2		2			
H4003	049	0	1	01	01	H4003_049_0	11	1	1	10				10000	3073	3073																	2		13b;13i;13i-O;14c;		2		1	180.00	7	13b;13i1;13i2;13i3;13i6;13i10;13i-O1;14c4;14c8;14c17;
H4003	049	0	1	01	01	H4003_049_0	11	3	1	10				10000	3073	3073																	2		13i;13i-O;		2		2			
H4003	049	0	1	01	01	H4003_049_0	11	2	1	01	0100000000				213	44																	2		13d;		2		2			
H4003	051	0	1	02	01	H4003_051_0	12	2	1	01	1111111111	2	2		1258	1258																	2		13b;13i;13i-O;14c;	2	2		1	100.00	7	13b;13i1;13i2;13i3;13i6;13i10;13i-O1;14c4;14c8;14c17;
H4003	051	0	1	02	01	H4003_051_0	12	1	1	01	1111111111	2	2		1258	1258																	2		13i;13i-O;	2	2		2			
H4003	052	0	1	01	01	H4003_052_0	8	2	1	01	0100000000				25	5																	2		13d;		2		2			
H4003	052	0	1	01	01	H4003_052_0	8	1	1	01	1111111111	2	2		325	325																	2		13b;13i;13i-O;14c;		2		1	155.00	7	13b;13i1;13i2;13i3;13i6;13i10;13i-O1;14c4;14c8;14c17;
H4003	053	0	1	01	01	H4003_053_0	10	1	1	01	1111111111	2	2		279	279																	2		13b;13i;13i-O;14c;		2		1	200.00	7	13b;13i1;13i2;13i3;13i6;13i10;13i-O1;14c4;14c8;14c17;
H4003	053	0	1	01	01	H4003_053_0	10	2	1	01	0100000000				22	4																	2		13d;		2		2			
H4003	054	0	1	02	01	H4003_054_0	10	1	1	01	1111111111	2	2		1995	1995																	2		13b;13i;13i-O;14c;	2	2		1	50.00	7	13b;13i1;13i2;13i3;13i6;13i10;13i-O1;14c4;14c8;14c17;
H4003	055	0	1	02	01	H4003_055_0	9	1	1	01	1111111111	2	2		1556	1556																	2		13b;13i;13i-O;14c;	2	2		1	30.00	7	13b;13i1;13i2;13i3;13i6;13i10;13i-O1;14c4;14c8;14c17;
H4003	057	0	1	02	01	H4003_057_0	9	1	1	01	1111111111	2	2		1630	1630																	2		13b;13i;13i-O;14c;	2	2		1	225.00	7	13b;13i1;13i2;13i3;13i6;13i10;13i-O1;14c4;14c8;14c17;
H4003	058	0	1	01	01	H4003_058_0	9	1	1	10				10000	1667	1667																	2		13b;13i;13i-O;14c;		2		1	325.00	7	13b;13i1;13i2;13i3;13i6;13i10;13i-O1;14c4;14c8;14c17;
H4003	058	0	1	01	01	H4003_058_0	9	2	1	01	0100000000				116	24																	2		13d;		2		2			
H4004	048	0	1	01	01	H4004_048_0	8	2	1	01	0100000000				687	142																	2		13d;		2		2			
H4004	048	0	1	01	01	H4004_048_0	8	3	1	10				10000	9893	9893																	2		13i-O;		2		2			
H4004	048	0	1	01	01	H4004_048_0	8	1	1	10				10000	9893	9893																	2		13b;13i;13i-O;14c;		2		1	65.00	7	13b;13i1;13i2;13i3;13i6;13i10;13i-O1;14c4;14c8;14c17;
H4004	056	0	1	02	01	H4004_056_0	9	1	1	01	1111111111	2	2		5511	5511																	2		13i-O;	2	2		2			
H4004	056	0	1	02	01	H4004_056_0	9	2	1	01	1111111111	2	2		5511	5511																	2		13b;13i;13i-O;14c;	2	2		1	50.00	7	13b;13i1;13i2;13i3;13i6;13i10;13i-O1;14c4;14c8;14c17;
H4004	062	0	1	01	01	H4004_062_0	11	2	1	01	0100000000				1549	320																	2		13d;		2		2			
H4004	062	0	1	01	01	H4004_062_0	11	1	1	10				10000	22313	22313																	2		13b;13i;13i-O;14c;		2		1	200.00	7	13b;13i1;13i2;13i3;13i6;13i10;13i-O1;14c4;14c8;14c17;
H4004	063	0	1	02	01	H4004_063_0	9	1	1	01	1111111111	2	2		6059	6059																	2		13b;13i;13i-O;14c;	2	2		1	130.00	7	13b;13i1;13i2;13i3;13i6;13i10;13i-O1;14c4;14c8;14c17;
H4004	065	0	1	02	01	H4004_065_0	8	1	1	01	1111111111	2	2		20540	20540																	2		13b;13i;13i-O;14c;	2	2		1	110.00	7	13b;13i1;13i2;13i3;13i6;13i10;13i-O1;14c4;14c8;14c17;
H4005	001	0	1	04	01	H4005_001_0	7	1	3								01111111111111110000																2		10b;13b;13i;	1	2		1	75.00	7	10b1;13b;13i1;13i6;13i10;
H4007	012	0	1	01	01	H4007_012_0	6	3	2														10010000011111	Maligent Neoplasm	Leukemia	Chronic Kidney Disease (CKD) & End Stage Renal Disease (ESRD)	Hepatitis	Pressure Ulcer	2	2			2		13b;		2		2			
H4007	012	0	1	01	01	H4007_012_0	6	2	3								01111111111111110000																1	001	13i;		2		2			
H4007	012	0	1	01	01	H4007_012_0	6	1	1	01	1111111111	2	2		2649	2649																	2		13b;13d;13e;13i;14c;		2		1	600	3	13b;13d;13e;13i1;13i3;13i4;13i5;13i6;13i10;14c8;
H4007	016	0	1	01	01	H4007_016_0	6	1	1	10				10000	3072	3072																	2		13b;13d;13e;13f;14c;		2		1	600	3	13b;13d;13e;13f;14c8;
H4007	016	0	1	01	01	H4007_016_0	6	2	2														10010000011111	Maligent Neoplasm	Leukemia	Chronic Kidney Disease (CKD) & End Stage Renal Disease (ESRD)	Hepatitis	Pressure Ulcer	2	2			2		13b;		2		2			
H4007	018	0	1	01	01	H4007_018_0	6	2	3								01111111111111110000																1	001	13i;		2		2			
H4007	018	0	1	01	01	H4007_018_0	6	1	1	10				10000	4320	4320																	2		13b;13d;13e;13f;14c;		2		1	900	3	13b;13d;13e;13f;14c8;
H4007	019	0	1	01	01	H4007_019_0	5	1	1	10				10000	2860	2860																	2		13b;13d;13e;13f;14c;		2		1	900	3	13b;13d;13e;13f;14c8;
H4007	020	0	1	01	01	H4007_020_0	4	1	1	01	1111111111	2	2		1055	1055																	2		13b;13d;13e;13i;14c;		2		1	300	3	13b;13d;13e;13i1;13i3;13i4;13i5;13i6;13i10;14c8;
H4007	021	0	1	01	01	H4007_021_0	5	2	3								01111111111111110000																1	001	13i;		2		2			
H4007	021	0	1	01	01	H4007_021_0	5	1	1	01	1111111111	2	2		938	938																	2		13b;13d;13e;13i;14c;		2		1	900	3	13b;13d;13e;13i1;13i3;13i4;13i5;13i6;13i10;14c8;
H4007	022	0	1	01	01	H4007_022_0	4	1	1	10				10000	1934	1934																	2		13b;13d;13e;13f;14c;		2		1	600	3	13b;13d;13e;13f;14c8;
H4007	024	0	1	01	01	H4007_024_0	4	1	1	01	1111111111	2	2		944	944																	2		13b;13d;13e;13i;14c;		2		1	1800	3	13b;13d;13e;13i1;13i3;13i4;13i5;13i6;13i10;14c8;
H4007	026	0	1	01	01	H4007_026_0	4	1	1	10				10000	1455	1455																	2		13b;13d;13e;13f;14c;		2		1	900	3	13b;13d;13e;13f;14c8;
H4007	027	0	1	01	01	H4007_027_0	3	1	1	10				10000	1554	1554																	2		13b;13d;13e;13f;14c;		2		1	3180	3	13b;13d;13e;13f;14c8;
H4036	023	0	1	04	01	H4036_023_0	7	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;	1	2		2			
H4073	002	0	1	01	01	H4073_002_0	6	1	3								01111111111111110000																2		13i;		1	13i;	1	600.00	3	13i10;
H4073	002	0	1	01	01	H4073_002_0	6	2	1	10				01111	3117	935																	2		13d;		1	13d;	1	300.00	3	13d;
H4091	001	0	1	04	01	H4091_001_0	6	1	3								00000010000000001110	Alzheimer's Disease, intellectual disabilities and related conditions	Anxiety disorders, bipolar disorder, depression, paranoid disorder	Schizophrenia													2		13i;	1	2		2			
H4091	002	0	1	04	01	H4091_002_0	7	1	3								10000111000000011111	Alzheimer's Disease, intellectual disabilities and related conditions	Anxiety disorders, bipolar disorder, depression, paranoid disorder	Schizophrenia, Asthma, Chronic bronchitis, Emphysema, COPD	Peripheral vascular disease, Ischemic heart disease	Malnutrition including failure to thrive											2		13i;	1	2		2			
H4091	003	0	1	04	01	H4091_003_0	6	1	3								10000111000000011111	Alzheimer's Disease, intellectual disabilities and related conditions	Anxiety disorders, bipolar disorder, depression, paranoid disorder	Schizophrenia, Asthma, Chronic bronchitis, Emphysema, COPD	Peripheral vascular disease, Ischemic heart disease	Malnutrition including failure to thrive											2		13i;	1	2		2			
H4094	001	0	1	02	01	H4094_001_0	2	1	1	10				01111	980	833																	2		13d;	2	1	13d;	2			
H4140	002	0	1	02	01	H4140_002_0	5	1	1	10				01111	4788	3591																	2		13i;	2	1	13i;	1	50.00	7	13i1;13i10;
H4141	003	0	1	01	01	H4141_003_0	3	3	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		1	13d;	2			
H4141	003	0	1	01	01	H4141_003_0	3	2	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H4141	003	0	1	01	01	H4141_003_0	3	1	1	10				01111	33098	33098																	2		13b;13d;13e;13f;14c;		1	13b;13d;13e;13f;14c;	1	1800	3	13b;13d;13e;13f;14c8;
H4141	015	0	1	01	01	H4141_015_0	3	1	2														01000000000000										1	010	13d;		2		2			
H4141	017	3	1	01	01	H4141_017_3	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H4141	021	0	1	01	01	H4141_021_0	3	4	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		1	13d;	2			
H4141	021	0	1	01	01	H4141_021_0	3	1	1	10				01111	360	288																	2		13b;13d;13e;13f;14c;		1	13b;13d;13e;13f;14c;	1	1800	3	13b;13d;13e;13f;14c8;
H4141	021	0	1	01	01	H4141_021_0	3	2	1	10				01111	360	360																	1	010	13b;13d;13e;13f;14c;		1	13b;13d;13e;13f;14c;	1	300	3	13b;13d;13e;13f;14c8;
H4141	021	0	1	01	01	H4141_021_0	3	3	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H4152	004	0	1	01	01	H4152_004_0	9	1	3								00001001000000000000																2		16b;		2		2			
H4152	005	0	1	01	01	H4152_005_0	10	1	3								00001001000000000000																2		16b;		2		2			
H4152	007	0	1	02	01	H4152_007_0	11	1	3								00001001000000000000																2		16b;	2	2		2			
H4152	013	0	1	01	01	H4152_013_0	11	1	3								00001001000000000000																2		16b;		2		2			
H4152	018	0	1	02	01	H4152_018_0	10	1	3								00001001000000000000																2		16b;	2	2		2			
H4152	020	0	1	02	01	H4152_020_0	10	2	1	10				01111	849	509																	2		13b;13i;	2	2		1	75.00	7	13b;13i1;
H4152	020	0	1	02	01	H4152_020_0	10	1	3								00001001000000000000																2		16b;	2	2		2			
H4152	021	0	1	01	01	H4152_021_0	10	2	3								00001001000000000000																2		16b;		2		2			
H4152	021	0	1	01	01	H4152_021_0	10	1	1	10				01111	2900	1740																	2		13b;13i;		2		1	150.00	7	13b;13i1;
H4161	001	0	1	01	01	H4161_001_0	7	2	1	10				01111	21983	21983																	2		13i;		2		2			
H4161	001	0	1	01	01	H4161_001_0	7	1	1	10				01111	21983	11343																	2		13i;		2		2			
H4161	001	0	1	01	01	H4161_001_0	7	3	1	10				01111	21983	21983																	2		13i;		2		2			
H4161	002	0	1	01	01	H4161_002_0	7	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H4161	003	0	1	01	01	H4161_003_0	5	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H4161	005	0	1	01	01	H4161_005_0	5	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H4161	006	0	1	01	01	H4161_006_0	5	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H4198	007	0	1	01	01	H4198_007_0	4	1	2														01110000000000						2	1			2		13d;		2		2			
H4198	008	0	1	01	01	H4198_008_0	5	1	2														01110000000000						2	1			2		13d;		2		2			
H4198	009	0	1	01	01	H4198_009_0	5	1	2														01110000000000						2	1			2		13d;		2		2			
H4213	016	1	1	09	04	H4213_016_1	2	1	3								00010001000000011100	Coronary artery disease	Sjgrens Syndrome														2		16a;16b;		2		2			
H4213	016	3	1	09	04	H4213_016_3	2	1	3								00010001000000011100	Coronary artery disease	Sjgrens Syndrome														2		16a;16b;		2		2			
H4213	016	4	1	09	04	H4213_016_4	2	1	3								00010001000000011100	Coronary artery disease	Sjgrens Syndrome														2		16a;16b;		2		2			
H4213	017	1	1	09	04	H4213_017_1	3	1	3								00010001000000011100	Coronary artery disease	Sjgrens Syndrome														2		16a;16b;		2		2			
H4213	017	5	1	09	04	H4213_017_5	3	1	3								00010001000000011100	Coronary artery disease	Sjgrens Syndrome														2		16a;16b;		2		2			
H4213	017	6	1	09	04	H4213_017_6	3	1	3								00010001000000011100	Coronary artery disease	Sjgrens Syndrome														2		16a;16b;		2		2			
H4227	001	0	1	01	01	H4227_001_0	7	1	3								11111111111111111111	Obesity	Dermatologic Disorders	Osteoporosis	Malnutrition	Endocrine disorders											2		13i;		1	13i;	1	0.00	5	13i1;
H4227	002	0	1	01	01	H4227_002_0	6	1	3								11111111111111111111	Obesity	Dermatologic disorders	Osteoporosis	Malnutrition	Endocrine disorders											2		13i;		1	13i;	1	0.00	5	13i1;
H4232	002	0	1	01	01	H4232_002_0	4	1	3								01111111111111110000																1	001	13i;		1	13i;	2			
H4279	001	0	1	01	01	H4279_001_0	6	1	1	10				01111	41754	41754																	2		13b;13i;		1	13b;13i;	1	400.00	5	13b;13i1;
H4279	004	0	1	01	01	H4279_004_0	6	1	1	10				01111	443	443																	2		13b;13i;		1	13b;13i;	1	400.00	5	13b;13i1;
H4286	001	0	1	01	01	H4286_001_0	10	1	3								11111111111111111111	Prediabetes	Hypertension	Hypercholesterolemia	Depression	Obesity/Overweight											2		13i;		2		2			
H4286	002	0	1	01	01	H4286_002_0	14	1	3								11111111111111111111	Prediabetes	Hypertension	Hypercholesterolemia	Depression	Obesity/Overweight											1	001	13c;13i;		2		2			
H4304	801	0	1	04	01	H4304_801_0	4	1	3								00000000000000001000	Fall Risk or Diagnosis of Fall Risk															2		14c;	1	2		2			
H4304	802	0	1	04	01	H4304_802_0	4	1	3								00000000000000001000	Fall Risk or Diagnosis of Fall Risk															2		14c;	1	2		2			
H4304	803	0	1	04	01	H4304_803_0	5	1	3								00000000000000001000	Fall Risk or Diagnosis of Fall Risk															2		14c;	1	2		2			
H4343	001	0	1	01	01	H4343_001_0	5	1	3								01111111111111110000																2		13i;		1	13i;	1	600	3	13i10;
H4343	002	0	1	01	01	H4343_002_0	5	1	3								01111111111111110000																2		13i;		1	13i;	1	600	3	13i10;
H4343	003	0	1	01	01	H4343_003_0	5	1	3								01111111111111110000																2		13i;14c;		1	13i;14c;	1	1500	3	13i10;
H4343	004	0	1	01	01	H4343_004_0	5	1	3								01111111111111110000																2		13i;14c;		1	13i;14c;	1	1500	3	13i10;
H4343	005	0	1	01	01	H4343_005_0	5	1	3								01111111111111110000																2		13i;14c;		1	13i;14c;	1	1500	3	13i10;
H4343	006	0	1	01	01	H4343_006_0	6	1	3								01111111111111110000																2		13i;14c;		1	13i;14c;	1	1500	3	13i10;
H4346	001	0	1	01	01	H4346_001_0	5	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H4346	005	0	1	01	01	H4346_005_0	5	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H4346	006	0	1	01	01	H4346_006_0	5	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H4346	008	0	1	01	01	H4346_008_0	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H4346	014	0	1	01	01	H4346_014_0	5	1	1	10				01111	2041	1053																	2		13i;		2		2			
H4346	017	0	1	01	01	H4346_017_0	5	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H4346	019	0	1	01	01	H4346_019_0	5	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H4346	024	0	1	01	01	H4346_024_0	5	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H4346	025	0	1	01	01	H4346_025_0	5	1	1	10				01111	1419	732																	2		13i;		2		2			
H4346	025	0	1	01	01	H4346_025_0	5	2	1	10				01111	1419	1419																	2		13i;		2		2			
H4407	004	0	1	01	01	H4407_004_0	4	1	1	10				01111	1849	1109																	2		13i;		2		2			
H4407	029	0	1	01	01	H4407_029_0	4	1	1	10				01111	207	124																	2		13i;		2		2			
H4461	022	0	1	01	01	H4461_022_0	4	1	1	10				01111	6771	6771																	2		13b;13d;13e;13f;14c;		1	13b;13d;13e;13f;14c;	1	2100	3	13b;13d;13e;13f;14c8;
H4461	022	0	1	01	01	H4461_022_0	4	2	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H4461	029	0	1	01	01	H4461_029_0	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H4461	038	0	1	01	01	H4461_038_0	3	1	1	10				01111	7129	7129																	2		13b;13d;13e;13f;14c;		1	13b;13d;13e;13f;14c;	1	2100	3	13b;13d;13e;13f;14c8;
H4461	038	0	1	01	01	H4461_038_0	3	2	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H4461	039	0	1	01	01	H4461_039_0	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		1	13d;	2			
H4490	002	0	1	01	01	H4490_002_0	4	1	3								01111111111111110000																1	001	13i;		1	13i;	2			
H4490	003	0	1	01	01	H4490_003_0	5	1	3								01111111111111110000																1	001	13i;		1	13i;	2			
H4513	027	0	1	01	01	H4513_027_0	4	2	1	10				01111	772	463																	2		13i;		2		2			
H4513	027	0	1	01	01	H4513_027_0	4	1	1	10				01111	772	463																	2		13i;		2		2			
H4513	039	0	1	01	01	H4513_039_0	4	2	1	10				01111	188	113																	2		13i;		2		2			
H4513	039	0	1	01	01	H4513_039_0	4	1	1	10				01111	188	113																	2		13i;		2		2			
H4513	055	0	1	01	01	H4513_055_0	4	1	1	10				01111	3778	2267																	2		13i;		2		2			
H4513	056	1	1	01	01	H4513_056_1	4	1	1	10				01111	7090	4254																	2		13i;		2		2			
H4513	060	1	1	01	01	H4513_060_1	4	2	1	10				01111	7678	4607																	2		13i;		2		2			
H4513	060	1	1	01	01	H4513_060_1	4	1	1	10				01111	7678	4607																	2		13i;		2		2			
H4513	060	2	1	01	01	H4513_060_2	4	1	1	10				01111	16865	10119																	2		13i;		2		2			
H4513	060	2	1	01	01	H4513_060_2	4	2	1	10				01111	16865	10119																	2		13i;		2		2			
H4513	060	3	1	01	01	H4513_060_3	4	1	1	10				01111	4176	2506																	2		13i;		2		2			
H4513	060	3	1	01	01	H4513_060_3	4	2	1	10				01111	4176	2506																	2		13i;		2		2			
H4513	060	4	1	01	01	H4513_060_4	4	2	1	10				01111	1035	621																	2		13i;		2		2			
H4513	060	4	1	01	01	H4513_060_4	4	1	1	10				01111	1035	621																	2		13i;		2		2			
H4513	060	5	1	01	01	H4513_060_5	4	2	1	10				01111	1235	741																	2		13i;		2		2			
H4513	060	5	1	01	01	H4513_060_5	4	1	1	10				01111	1235	741																	2		13i;		2		2			
H4513	062	0	1	01	01	H4513_062_0	3	1	3								00000000000000001000	Vision loss, Hearing loss, PTSD															2		13i-O;		2		2			
H4513	063	0	1	01	01	H4513_063_0	5	1	1	10				01111	1091	655																	2		13i;		2		2			
H4513	075	0	1	01	01	H4513_075_0	4	1	1	10				01111	50	30																	2		13i;		2		2			
H4513	075	0	1	01	01	H4513_075_0	4	2	1	10				01111	50	30																	2		13i;		2		2			
H4514	013	1	1	02	01	H4514_013_1	3	1	1	10				01111	38374	32618																	2		13d;	2	1	13d;	2			
H4514	013	2	1	02	01	H4514_013_2	3	1	1	10				01111	7996	6797																	2		13d;	2	1	13d;	2			
H4514	013	3	1	02	01	H4514_013_3	3	1	1	10				01111	4892	4158																	2		13d;	2	1	13d;	2			
H4514	016	0	1	02	01	H4514_016_0	5	1	1	10				01111	5058	4299																	2		13d;	2	1	13d;	2			
H4514	018	0	1	02	01	H4514_018_0	3	1	1	10				01111	603	513																	2		13d;	2	1	13d;	2			
H4514	019	0	1	02	01	H4514_019_0	3	1	1	10				01111	171	145																	2		13d;	2	1	13d;	2			
H4523	801	0	1	01	01	H4523_801_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H4523	802	0	1	01	01	H4523_802_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H4527	003	0	1	02	01	H4527_003_0	3	1	1	10				01111	1875	1594																	2		13d;	2	1	13d;	2			
H4527	004	0	1	02	01	H4527_004_0	3	1	1	10				01111	385	327																	2		13d;	2	1	13d;	2			
H4527	006	0	1	02	01	H4527_006_0	3	1	1	10				01111	1030	876																	2		13d;	2	1	13d;	2			
H4527	015	0	1	02	01	H4527_015_0	3	1	1	10				01111	18823	16000																	2		13d;	2	1	13d;	2			
H4527	041	0	1	02	01	H4527_041_0	4	1	3								00001101000000000000																2		13i;	2	1	13i;	2			
H4537	004	0	1	04	01	H4537_004_0	6	1	3								01111111111111110000																2		13i;	1	1	13i;	1	600	3	13i10;
H4537	004	0	1	04	01	H4537_004_0	6	2	1	10				01111	126	38																	2		13d;	1	1	13d;	1	300.00	3	13d;
H4590	020	0	1	02	01	H4590_020_0	5	1	1	10				01111	36078	30666																	2		13d;	2	1	13d;	2			
H4590	022	0	1	02	01	H4590_022_0	5	1	1	10				01111	24295	20651																	2		13d;	2	1	13d;	2			
H4590	033	0	1	02	01	H4590_033_0	5	1	1	10				01111	9078	7716																	2		13d;	2	1	13d;	2			
H4590	037	0	1	02	01	H4590_037_0	5	1	3								00001101000000000000																2		13i;	2	1	13i;	2			
H4590	044	0	1	02	01	H4590_044_0	5	1	3								00001101000000000000																2		13i;	2	1	13i;	2			
H4604	017	0	1	02	01	H4604_017_0	2	1	3								00001101000000000000																2		13i;	2	1	13i;	2			
H4605	001	0	1	04	01	H4605_001_0	6	3	3								01111111111111110000																1	001	13i;	1	2		2			
H4605	001	0	1	04	01	H4605_001_0	6	2	2														00000000001000	Pre-diabetes									2		14c;	1	2		2			
H4605	001	0	1	04	01	H4605_001_0	6	1	2														01000000000000										2		7f;	1	2		2			
H4605	002	0	1	04	01	H4605_002_0	8	1	2														01000000000000										2		7f;	1	2		2			
H4605	002	0	1	04	01	H4605_002_0	8	2	2														00000000001000	Pre-diabetes									2		14c;	1	2		2			
H4605	002	0	1	04	01	H4605_002_0	8	3	3								01111111111111110000																1	001	13i;	1	2		2			
H4605	004	0	1	04	01	H4605_004_0	9	3	3								01111111111111110000																1	001	13i;	1	2		2			
H4605	004	0	1	04	01	H4605_004_0	9	2	2														00000000001000	Pre-diabetes									2		14c;	1	2		2			
H4605	004	0	1	04	01	H4605_004_0	9	1	2														01000000000000										2		7f;	1	2		2			
H4605	007	0	1	04	01	H4605_007_0	9	1	2														01000000000000										2		7f;	1	2		2			
H4605	007	0	1	04	01	H4605_007_0	9	3	3								01111111111111110000																1	001	13i;	1	2		2			
H4605	007	0	1	04	01	H4605_007_0	9	2	2														00000000001000	Pre-diabetes									2		14c;	1	2		2			
H4605	008	0	1	04	01	H4605_008_0	9	1	2														01000000000000										2		7f;	1	2		2			
H4605	008	0	1	04	01	H4605_008_0	9	2	2														00000000001000	Pre-diabetes									2		14c;	1	2		2			
H4605	008	0	1	04	01	H4605_008_0	9	3	3								01111111111111110000																1	001	13i;	1	2		2			
H4605	009	0	1	04	01	H4605_009_0	8	3	3								01111111111111110000																1	001	13i;	1	2		2			
H4605	009	0	1	04	01	H4605_009_0	8	1	2														01000000000000										2		7f;	1	2		2			
H4605	009	0	1	04	01	H4605_009_0	8	2	2														00000000001000	Pre-diabetes									2		14c;	1	2		2			
H4605	801	0	1	04	01	H4605_801_0	1	1	2														01000000000000										2		7f;	1	2		2			
H4605	801	0	1	04	01	H4605_801_0	1	3	3								01111111111111110000																1	001	13i;	1	2		2			
H4605	801	0	1	04	01	H4605_801_0	1	2	2														00000000001000	Pre-diabetes									2		14c;	1	2		2			
H4605	802	0	1	04	01	H4605_802_0	1	2	2														00000000001000	Pre-diabetes									2		14c;	1	2		2			
H4605	802	0	1	04	01	H4605_802_0	1	3	3								01111111111111110000																1	001	13i;	1	2		2			
H4605	802	0	1	04	01	H4605_802_0	1	1	2														01000000000000										2		7f;	1	2		2			
H4605	803	0	1	04	01	H4605_803_0	1	1	2														01000000000000										2		7f;	1	2		2			
H4605	803	0	1	04	01	H4605_803_0	1	3	3								01111111111111110000																1	001	13i;	1	2		2			
H4605	803	0	1	04	01	H4605_803_0	1	2	2														00000000001000	Pre-diabetes									2		14c;	1	2		2			
H4605	804	0	1	04	01	H4605_804_0	1	3	3								01111111111111110000																1	001	13i;	1	2		2			
H4605	804	0	1	04	01	H4605_804_0	1	2	2														00000000001000	Pre-diabetes									2		14c;	1	2		2			
H4605	804	0	1	04	01	H4605_804_0	1	1	2														01000000000000										2		7f;	1	2		2			
H4623	001	0	1	02	01	H4623_001_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H4623	002	0	1	02	01	H4623_002_0	3	1	1	01	1111111111	2	2		2317	2317																	2		13b;13d;13e;13i;14c;	1	2		1	600	3	13b;13d;13e;13i1;13i3;13i4;13i5;13i6;13i10;14c8;
H4623	002	0	1	02	01	H4623_002_0	3	2	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13c;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	2		1	1000	3	7b1;7f;10b1;13a;13b;13c;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H4624	001	0	1	01	01	H4624_001_0	10	1	3								01111111111111110000																2		13i;		2		2			
H4624	002	0	1	02	01	H4624_002_0	9	1	3								01111111111111110000																2		13i;	2	2		2			
H4624	003	0	1	01	01	H4624_003_0	9	1	3								01111111111111110000																2		13i;		2		2			
H4624	006	0	1	01	01	H4624_006_0	9	1	3								01111111111111110000																2		13i;		2		2			
H4624	007	0	1	02	01	H4624_007_0	9	1	3								01111111111111110000																2		13i;	2	2		2			
H4624	010	0	1	01	01	H4624_010_0	9	1	3								01111111111111110000																2		13i;		2		2			
H4624	011	0	1	01	01	H4624_011_0	9	1	3								01111111111111110000																2		13i;		2		2			
H4624	012	0	1	01	01	H4624_012_0	9	1	3								01111111111111110000																2		13i;		2		2			
H4624	015	0	1	02	01	H4624_015_0	10	1	3								01111111111111110000																2		13i;	2	2		2			
H4624	016	0	1	02	01	H4624_016_0	8	1	3								01111111111111110000																1	001	13i;	2	2		2			
H4624	017	0	1	02	01	H4624_017_0	9	1	3								01111111111111110000																2		13i;	2	2		2			
H4624	018	0	1	02	01	H4624_018_0	8	1	3								01111111111111110000																2		13i;	2	2		2			
H4624	019	0	1	01	01	H4624_019_0	8	1	3								01111111111111110000																2		13i;		2		2			
H4675	001	0	1	01	01	H4675_001_0	8	1	3								00001101000000000000																1	001	13i;		1	13i;	2			
H4676	002	0	1	01	01	H4676_002_0	9	1	1	10				01111	3340	3340																	2		13c;		2		1	50.00	7	13c;
H4699	003	0	1	04	01	H4699_003_0	5	1	3								01111111111111110000																2		13i;	1	1	13i;	1	600	3	13i10;
H4699	003	0	1	04	01	H4699_003_0	5	2	1	10				01111	457	137																	2		13d;	1	1	13d;	1	300.00	3	13d;
H4699	004	0	1	04	01	H4699_004_0	4	1	3								01111111111111110000																2		13i;	1	1	13i;	1	600	3	13i10;
H4699	005	0	1	04	01	H4699_005_0	5	2	1	10				01111	395	119																	2		13d;	1	1	13d;	1	300.00	3	13d;
H4699	005	0	1	04	01	H4699_005_0	5	1	3								01111111111111110000																2		13i;	1	1	13i;	1	900	3	13i10;
H4711	011	0	1	01	01	H4711_011_0	3	1	1	10				01111	238273	238273																	2		13i;13i-O;14c;		1	13i;13i-O;14c;	1	210.00	5	13i1;13i-O1;
H4711	012	0	1	01	01	H4711_012_0	2	1	1	10				01111	238273	238273																	2		10b;13i;13i-O;14c;		1	10b;13i;13i-O;14c;	1	270.00	5	10b2;13i1;13i4;13i-O1;
H4711	013	0	1	01	01	H4711_013_0	3	1	1	10				01111	238273	238273																	2		13i;13i-O;14c;		1	13i;13i-O;14c;	1	210.00	5	13i1;13i-O1;
H4711	801	0	1	01	01	H4711_801_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H4711	802	0	1	01	01	H4711_802_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H4739	001	0	1	01	01	H4739_001_0	7	1	3								11111111111111111111	Obesity	Dermatologic disorders	Osteoporosis	Malnutrition	Endocrine disorders											2		13i;		1	13i;	1	0.00	5	13i1;
H4835	801	0	1	01	01	H4835_801_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H4835	802	0	1	01	01	H4835_802_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H4847	004	0	1	01	01	H4847_004_0	6	2	1	10				01111	5317	1861																	2		13d;		1	13d;	1	600.00	3	13d;
H4847	004	0	1	01	01	H4847_004_0	6	1	3								01111111111111110000																2		13b;13d;13i;14c;		1	13b;13d;13i;14c;	1	400	3	13b;13d;13i5;14c8;
H4868	004	0	1	01	01	H4868_004_0	5	1	1	10				01111	5840	1752																	2		13d;		1	13d;	1	300.00	3	13d;
H4868	014	0	1	01	01	H4868_014_0	5	1	1	10				01111	45588	15956																	2		13d;		1	13d;	1	600.00	3	13d;
H4875	022	1	1	04	01	H4875_022_1	14	1	3								01111111111111110000																2		13i;	1	1	13i;	2			
H4875	022	2	1	04	01	H4875_022_2	14	1	3								01111111111111110000																2		13i;	1	1	13i;	2			
H4875	022	5	1	04	01	H4875_022_5	13	1	3								01111111111111110000																2		13i;	1	1	13i;	2			
H4875	023	0	1	04	01	H4875_023_0	13	1	3								01111111111111110000																2		13i;	1	1	13i;	2			
H4909	018	0	1	04	01	H4909_018_0	8	2	1	10				01111	2334	2334																	2		13i;	1	1	13i;	2			
H4909	018	0	1	04	01	H4909_018_0	8	1	1	10				01111	2334	2334																	2		13i;	1	1	13i;	2			
H4909	022	0	1	04	01	H4909_022_0	5	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;	1	2		2			
H4909	025	0	1	04	01	H4909_025_0	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;	1	2		2			
H4909	026	0	1	04	01	H4909_026_0	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;	1	1	13i;	2			
H4909	028	0	1	04	01	H4909_028_0	8	1	1	10				01111	950	490																	2		13i;	1	2		2			
H4909	028	0	1	04	01	H4909_028_0	8	3	1	10				01111	950	950																	2		13i;	1	2		2			
H4909	028	0	1	04	01	H4909_028_0	8	2	1	10				01111	950	950																	2		13i;	1	2		2			
H4922	003	0	1	01	01	H4922_003_0	7	1	3								00000001000000000000																1	001	13i;		1	13i;	1	150.00	7	13i1;
H4922	010	0	1	01	01	H4922_010_0	6	1	3								00000001000000000000																1	001	13i;		1	13i;	1	150.00	7	13i1;
H4931	007	0	1	01	01	H4931_007_0	9	1	1	01	0100000000				4713	471																	1	001	13d;		2		2			
H4931	007	0	1	01	01	H4931_007_0	9	2	3								01111111111111111000	MSK															2		13i;		2		1	75.00	5	13i1;
H4931	015	0	1	01	01	H4931_015_0	9	2	3								01111111111111111000	MSK															2		13i;		2		1	75.00	5	13i1;
H4931	015	0	1	01	01	H4931_015_0	9	1	1	01	0100000000				1278	128																	1	001	13d;		2		2			
H4937	001	0	1	04	01	H4937_001_0	5	1	3								00011101000010010000																2		13i-O;	1	1	13i-O;	2			
H4982	008	0	1	01	01	H4982_008_0	7	1	1	10				01111	238273	238273																	2		13i;13i-O;14c;		1	13i;13i-O;14c;	1	100.00	5	13i1;13i-O1;
H4982	009	0	1	01	01	H4982_009_0	5	1	1	10				01111	238273	238273																	2		13i;13i-O;14c;		1	13i;13i-O;14c;	1	100.00	5	13i1;13i-O1;
H4982	016	0	1	01	01	H4982_016_0	5	1	1	10				01111	238273	238273																	2		13i;13i-O;14c;		1	13i;13i-O;14c;	1	100.00	5	13i1;13i-O1;
H4982	801	0	1	01	01	H4982_801_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H4982	802	0	1	01	01	H4982_802_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H5008	002	0	1	02	01	H5008_002_0	2	1	1	10				01111	71124	60455																	2		13d;	2	1	13d;	2			
H5008	010	0	1	02	01	H5008_010_0	2	1	1	10				01111	28047	23840																	2		13d;	2	1	13d;	2			
H5008	011	0	1	02	01	H5008_011_0	2	1	1	10				01111	26232	22297																	2		13d;	2	1	13d;	2			
H5008	015	0	1	02	01	H5008_015_0	2	1	1	10				01111	4046	3439																	2		13d;	2	1	13d;	2			
H5008	016	0	1	02	01	H5008_016_0	2	1	1	10				01111	809	688																	2		13d;	2	1	13d;	2			
H5009	001	0	1	04	01	H5009_001_0	6	1	2														01000000000000										2		7f;	1	2		2			
H5009	001	0	1	04	01	H5009_001_0	6	2	2														00000000001000	Pre-diabetes									2		14c;	1	2		2			
H5009	001	0	1	04	01	H5009_001_0	6	3	3								01111111111111110000																1	001	13i;	1	2		2			
H5009	002	0	1	04	01	H5009_002_0	9	2	2														00000000001000	Pre-diabetes									2		14c;	1	2		2			
H5009	002	0	1	04	01	H5009_002_0	9	1	2														01000000000000										2		7f;	1	2		2			
H5009	002	0	1	04	01	H5009_002_0	9	3	3								01111111111111110000																1	001	13i;	1	2		2			
H5009	008	0	1	04	01	H5009_008_0	8	2	2														00000000001000	Pre-diabetes									2		14c;	1	2		2			
H5009	008	0	1	04	01	H5009_008_0	8	3	3								01111111111111110000																1	001	13i;	1	2		2			
H5009	008	0	1	04	01	H5009_008_0	8	1	2														01000000000000										2		7f;	1	2		2			
H5009	009	0	1	04	01	H5009_009_0	9	1	2														01000000000000										2		7f;	1	2		2			
H5009	009	0	1	04	01	H5009_009_0	9	2	2														00000000001000	Pre-diabetes									2		14c;	1	2		2			
H5009	009	0	1	04	01	H5009_009_0	9	3	3								01111111111111110000																1	001	13i;	1	2		2			
H5009	801	0	1	04	01	H5009_801_0	1	3	3								01111111111111110000																1	001	13i;	1	2		2			
H5009	801	0	1	04	01	H5009_801_0	1	2	2														00000000001000	Pre-diabetes									2		14c;	1	2		2			
H5009	801	0	1	04	01	H5009_801_0	1	1	2														01000000000000										2		7f;	1	2		2			
H5009	802	0	1	04	01	H5009_802_0	1	3	3								01111111111111110000																1	001	13i;	1	2		2			
H5009	802	0	1	04	01	H5009_802_0	1	2	2														00000000001000	Pre-diabetes									2		14c;	1	2		2			
H5009	802	0	1	04	01	H5009_802_0	1	1	2														01000000000000										2		7f;	1	2		2			
H5009	803	0	1	04	01	H5009_803_0	1	3	3								01111111111111110000																1	001	13i;	1	2		2			
H5009	803	0	1	04	01	H5009_803_0	1	2	2														00000000001000	Pre-diabetes									2		14c;	1	2		2			
H5009	803	0	1	04	01	H5009_803_0	1	1	2														01000000000000										2		7f;	1	2		2			
H5009	804	0	1	04	01	H5009_804_0	1	2	2														00000000001000	Pre-diabetes									2		14c;	1	2		2			
H5009	804	0	1	04	01	H5009_804_0	1	1	2														01000000000000										2		7f;	1	2		2			
H5009	804	0	1	04	01	H5009_804_0	1	3	3								01111111111111110000																1	001	13i;	1	2		2			
H5010	001	0	1	04	01	H5010_001_0	6	1	2														01000000000000										2		7f;	1	2		2			
H5010	001	0	1	04	01	H5010_001_0	6	2	2														00000000001000	Pre-diabetes									2		14c;	1	2		2			
H5010	001	0	1	04	01	H5010_001_0	6	3	3								01111111111111110000																1	001	13i;	1	2		2			
H5010	008	1	1	04	01	H5010_008_1	9	1	2														01000000000000										2		7f;	1	2		2			
H5010	008	1	1	04	01	H5010_008_1	9	2	2														00000000001000	Pre-diabetes									2		14c;	1	2		2			
H5010	008	1	1	04	01	H5010_008_1	9	3	3								01111111111111110000																1	001	13i;	1	2		2			
H5010	008	2	1	04	01	H5010_008_2	9	2	2														00000000001000	Pre-diabetes									2		14c;	1	2		2			
H5010	008	2	1	04	01	H5010_008_2	9	1	2														01000000000000										2		7f;	1	2		2			
H5010	008	2	1	04	01	H5010_008_2	9	3	3								01111111111111110000																1	001	13i;	1	2		2			
H5010	009	1	1	04	01	H5010_009_1	8	3	3								01111111111111110000																1	001	13i;	1	2		2			
H5010	009	1	1	04	01	H5010_009_1	8	1	2														01000000000000										2		7f;	1	2		2			
H5010	009	1	1	04	01	H5010_009_1	8	2	2														00000000001000	Pre-diabetes									2		14c;	1	2		2			
H5010	009	2	1	04	01	H5010_009_2	8	3	3								01111111111111110000																1	001	13i;	1	2		2			
H5010	009	2	1	04	01	H5010_009_2	8	1	2														01000000000000										2		7f;	1	2		2			
H5010	009	2	1	04	01	H5010_009_2	8	2	2														00000000001000	Pre-diabetes									2		14c;	1	2		2			
H5015	001	0	1	01	01	H5015_001_0	5	1	3								01111111111111110000																2		13i;		2		1	100.00	3	13i6;
H5042	009	0	1	04	01	H5042_009_0	14	1	3								01111111111111110000																1	011	14c;	1	2		2			
H5042	011	0	1	04	01	H5042_011_0	13	1	3								01111111111111110000																1	011	14c;	1	2		2			
H5042	012	0	1	04	01	H5042_012_0	12	1	3								01111111111111110000																1	011	14c;	1	2		2			
H5050	004	0	1	01	01	H5050_004_0	12	1	2														00000000001000	Meets clinical criteria for hospital care in home based on health status									2		13d;		2		2			
H5050	009	0	1	01	01	H5050_009_0	12	1	2														00000000001000	Meets clinical criteria for hospital care in home based on health status									2		13d;		2		2			
H5050	013	0	1	01	01	H5050_013_0	12	1	2														00000000001000	Meets clinical criteria for hospital care in home based on health status									2		13d;		2		2			
H5050	017	0	1	01	01	H5050_017_0	12	1	2														00000000001000	Meets clinical criteria for hospital care in home based on health status									2		13d;		2		2			
H5050	019	0	1	01	01	H5050_019_0	12	1	2														00000000001000	Meets clinical criteria for hospital care in home based on health status									2		13d;		2		2			
H5050	021	0	1	01	01	H5050_021_0	12	1	2														00000000001000	Meets clinical criteria for hospital care in home based on health status									2		13d;		2		2			
H5050	022	0	1	01	01	H5050_022_0	12	1	2														00000000001000	Meets clinical criteria for hospital care in home based on health status									2		13d;		2		2			
H5050	023	0	1	01	01	H5050_023_0	12	1	2														00000000001000	Meets clinical criteria for hospital care in home based on health status									2		13d;		2		2			
H5087	001	0	1	01	01	H5087_001_0	6	2	1	10				01111	18319	6412																	2		13d;		1	13d;	1	600.00	3	13d;
H5087	001	0	1	01	01	H5087_001_0	6	1	3								01111111111111110000																2		13i;		1	13i;	1	900	3	13i10;
H5087	027	0	1	01	01	H5087_027_0	7	1	3								01111111111111110000																2		13i;		1	13i;	1	900	3	13i10;
H5087	027	0	1	01	01	H5087_027_0	7	2	1	10				01111	1048	314																	2		13d;		1	13d;	1	300.00	3	13d;
H5117	004	0	1	01	01	H5117_004_0	5	1	1	10				01111	179	54																	2		13d;		1	13d;	1	300.00	3	13d;
H5178	001	0	1	01	01	H5178_001_0	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		1	13d;	2			
H5199	016	0	1	04	01	H5199_016_0	6	1	3								01111111111111110000																2		13i;	1	1	13i;	1	600	3	13i10;
H5199	016	0	1	04	01	H5199_016_0	6	2	1	10				01111	730	219																	2		13d;	1	1	13d;	1	300.00	3	13d;
H5211	001	0	1	02	01	H5211_001_0	4	1	2														00010000000000										2		13c;	2	1	13c;	2			
H5211	002	0	1	02	01	H5211_002_0	4	1	2														00010000000000										2		13c;	2	1	13c;	2			
H5211	003	0	1	02	01	H5211_003_0	3	1	2														00010000000000										2		13c;	2	1	13c;	2			
H5211	004	0	1	02	01	H5211_004_0	4	1	2														00010000000000										2		13c;	2	1	13c;	2			
H5211	010	0	1	01	01	H5211_010_0	6	1	2														00010000000000										2		13c;		2		2			
H5211	012	0	1	02	01	H5211_012_0	4	1	2														00010000000000										2		13c;	2	1	13c;	2			
H5211	013	0	1	02	01	H5211_013_0	4	1	2														00010000000000										2		13c;	2	1	13c;	2			
H5215	001	0	1	04	01	H5215_001_0	7	1	3								00110110110010100000																1	001	10b;13a;14c;	1	2		2			
H5215	002	0	1	04	01	H5215_002_0	8	1	3								00110110110010100000																1	001	10b;13a;14c;	1	2		2			
H5215	005	0	1	04	01	H5215_005_0	7	1	3								00110110110010100000																1	001	10b;13a;14c;	1	2		2			
H5215	006	0	1	04	01	H5215_006_0	6	1	3								00110110110010100000																1	001	10b;13a;14c;	1	2		2			
H5215	007	0	1	04	01	H5215_007_0	7	1	3								00110110110010100000																1	001	10b;13a;14c;	1	2		2			
H5215	008	0	1	04	01	H5215_008_0	7	1	3								00110110110010100000																1	001	10b;13a;14c;	1	2		2			
H5215	009	0	1	04	01	H5215_009_0	9	1	3								00110110110010100000																1	001	10b;13a;14c;	1	2		2			
H5215	010	0	1	04	01	H5215_010_0	9	1	3								00110110110010100000																1	001	10b;13a;14c;	1	2		2			
H5215	011	0	1	04	01	H5215_011_0	8	1	3								00110110110010100000																1	001	10b;13a;14c;	1	2		2			
H5215	012	0	1	04	01	H5215_012_0	9	1	3								00110110110010100000																1	001	10b;13a;14c;	1	2		2			
H5215	013	0	1	04	01	H5215_013_0	6	1	3								00110110110010100000																1	001	10b;13a;14c;	1	2		2			
H5215	014	0	1	04	01	H5215_014_0	6	1	3								00110110110010100000																1	001	10b;13a;14c;	1	2		2			
H5216	014	0	1	04	01	H5216_014_0	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	014	0	1	04	01	H5216_014_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13c;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5216	017	0	1	04	01	H5216_017_0	3	1	3								00000101000010001000	Depression															1	001	13c;	1	1	13c;	2			
H5216	023	0	1	04	01	H5216_023_0	4	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	027	0	1	04	01	H5216_027_0	4	1	3								00000101000010001000	Depression															1	001	13c;	1	2		2			
H5216	029	0	1	04	01	H5216_029_0	4	1	3								00000101000010001000	Depression															1	001	13c;	1	2		2			
H5216	032	0	1	04	01	H5216_032_0	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	1	13d;	2			
H5216	032	0	1	04	01	H5216_032_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5216	034	0	1	04	01	H5216_034_0	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	1	13d;	2			
H5216	034	0	1	04	01	H5216_034_0	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	1	13d;	2			
H5216	037	0	1	04	01	H5216_037_0	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	1	13d;	2			
H5216	042	0	1	04	01	H5216_042_0	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	042	0	1	04	01	H5216_042_0	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	043	1	1	04	01	H5216_043_1	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5216	043	1	1	04	01	H5216_043_1	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	043	1	1	04	01	H5216_043_1	3	3	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	043	5	1	04	01	H5216_043_5	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	1	13d;	2			
H5216	043	5	1	04	01	H5216_043_5	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	1	13d;	2			
H5216	043	6	1	04	01	H5216_043_6	3	3	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	043	6	1	04	01	H5216_043_6	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	043	6	1	04	01	H5216_043_6	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5216	047	0	1	04	01	H5216_047_0	2	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	048	0	1	04	01	H5216_048_0	2	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	062	0	1	04	01	H5216_062_0	3	1	3								00000001000000101110	Chronic Kidney Disease	Peripheral Vascular Disease	Chronic Foot Ulcers													1	001	13i-O;	1	2		2			
H5216	068	0	1	04	01	H5216_068_0	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	068	0	1	04	01	H5216_068_0	3	1	3								00000001000000101110	Chronic Kidney Disease	Peripheral Vascular Disease	Chronic Foot Ulcers													1	001	13i-O;	1	2		2			
H5216	073	0	1	04	01	H5216_073_0	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	1	13d;	2			
H5216	077	0	1	04	01	H5216_077_0	4	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	078	1	1	04	01	H5216_078_1	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	1	13d;	2			
H5216	081	0	1	04	01	H5216_081_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5216	081	0	1	04	01	H5216_081_0	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	083	0	1	04	01	H5216_083_0	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	1	13d;	2			
H5216	083	0	1	04	01	H5216_083_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5216	116	0	1	04	01	H5216_116_0	2	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	117	0	1	04	01	H5216_117_0	4	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	1	13d;	2			
H5216	120	0	1	04	01	H5216_120_0	5	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	128	0	1	04	01	H5216_128_0	2	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	128	0	1	04	01	H5216_128_0	2	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	129	0	1	04	01	H5216_129_0	2	1	3								00000101000010001000	Depression															1	001	13c;	1	2		2			
H5216	137	0	1	04	01	H5216_137_0	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	1	13d;	2			
H5216	137	0	1	04	01	H5216_137_0	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	1	13d;	2			
H5216	140	0	1	04	01	H5216_140_0	2	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5216	140	0	1	04	01	H5216_140_0	2	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	141	0	1	04	01	H5216_141_0	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	1	13d;	2			
H5216	144	0	1	04	01	H5216_144_0	4	1	3								00000101000011000000																1	001	13c;	1	2		2			
H5216	144	0	1	04	01	H5216_144_0	4	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	149	0	1	04	01	H5216_149_0	4	1	3								00000101000010001000	Depression															1	001	13c;	1	2		2			
H5216	152	0	1	04	01	H5216_152_0	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	152	0	1	04	01	H5216_152_0	3	1	3								00000101000010001000	Depression															1	001	13c;	1	1	13c;	2			
H5216	154	0	1	04	01	H5216_154_0	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	1	13d;	2			
H5216	154	0	1	04	01	H5216_154_0	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	1	13d;	2			
H5216	157	0	1	04	01	H5216_157_0	2	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	157	0	1	04	01	H5216_157_0	2	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	160	0	1	04	01	H5216_160_0	3	1	1	01	1111111111	2	2		4053	4053																	2		13b;13d;13e;13i;14c;	1	2		1	600	3	13b;13d;13e;13i1;13i3;13i4;13i5;13i6;13i10;14c8;
H5216	161	0	1	04	01	H5216_161_0	3	1	1	01	1111111111	2	2		1291	1291																	2		13b;13d;13e;13i;14c;	1	2		1	600	3	13b;13d;13e;13i1;13i3;13i4;13i5;13i6;13i10;14c8;
H5216	164	0	1	04	01	H5216_164_0	3	2	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13c;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13c;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1000	3	7b1;7f;10b1;13a;13b;13c;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5216	164	0	1	04	01	H5216_164_0	3	1	1	10				01111	2388	2388																	2		13b;13d;13e;13f;14c;	1	1	13b;13d;13e;13f;14c;	1	1800	3	13b;13d;13e;13f;14c8;
H5216	171	0	1	04	01	H5216_171_0	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	1	13d;	2			
H5216	195	0	1	04	01	H5216_195_0	4	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	1	13d;	2			
H5216	197	0	1	04	01	H5216_197_0	4	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	1	13d;	2			
H5216	197	0	1	04	01	H5216_197_0	4	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	1	13d;	2			
H5216	200	0	1	04	01	H5216_200_0	2	1	1	01	1111111111	2	2		5468	5468																	2		13b;13d;13e;13i;14c;	1	2		1	600	3	13b;13d;13e;13i1;13i3;13i4;13i5;13i6;13i10;14c8;
H5216	201	0	1	04	01	H5216_201_0	2	1	1	01	1111111111	2	2		5014	5014																	2		13b;13d;13e;13i;14c;	1	2		1	600	3	13b;13d;13e;13i1;13i3;13i4;13i5;13i6;13i10;14c8;
H5216	203	1	1	04	01	H5216_203_1	4	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	205	0	1	04	01	H5216_205_0	5	1	1	10				01111	29090	29090																	2		13b;13d;13e;13f;14c;	1	1	13b;13d;13e;13f;14c;	1	1800	3	13b;13d;13e;13f;14c8;
H5216	205	0	1	04	01	H5216_205_0	5	2	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5216	205	0	1	04	01	H5216_205_0	5	3	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	1	13d;	2			
H5216	206	0	1	04	01	H5216_206_0	4	1	1	10				01111	20045	20045																	2		13b;13d;13e;13f;14c;	1	1	13b;13d;13e;13f;14c;	1	900	3	13b;13d;13e;13f;14c8;
H5216	206	0	1	04	01	H5216_206_0	4	2	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5216	206	0	1	04	01	H5216_206_0	4	3	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	1	13d;	2			
H5216	211	0	1	04	01	H5216_211_0	3	1	3								00000101000010001000	Depression															1	001	13c;	1	1	13c;	2			
H5216	213	0	1	04	01	H5216_213_0	2	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	213	0	1	04	01	H5216_213_0	2	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	216	0	1	04	01	H5216_216_0	2	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	1	13d;	2			
H5216	217	0	1	04	01	H5216_217_0	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	217	0	1	04	01	H5216_217_0	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	218	0	1	04	01	H5216_218_0	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	219	0	1	04	01	H5216_219_0	3	1	1	10				01111	1875	1875																	2		13b;13d;13e;13f;14c;	1	1	13b;13d;13e;13f;14c;	1	1500	3	13b;13d;13e;13f;14c8;
H5216	219	0	1	04	01	H5216_219_0	3	2	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13c;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13c;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1000	3	7b1;7f;10b1;13a;13b;13c;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5216	220	0	1	04	01	H5216_220_0	6	2	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5216	220	0	1	04	01	H5216_220_0	6	1	1	10				01111	8923	8923																	2		13b;13d;13e;13f;14c;	1	1	13b;13d;13e;13f;14c;	1	900	3	13b;13d;13e;13f;14c8;
H5216	221	0	1	04	01	H5216_221_0	2	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	223	0	1	04	01	H5216_223_0	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	224	0	1	04	01	H5216_224_0	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	224	0	1	04	01	H5216_224_0	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	227	0	1	04	01	H5216_227_0	4	2	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5216	227	0	1	04	01	H5216_227_0	4	1	1	10				01111	2968	2968																	2		13b;13d;13e;13f;14c;	1	1	13b;13d;13e;13f;14c;	1	2100	3	13b;13d;13e;13f;14c8;
H5216	227	0	1	04	01	H5216_227_0	4	3	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	1	13d;	2			
H5216	228	0	1	04	01	H5216_228_0	3	1	1	10				01111	8092	8092																	2		13b;13d;13e;13f;14c;	1	1	13b;13d;13e;13f;14c;	1	1200	3	13b;13d;13e;13f;14c8;
H5216	228	0	1	04	01	H5216_228_0	3	2	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13c;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13c;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1000	3	7b1;7f;10b1;13a;13b;13c;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5216	228	0	1	04	01	H5216_228_0	3	3	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	1	13d;	2			
H5216	231	0	1	04	01	H5216_231_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13c;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13c;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5216	239	0	1	04	01	H5216_239_0	4	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	240	0	1	04	01	H5216_240_0	4	2	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5216	240	0	1	04	01	H5216_240_0	4	3	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	1	13d;	2			
H5216	240	0	1	04	01	H5216_240_0	4	1	1	10				01111	309	309																	2		13b;13d;13e;13f;14c;	1	1	13b;13d;13e;13f;14c;	1	900	3	13b;13d;13e;13f;14c8;
H5216	242	0	1	04	01	H5216_242_0	5	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5216	242	0	1	04	01	H5216_242_0	5	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	1	13d;	2			
H5216	243	0	1	04	01	H5216_243_0	4	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	1	13d;	2			
H5216	243	0	1	04	01	H5216_243_0	4	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5216	244	0	1	04	01	H5216_244_0	4	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	244	0	1	04	01	H5216_244_0	4	1	3								01111111111111110000																1	001	13b;13i;13i-O;14c;	1	2		1	900	3	13b;13i1;13i3;13i4;13i5;13i6;13i10;13i-O1;14c8;
H5216	246	0	1	04	01	H5216_246_0	5	1	3								01111111111111110000																1	001	13b;13i;13i-O;14c;	1	2		1	900	3	13b;13i1;13i3;13i4;13i5;13i6;13i10;13i-O1;14c8;
H5216	246	0	1	04	01	H5216_246_0	5	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	247	0	1	04	01	H5216_247_0	2	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	254	0	1	04	01	H5216_254_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5216	254	0	1	04	01	H5216_254_0	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	256	0	1	04	01	H5216_256_0	3	1	3								00000001000000101110	Chronic Kidney Disease	Peripheral Vascular Disease	Chronic Foot Ulcers													1	001	13i-O;	1	2		2			
H5216	257	0	1	04	01	H5216_257_0	4	1	3								01111111111111111110	Chronic Kidney Disease	Peripheral Vascular Disease	Chronic foot ulcers													1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	2		1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5216	261	0	1	04	01	H5216_261_0	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	264	0	1	04	01	H5216_264_0	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	265	0	1	04	01	H5216_265_0	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	265	0	1	04	01	H5216_265_0	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	266	0	1	04	01	H5216_266_0	3	1	3								00000101000011000000																1	001	13c;	1	2		2			
H5216	266	0	1	04	01	H5216_266_0	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	267	0	1	04	01	H5216_267_0	3	1	1	10				01111	9055	9055																	2		13b;13d;13e;13f;14c;	1	1	13b;13d;13e;13f;14c;	1	1800	3	13b;13d;13e;13f;14c8;
H5216	267	0	1	04	01	H5216_267_0	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	1	13d;	2			
H5216	268	0	1	04	01	H5216_268_0	4	3	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	1	13d;	2			
H5216	268	0	1	04	01	H5216_268_0	4	2	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13c;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13c;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1000	3	7b1;7f;10b1;13a;13b;13c;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5216	268	0	1	04	01	H5216_268_0	4	1	1	10				01111	5717	5717																	2		13b;13d;13e;13f;14c;	1	1	13b;13d;13e;13f;14c;	1	2100	3	13b;13d;13e;13f;14c8;
H5216	274	0	1	04	01	H5216_274_0	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	277	0	1	04	01	H5216_277_0	3	2	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5216	277	0	1	04	01	H5216_277_0	3	1	1	10				01111	8138	8138																	2		13b;13d;13e;13f;14c;	1	1	13b;13d;13e;13f;14c;	1	2400	3	13b;13d;13e;13f;14c8;
H5216	277	0	1	04	01	H5216_277_0	3	3	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	1	13d;	2			
H5216	278	2	1	04	01	H5216_278_2	2	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	278	2	1	04	01	H5216_278_2	2	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5216	279	0	1	04	01	H5216_279_0	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	1	13d;	2			
H5216	279	0	1	04	01	H5216_279_0	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	1	13d;	2			
H5216	280	1	1	04	01	H5216_280_1	4	1	1	01	1111111111	2	2		15232	15232																	2		13b;13d;13e;13i;14c;	1	2		1	600	3	13b;13d;13e;13i1;13i3;13i4;13i5;13i6;13i10;14c8;
H5216	280	1	1	04	01	H5216_280_1	4	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	280	2	1	04	01	H5216_280_2	3	1	1	01	1111111111	2	2		14527	14527																	2		13b;13d;13e;13i;14c;	1	2		1	600	3	13b;13d;13e;13i1;13i3;13i4;13i5;13i6;13i10;14c8;
H5216	280	2	1	04	01	H5216_280_2	3	2	2														01000000000000										1	010	13d;	1	2		2			
H5216	281	0	1	04	01	H5216_281_0	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	284	0	1	04	01	H5216_284_0	3	1	1	01	1111111111	2	2		6132	6132																	2		13b;13d;13e;13i;14c;	1	2		1	600	3	13b;13d;13e;13i1;13i3;13i4;13i5;13i6;13i10;14c8;
H5216	285	0	1	04	01	H5216_285_0	4	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	286	0	1	04	01	H5216_286_0	2	3	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	286	0	1	04	01	H5216_286_0	2	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	286	0	1	04	01	H5216_286_0	2	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	2		1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5216	290	0	1	04	01	H5216_290_0	2	1	1	10				01111	801	801																	2		13b;13d;13e;13f;14c;	1	1	13b;13d;13e;13f;14c;	1	1200	3	13b;13d;13e;13f;14c8;
H5216	291	0	1	04	01	H5216_291_0	2	1	1	10				01111	2377	2377																	2		13b;13d;13e;13f;14c;	1	1	13b;13d;13e;13f;14c;	1	1500	3	13b;13d;13e;13f;14c8;
H5216	292	0	1	04	01	H5216_292_0	3	1	1	10				01111	15444	15444																	2		13b;13d;13e;13f;14c;	1	1	13b;13d;13e;13f;14c;	1	1800	3	13b;13d;13e;13f;14c8;
H5216	293	0	1	04	01	H5216_293_0	4	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5216	294	0	1	04	01	H5216_294_0	4	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5216	296	0	1	04	01	H5216_296_0	4	1	1	10				01111	2224	2224																	2		13b;13d;13e;13f;14c;	1	1	13b;13d;13e;13f;14c;	1	1500	3	13b;13d;13e;13f;14c8;
H5216	296	0	1	04	01	H5216_296_0	4	2	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	3000.00	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5216	298	0	1	04	01	H5216_298_0	4	1	1	10				01111	9408	9408																	2		13b;13d;13e;13f;14c;	1	2		1	1200	3	13b;13d;13e;13f;14c8;
H5216	301	4	1	04	01	H5216_301_4	1	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	302	0	1	04	01	H5216_302_0	3	1	1	10				01111	2359	2359																	2		13b;13d;13e;13f;14c;	1	1	13b;13d;13e;13f;14c;	1	900	3	13b;13d;13e;13f;14c8;
H5216	302	0	1	04	01	H5216_302_0	3	2	2														01000000000000										1	010	13d;	1	1	13d;	2			
H5216	304	0	1	04	01	H5216_304_0	5	1	3								00000001000000101110	Chronic Kidney Disease	Peripheral Vascular Disease	Chronic foot ulcers													1	001	13i-O;	1	2		2			
H5216	307	0	1	04	01	H5216_307_0	4	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	1	13d;	2			
H5216	308	0	1	04	01	H5216_308_0	4	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	1	13d;	2			
H5216	308	0	1	04	01	H5216_308_0	4	1	3								00000101000011000000																1	001	13c;	1	1	13c;	2			
H5216	309	0	1	04	01	H5216_309_0	4	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	1	13d;	2			
H5216	310	0	1	04	01	H5216_310_0	3	1	1	01	1111111111	2	2		2459	2459																	2		13b;13d;13e;13i;14c;	1	2		1	600	3	13b;13d;13e;13i1;13i3;13i4;13i5;13i6;13i10;14c8;
H5216	310	0	1	04	01	H5216_310_0	3	2	3								00000101000011000000																1	001	13c;	1	2		2			
H5216	310	0	1	04	01	H5216_310_0	3	3	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	311	0	1	04	01	H5216_311_0	3	1	3								00000001000000101110	Chronic Kidney Disease	Peripheral Vascular Disease	Chronic Foot Ulcers													1	001	13i-O;	1	2		2			
H5216	312	0	1	04	01	H5216_312_0	5	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	1	13d;	2			
H5216	312	0	1	04	01	H5216_312_0	5	1	3								00000101000011000000																1	001	13c;	1	1	13c;	2			
H5216	315	0	1	04	01	H5216_315_0	1	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	316	1	1	04	01	H5216_316_1	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5216	316	2	1	04	01	H5216_316_2	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5216	316	2	1	04	01	H5216_316_2	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	316	3	1	04	01	H5216_316_3	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5216	317	0	1	04	01	H5216_317_0	3	1	1	01	1111111111	2	2		1223	68																	2		13b;13d;13e;13i;14c;	1	2		1	600	3	13b;13d;13e;13i1;13i3;13i4;13i5;13i6;13i10;14c8;
H5216	318	1	1	04	01	H5216_318_1	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5216	318	2	1	04	01	H5216_318_2	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13c;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5216	318	2	1	04	01	H5216_318_2	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	318	3	1	04	01	H5216_318_3	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5216	323	0	1	04	01	H5216_323_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5216	323	0	1	04	01	H5216_323_0	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	329	0	1	04	01	H5216_329_0	2	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	329	0	1	04	01	H5216_329_0	2	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5216	330	0	1	04	01	H5216_330_0	3	1	1	10				01111	840	840																	2		13b;13d;13e;13f;14c;	1	1	13b;13d;13e;13f;14c;	1	1800	3	13b;13d;13e;13f;14c8;
H5216	331	0	1	04	01	H5216_331_0	3	2	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13c;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13c;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1000	3	7b1;7f;10b1;13a;13b;13c;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5216	331	0	1	04	01	H5216_331_0	3	3	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	1	13d;	2			
H5216	331	0	1	04	01	H5216_331_0	3	1	1	10				01111	6763	6763																	2		13b;13d;13e;13f;14c;	1	1	13b;13d;13e;13f;14c;	1	2100	3	13b;13d;13e;13f;14c8;
H5216	332	0	1	04	01	H5216_332_0	3	1	1	10				01111	839	839																	2		13b;13d;13e;13f;14c;	1	1	13b;13d;13e;13f;14c;	1	2100	3	13b;13d;13e;13f;14c8;
H5216	333	0	1	04	01	H5216_333_0	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	334	0	1	04	01	H5216_334_0	4	1	3								01111111111111110000																1	001	13b;13i;13i-O;14c;	1	2		1	900	3	13b;13i1;13i3;13i4;13i5;13i6;13i10;13i-O1;14c8;
H5216	335	0	1	04	01	H5216_335_0	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	335	0	1	04	01	H5216_335_0	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	336	0	1	04	01	H5216_336_0	3	1	3								00000101000010001000	Depression															1	001	13c;	1	2		2			
H5216	337	1	1	04	01	H5216_337_1	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5216	337	2	1	04	01	H5216_337_2	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5216	337	3	1	04	01	H5216_337_3	4	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13c;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5216	338	0	1	04	01	H5216_338_0	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	338	0	1	04	01	H5216_338_0	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	340	0	1	04	01	H5216_340_0	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	1	13d;	2			
H5216	343	0	1	04	01	H5216_343_0	3	2	3								00000101000010001000	Depression															1	001	13c;	1	2		2			
H5216	343	0	1	04	01	H5216_343_0	3	1	1	01	1111111111	2	2		1992	1992																	2		13b;13d;13e;13i;14c;	1	2		1	600	3	13b;13d;13e;13i1;13i3;13i4;13i5;13i6;13i10;14c8;
H5216	345	0	1	04	01	H5216_345_0	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	1	13d;	2			
H5216	345	0	1	04	01	H5216_345_0	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	1	13d;	2			
H5216	346	0	1	04	01	H5216_346_0	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	1	13d;	2			
H5216	347	0	1	04	01	H5216_347_0	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	348	0	1	04	01	H5216_348_0	1	2	2														01000000000000										1	010	13d;	1	2		2			
H5216	348	0	1	04	01	H5216_348_0	1	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	351	0	1	04	01	H5216_351_0	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	351	0	1	04	01	H5216_351_0	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	352	0	1	04	01	H5216_352_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5216	352	0	1	04	01	H5216_352_0	3	3	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	352	0	1	04	01	H5216_352_0	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	353	0	1	04	01	H5216_353_0	4	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5216	358	0	1	04	01	H5216_358_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5216	358	0	1	04	01	H5216_358_0	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	358	0	1	04	01	H5216_358_0	3	3	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5216	360	0	1	04	01	H5216_360_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b2;18a1;18a2;18b1;
H5253	024	0	1	02	01	H5253_024_0	2	1	1	10				01111	13448	11431																	2		13d;	2	1	13d;	2			
H5253	041	0	1	02	01	H5253_041_0	2	1	1	10				01111	53386	45378																	2		13d;	2	1	13d;	2			
H5253	059	0	1	02	01	H5253_059_0	2	1	1	10				01111	48351	41098																	2		13d;	2	1	13d;	2			
H5253	116	0	1	02	01	H5253_116_0	3	1	1	10				01111	3554	3021																	2		13d;	2	1	13d;	2			
H5253	122	0	1	02	01	H5253_122_0	2	1	1	10				01111	697	592																	2		13d;	2	1	13d;	2			
H5262	001	0	1	01	01	H5262_001_0	3	2	3								00000101000000001100	Hypertension	Pre-Diabetes/ Obesity														1	001	13b;13i;		2		2			
H5262	001	0	1	01	01	H5262_001_0	3	1	2														10110000001111	Pneumonia	UTI	Cellulitis	Asthma	Deep Vein Thrombosis/ Pulmonary Embolism	2	2			1	001	13d;		2		2			
H5262	003	0	1	01	01	H5262_003_0	3	2	3								00000101000000001100	Hypertension	Pre-Diabetes/ Obesity														1	001	13b;13i;		2		2			
H5262	003	0	1	01	01	H5262_003_0	3	1	2														10110000001111	Pneumonia	UTI	Cellulitis	Asthma	Deep Vein Thrombosis/ Pulmonary Embolism	2	2			1	001	13d;		2		2			
H5262	004	0	1	01	01	H5262_004_0	3	1	2														10110000001111	Pneumonia	UTI	Cellulitis	Asthma	Deep Vein Thrombosis/ Pulmonary Embolism	2	2			1	001	13d;		2		2			
H5262	004	0	1	01	01	H5262_004_0	3	2	3								00000101000000001100	Hypertension	Pre-Diabetes/ Obesity														1	001	13b;13i;		2		2			
H5262	005	0	1	01	01	H5262_005_0	3	2	3								00000101000000001100	Hypertension	Pre-Diabetes/ Obesity														1	001	13b;13i;		2		2			
H5262	005	0	1	01	01	H5262_005_0	3	1	2														10110000001111	Pneumonia	UTI	Cellulitis	Asthma	Deep Vein Thrombosis/ Pulmonary Embolism	2	2			1	001	13d;		2		2			
H5262	007	0	1	01	01	H5262_007_0	3	1	3								00000101000000001100	Hypertension	Pre-Diabetes/Obesity														1	001	13b;13i;		2		2			
H5262	008	0	1	01	01	H5262_008_0	3	1	3								00000101000000001100	Hypertension	Pre-Diabetes/Obesity														1	001	13b;13i;		2		2			
H5262	009	0	1	01	01	H5262_009_0	3	1	3								00000101000000001100	Hypertension	Pre-Diabetes/Obesity														1	001	13b;13i;		2		2			
H5262	010	0	1	01	01	H5262_010_0	3	1	3								00000101000000001100	Hypertension	Per-Diabetes/Obesity														1	001	13b;13i;		2		2			
H5262	011	0	1	01	01	H5262_011_0	2	1	3								00000101000000001100	Hypertension	Pre-Diabetes/ Obesity														1	001	13b;13i;		2		2			
H5262	012	0	1	01	01	H5262_012_0	3	1	3								00000101000000001100	Hypertension	Pre-Diabetes/ Obesity														1	001	13b;13i;		2		2			
H5262	013	0	1	01	01	H5262_013_0	2	1	3								00000101000000001100	Hypertension	Pre-Diabetes/ Obesity														1	001	13b;13i;		2		2			
H5262	018	0	1	01	01	H5262_018_0	2	1	3								00000101000000001100	Hypertension	Pre-Diabetes/ Obesity														1	001	13b;13i;		2		2			
H5262	019	0	1	01	01	H5262_019_0	3	1	3								00000101000000001100	Hypertension	Pre-Diabetes/ Obesity														1	001	13b;13i;		2		2			
H5262	020	0	1	01	01	H5262_020_0	2	1	3								00000101000000001100	Hypertension	Pre-Diabetes/ Obesity														1	001	13b;13i;		2		2			
H5262	021	0	1	01	01	H5262_021_0	3	2	3								00000101000000001100	Hypertension	Pre-Diabetes/ Obesity														1	001	13b;13i;		2		2			
H5262	021	0	1	01	01	H5262_021_0	3	1	2														10110000001111	Pneumonia	UTI	Cellulitis	Asthma	Deep Vein Thrombosis/ Pulmonary Embolism	2	2			1	001	13d;		2		2			
H5262	023	0	1	01	01	H5262_023_0	3	1	3								00000101000000001100	Hypertension	Pre-Diabetes/Obesity														1	001	13b;13i;		2		2			
H5262	024	0	1	01	01	H5262_024_0	3	1	3								00000101000000001100	Hypertension	Pre-Diabetes/ Obesity														1	001	13b;13i;		2		2			
H5262	025	0	1	01	01	H5262_025_0	3	1	3								00000101000000001100	Hypertension	Pre-Diabetes/ Obesity														1	001	13b;13i;		2		2			
H5262	026	0	1	01	01	H5262_026_0	3	1	3								00000101000000001100	Hypertension	Pre-Diabetes/ Obesity														1	001	13b;13i;		2		2			
H5262	027	0	1	01	01	H5262_027_0	3	1	3								00000101000000001100	Hypertension	Pre-Diabetes/ Obesity														1	001	13b;13i;		2		2			
H5262	029	0	1	01	01	H5262_029_0	4	1	3								00000101000000001100	Hypertension	Pre-Diabetes/ Obesity														1	001	13b;13i;		2		2			
H5262	030	0	1	01	01	H5262_030_0	4	1	3								00000101000000001100	Hypertension	Pre-Diabetes/ Obesity														1	001	13b;13i;		2		2			
H5262	031	0	1	01	01	H5262_031_0	4	1	3								00000101000000001100	Hypertension	Pre-Diabetes/ Obesity														1	001	13b;13i;		2		2			
H5294	010	0	1	01	01	H5294_010_0	6	1	3								01111111111111110000																2		13i;14c;		1	13i;14c;	1	1500	3	13i10;
H5294	010	0	1	01	01	H5294_010_0	6	2	1	10				01111	12235	4282																	2		13d;		1	13d;	1	600.00	3	13d;
H5294	011	0	1	01	01	H5294_011_0	4	1	3								01111111111111110000																2		13i;		1	13i;	1	600	3	13i10;
H5294	013	0	1	01	01	H5294_013_0	4	1	3								01111111111111110000																2		13i;14c;		1	13i;14c;	1	600	3	13i10;
H5294	015	0	1	01	01	H5294_015_0	7	2	1	10				01111	9653	2896																	2		13d;		1	13d;	1	300.00	3	13d;
H5294	015	0	1	01	01	H5294_015_0	7	1	3								01111111111111110000																2		13i;14c;		1	13i;14c;	1	1200	3	13i10;
H5294	016	0	1	01	01	H5294_016_0	4	1	3								01111111111111110000																2		13i;14c;		1	13i;14c;	1	600	3	13i10;
H5294	017	0	1	01	01	H5294_017_0	4	1	3								01111111111111110000																2		13i;		1	13i;	1	600	3	13i10;
H5294	018	0	1	01	01	H5294_018_0	4	1	3								01111111111111110000																2		13i;		1	13i;	1	600	3	13i10;
H5296	003	0	1	02	01	H5296_003_0	6	1	3								01111111111111110000																2		13i-O;	2	2		2			
H5296	004	0	1	01	01	H5296_004_0	5	1	3								01111111111111110000																2		13i;		2		2			
H5296	005	0	1	01	01	H5296_005_0	5	1	3								01111111111111110000																2		13i;13i-O;		2		2			
H5299	001	0	1	01	01	H5299_001_0	10	1	3								01111111111111111000	Other Eligible Chronic Conditions															2		13i;		2		1	25.00	7	13i1;
H5299	003	0	1	01	01	H5299_003_0	10	1	3								01111111111111111000	Other Eligible Chronic Conditions															2		13i;		2		1	50.00	7	13i1;
H5302	012	0	1	01	01	H5302_012_0	4	1	1	10				01111	238273	238273																	2		13b;13i;14c;		1	13b;13i;14c;	1	300.00	5	13b;13i1;
H5302	013	0	1	01	01	H5302_013_0	3	1	1	10				01111	238273	238273																	2		13b;13i;14c;		1	13b;13i;14c;	1	300.00	5	13b;13i1;
H5302	014	0	1	01	01	H5302_014_0	3	1	1	10				01111	238273	238273																	2		13b;13i;14c;		1	13b;13i;14c;	1	300.00	5	13b;13i1;
H5302	020	0	1	01	01	H5302_020_0	3	1	1	10				01111	238273	238273																	2		13b;13i;14c;		1	13b;13i;14c;	1	150.00	5	13b;13i1;
H5302	809	0	1	01	01	H5302_809_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H5302	810	0	1	01	01	H5302_810_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H5322	025	0	1	02	01	H5322_025_0	3	1	1	10				01111	52171	44345																	2		13d;	2	1	13d;	2			
H5322	026	0	1	02	01	H5322_026_0	3	1	1	10				01111	3968	3373																	2		13d;	2	1	13d;	2			
H5322	028	0	1	02	01	H5322_028_0	2	1	1	10				01111	32500	27625																	2		13d;	2	1	13d;	2			
H5322	029	0	1	02	01	H5322_029_0	3	1	1	10				01111	9956	8463																	2		13d;	2	1	13d;	2			
H5322	029	0	1	02	01	H5322_029_0	3	2	1	10				01111	9956	996																	2		13e;	2	1	13e;	2			
H5322	030	0	1	02	01	H5322_030_0	2	1	1	10				01111	25172	21396																	2		13d;	2	1	13d;	2			
H5322	031	0	1	02	01	H5322_031_0	4	2	1	10				01111	37803	2835																	2		13f;	2	1	13f;	2			
H5322	031	0	1	02	01	H5322_031_0	4	1	1	10				01111	37803	32133																	2		13d;	2	1	13d;	2			
H5322	033	0	1	02	01	H5322_033_0	4	1	1	10				01111	712	605																	2		13d;	2	1	13d;	2			
H5322	034	0	1	02	01	H5322_034_0	3	1	1	10				01111	676	575																	2		13d;	2	1	13d;	2			
H5325	001	0	1	01	01	H5325_001_0	2	1	1	10				01111	238273	238273																	2		10b;13i;13i-O;14c;		1	10b;13i;13i-O;14c;	1	270.00	5	10b2;13i1;13i4;13i-O1;
H5325	002	0	1	01	01	H5325_002_0	2	1	1	10				01111	238273	238273																	2		10b;13i;13i-O;14c;		1	10b;13i;13i-O;14c;	1	270.00	5	10b2;13i1;13i4;13i-O1;
H5325	003	0	1	01	01	H5325_003_0	2	1	1	10				01111	238273	238273																	2		10b;13i;13i-O;14c;		1	10b;13i;13i-O;14c;	1	270.00	5	10b2;13i1;13i4;13i-O1;
H5325	004	0	1	01	01	H5325_004_0	2	1	1	10				01111	238273	238273																	2		10b;13i;13i-O;14c;		1	10b;13i;13i-O;14c;	1	270.00	5	10b2;13i1;13i4;13i-O1;
H5325	005	0	1	01	01	H5325_005_0	2	1	1	10				01111	238273	238273																	2		10b;13i;13i-O;14c;		1	10b;13i;13i-O;14c;	1	300.00	5	10b2;13i1;13i4;13i-O1;
H5325	006	0	1	01	01	H5325_006_0	2	1	1	10				01111	238273	238273																	2		10b;13i;13i-O;14c;		1	10b;13i;13i-O;14c;	1	300.00	5	10b2;13i1;13i4;13i-O1;
H5325	007	0	1	01	01	H5325_007_0	3	1	1	10				01111	238273	238273																	2		10b;13i;13i-O;14c;		1	10b;13i;13i-O;14c;	1	270.00	5	10b2;13i1;13i4;13i-O1;
H5325	009	0	1	01	01	H5325_009_0	2	1	1	10				01111	238273	238273																	2		10b;13i;13i-O;14c;		1	10b;13i;13i-O;14c;	1	270.00	5	10b2;13i1;13i4;13i-O1;
H5374	001	0	1	01	01	H5374_001_0	10	1	3								01000110010011100000																2		13i;		2		2			
H5377	002	0	1	02	01	H5377_002_0	4	1	3								00000101000010001000	Depression															1	001	13c;	1	2		2			
H5398	002	0	1	01	01	H5398_002_0	5	1	3								01111111111111110000																2		13i;14c;		1	13i;14c;	1	1500	3	13i10;
H5398	004	0	1	01	01	H5398_004_0	5	1	3								01111111111111110000																2		13i;		1	13i;	1	600	3	13i10;
H5410	013	0	1	01	01	H5410_013_0	4	1	1	10				01111	1593	956																	2		13i;		2		2			
H5410	025	0	1	01	01	H5410_025_0	4	1	1	10				01111	261	157																	2		13i;		2		2			
H5410	031	0	1	01	01	H5410_031_0	5	1	1	10				01111	162	97																	2		13i;		2		2			
H5410	032	0	1	01	01	H5410_032_0	5	1	1	10				01111	209	125																	2		13i;		2		2			
H5410	042	0	1	01	01	H5410_042_0	4	1	1	10				01111	107	64																	2		13i;		2		2			
H5410	045	0	1	01	01	H5410_045_0	4	1	1	10				01111	91	55																	2		13i;		2		2			
H5410	046	0	1	01	01	H5410_046_0	4	1	1	10				01111	159	95																	2		13i;		2		2			
H5410	047	0	1	01	01	H5410_047_0	4	1	1	10				01111	64	38																	2		13i;		2		2			
H5410	049	0	1	01	01	H5410_049_0	5	1	1	10				01111	276	166																	2		13i;		2		2			
H5410	055	0	1	01	01	H5410_055_0	5	1	1	10				01111	64	38																	2		13i;		2		2			
H5410	056	0	1	01	01	H5410_056_0	5	1	1	10				01111	226	136																	2		13i;		2		2			
H5420	006	0	1	01	01	H5420_006_0	2	1	1	10				01111	15528	13199																	2		13d;		1	13d;	2			
H5420	014	0	1	01	01	H5420_014_0	2	1	3								00001101000000000000																2		13i;		1	13i;	2			
H5422	007	0	1	01	01	H5422_007_0	6	1	1	10				01111	5965	3078																	2		13i;		2		2			
H5422	007	0	1	01	01	H5422_007_0	6	2	1	10				01111	5965	5965																	2		13i;		2		2			
H5422	007	0	1	01	01	H5422_007_0	6	3	1	10				01111	5965	5965																	2		13i;		2		2			
H5422	011	0	1	01	01	H5422_011_0	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;13i-O;		2		2			
H5422	013	0	1	01	01	H5422_013_0	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;13i-O;		2		2			
H5422	014	0	1	01	01	H5422_014_0	7	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;13i-O;		2		2			
H5422	015	0	1	01	01	H5422_015_0	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;13i-O;		2		2			
H5422	016	0	1	01	01	H5422_016_0	6	5	1	10				01111	3007	3007																	2		13i-O;		2		2			
H5422	016	0	1	01	01	H5422_016_0	6	1	1	10				01111	3007	1552																	2		13i;		2		2			
H5422	016	0	1	01	01	H5422_016_0	6	2	1	10				01111	3007	3007																	2		13i;		2		2			
H5422	016	0	1	01	01	H5422_016_0	6	3	1	10				01111	3007	3007																	2		13i;		2		2			
H5422	016	0	1	01	01	H5422_016_0	6	4	1	10				01111	3007	3007																	2		13i;		2		2			
H5422	017	0	1	01	01	H5422_017_0	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;13i-O;		2		2			
H5422	018	0	1	01	01	H5422_018_0	7	1	1	10				01111	41	21																	2		13i;		2		2			
H5422	018	0	1	01	01	H5422_018_0	7	2	1	10				01111	41	41																	2		13i;		2		2			
H5422	018	0	1	01	01	H5422_018_0	7	3	1	10				01111	41	41																	2		13i;		2		2			
H5425	010	0	1	01	01	H5425_010_0	10	1	3								00011111010000100000																2		13i;		2		2			
H5425	028	0	1	01	01	H5425_028_0	7	1	3								00011111010000100000																2		13i;		2		2			
H5425	030	0	1	01	01	H5425_030_0	9	1	3								00011111010000100000																2		13i;		2		2			
H5425	033	0	1	01	01	H5425_033_0	7	1	3								00011111010000100000																2		13i;		2		2			
H5425	034	0	1	01	01	H5425_034_0	7	1	3								00011111010000100000																2		13i;		2		2			
H5425	055	0	1	01	01	H5425_055_0	8	1	3								00011111010000100000																2		13i;		2		2			
H5425	070	0	1	01	01	H5425_070_0	9	1	3								00011111010000100000																2		13i;		2		2			
H5425	076	0	1	01	01	H5425_076_0	8	1	3								00011111010000100000																2		13i;		2		2			
H5425	077	0	1	01	01	H5425_077_0	8	1	3								00011111010000100000																2		13i;		2		2			
H5425	079	0	1	01	01	H5425_079_0	8	1	3								00011111010000100000																2		13i;		2		2			
H5425	080	0	1	01	01	H5425_080_0	8	1	3								00011111010000100000																2		13i;		2		2			
H5425	086	0	1	01	01	H5425_086_0	8	1	3								00011111010000100000																2		13d;13i;		2		2			
H5425	087	0	1	01	01	H5425_087_0	8	1	3								00011111010000100000																2		13d;13i;		2		2			
H5425	091	0	1	01	01	H5425_091_0	8	1	3								00011111010000100000																2		13d;13i;		2		2			
H5425	092	0	1	01	01	H5425_092_0	7	1	3								00011111010000100000																2		13i;		1	13i;	2			
H5425	093	0	1	01	01	H5425_093_0	7	1	3								00011111010000100000																2		13i;		1	13i;	2			
H5427	070	0	1	01	01	H5427_070_0	6	1	3								00001101000000000000																2		13i;		2		2			
H5427	072	0	1	01	01	H5427_072_0	6	1	3								00001101000000000000																2		13i;		2		2			
H5427	077	0	1	01	01	H5427_077_0	5	1	3								00000000000010000000																2		13i;		2		2			
H5427	078	0	1	01	01	H5427_078_0	6	1	1	10				01111	8416	8416																	2		13i;		2		2			
H5427	087	0	1	01	01	H5427_087_0	5	1	1	10				01111	6986	6986																	2		13i;		2		2			
H5427	099	0	1	01	01	H5427_099_0	6	1	3								00001101000000000000																2		13i;		2		2			
H5427	108	0	1	01	01	H5427_108_0	6	1	3								00001101000000000000																2		13i;		2		2			
H5431	001	0	1	01	01	H5431_001_0	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13c;13i;13i-O;		2		2			
H5431	006	0	1	01	01	H5431_006_0	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13c;13i;13i-O;		2		2			
H5431	012	0	1	01	01	H5431_012_0	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13c;13i;13i-O;		2		2			
H5431	013	0	1	01	01	H5431_013_0	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13c;13i;13i-O;		2		2			
H5431	016	0	1	01	01	H5431_016_0	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13c;13i-O;		2		2			
H5431	016	0	1	01	01	H5431_016_0	6	3	1	10				01111	1264	1264																	2		13i;		2		2			
H5431	016	0	1	01	01	H5431_016_0	6	2	1	10				01111	1264	1264																	2		13i;		2		2			
H5431	017	0	1	01	01	H5431_017_0	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i-O;		2		2			
H5431	018	0	1	01	01	H5431_018_0	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i-O;		2		2			
H5431	019	0	1	01	01	H5431_019_0	8	3	1	10				01111	43384	43384																	2		13i;		2		2			
H5431	019	0	1	01	01	H5431_019_0	8	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13c;13i-O;		2		2			
H5431	019	0	1	01	01	H5431_019_0	8	2	1	10				01111	43384	43384																	2		13i;		2		2			
H5431	020	0	1	01	01	H5431_020_0	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i-O;		2		2			
H5439	010	0	1	04	01	H5439_010_0	3	1	3								01111111111111110000																2		13i;	1	1	13i;	2			
H5439	011	0	1	04	01	H5439_011_0	4	1	3								01111111111111110000																2		13i;	1	1	13i;	2			
H5439	017	0	1	04	01	H5439_017_0	4	1	3								01111111111111110000																2		13i;	1	1	13i;	2			
H5439	018	0	1	04	01	H5439_018_0	4	1	3								01111111111111110000																2		13i;	1	1	13i;	2			
H5439	019	0	1	04	01	H5439_019_0	5	1	3								01111111111111110000																2		13i;	1	1	13i;	2			
H5454	001	0	1	01	01	H5454_001_0	5	1	3								00001101000011000000																2		13i;		2		1	55.00	7	13i1;
H5454	002	0	1	01	01	H5454_002_0	5	1	3								00001101000011000000																2		13i;		2		1	55.00	7	13i1;
H5471	064	0	1	01	01	H5471_064_0	6	2	1	10				01111	24053	24053																	2		13i;		2		2			
H5471	064	0	1	01	01	H5471_064_0	6	1	1	10				01111	24053	24053																	2		13i;		2		2			
H5471	065	0	1	01	01	H5471_065_0	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H5471	066	0	1	01	01	H5471_066_0	6	2	1	10				01111	3803	3803																	2		13i;		2		2			
H5471	066	0	1	01	01	H5471_066_0	6	1	1	10				01111	3803	3803																	2		13i;		2		2			
H5471	068	0	1	01	01	H5471_068_0	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H5471	069	0	1	01	01	H5471_069_0	6	1	3								00001101000000000000																2		13i;		2		2			
H5471	070	0	1	01	01	H5471_070_0	6	1	3								00001101000000000000																2		13i;		2		2			
H5471	072	0	1	01	01	H5471_072_0	6	1	1	10				01111	3166	3166																	2		13i;		2		2			
H5471	072	0	1	01	01	H5471_072_0	6	2	1	10				01111	3166	3166																	2		13i;		2		2			
H5471	073	0	1	01	01	H5471_073_0	6	1	3								00001101000000000000																2		13i;		2		2			
H5471	075	0	1	01	01	H5471_075_0	8	1	3								00001101000000000000																2		13i;		2		2			
H5471	076	0	1	01	01	H5471_076_0	6	2	1	10				01111	2735	2735																	2		13i;		2		2			
H5471	076	0	1	01	01	H5471_076_0	6	1	1	10				01111	2735	2735																	2		13i;		2		2			
H5471	077	0	1	01	01	H5471_077_0	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H5471	080	0	1	01	01	H5471_080_0	6	1	3								00001101000000000000																2		13i;		2		2			
H5471	082	0	1	01	01	H5471_082_0	6	1	1	10				01111	5014	5014																	2		13i;		2		2			
H5471	082	0	1	01	01	H5471_082_0	6	2	1	10				01111	5014	5014																	2		13i;		2		2			
H5471	083	0	1	01	01	H5471_083_0	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13c;13i;13i-O;		2		2			
H5471	084	0	1	01	01	H5471_084_0	6	2	1	10				01111	526	526																	2		13i;		2		2			
H5471	084	0	1	01	01	H5471_084_0	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13c;13i-O;		2		2			
H5471	084	0	1	01	01	H5471_084_0	6	3	1	10				01111	526	526																	2		13i;		2		2			
H5471	085	0	1	01	01	H5471_085_0	6	1	3								00001101000000000000																2		13c;13i;13i-O;		2		2			
H5471	093	0	1	01	01	H5471_093_0	8	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H5471	105	0	1	01	01	H5471_105_0	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i-O;		2		2			
H5471	111	0	1	01	01	H5471_111_0	6	1	1	10				01111	160	160																	2		13i;		2		2			
H5471	111	0	1	01	01	H5471_111_0	6	2	1	10				01111	160	160																	2		13i;		2		2			
H5472	001	0	1	01	01	H5472_001_0	5	3	1	01	1111111011	2	2		6163	2157																	2		13i;		2		2			
H5472	001	0	1	01	01	H5472_001_0	5	1	3								01111111111111110000																2		13i-O;		2		2			
H5472	001	0	1	01	01	H5472_001_0	5	2	1	10				01111	6163	1849																	2		10b;13b;13i;13i-O;16b;17b;18b;		2		2			
H5472	002	0	1	01	01	H5472_002_0	5	1	3								01111111111111110000																2		13i;13i-O;		2		2			
H5475	001	0	1	02	01	H5475_001_0	7	1	3								01111111111111110000																2		13i;	1	1	13i;	1	600	3	13i10;
H5475	001	0	1	02	01	H5475_001_0	7	2	1	10				01111	20970	6291																	2		13d;	1	1	13d;	1	300.00	3	13d;
H5475	021	0	1	02	01	H5475_021_0	7	2	1	10				01111	1288	386																	2		13d;	1	1	13d;	1	300.00	3	13d;
H5475	021	0	1	02	01	H5475_021_0	7	1	3								01111111111111110000																2		13i;	1	1	13i;	1	600.00	3	13i10;
H5496	011	0	1	01	01	H5496_011_0	9	1	3								01111111111111110000																2		13i;		2		1	30.00	5	13i1;
H5521	116	0	1	04	01	H5521_116_0	3	1	3								01111111111111111100	Hyperlipidemia	Hypertension														2		13b;13i;	1	1	13b;13i;	1	75.00	5	13b;13i1;
H5521	134	0	1	04	01	H5521_134_0	5	1	3								01111111111111111100	Hyperlipidemia	Hypertension														2		13i;	1	1	13i;	2			
H5521	156	0	1	04	01	H5521_156_0	4	1	3								01111111111111111100	Hyperlipidemia	Hypertension														2		13i;	1	1	13i;	2			
H5521	169	0	1	04	01	H5521_169_0	2	1	1	10				01111	238273	238273																	2		13i;	1	1	13i;	2			
H5521	171	0	1	04	01	H5521_171_0	3	1	3								01111111111111111100	Hyperlipidemia	Hypertension														2		13b;13i;	1	1	13b;13i;	1	75.00	5	13b;13i1;
H5521	178	0	1	04	01	H5521_178_0	4	1	3								01111111111111111100	Hyperlipidemia	Hypertension														2		13b;13i;	1	1	13b;13i;	1	75.00	5	13b;13i1;
H5521	216	0	1	04	01	H5521_216_0	3	1	3								01111111111111111100	Hyperlipidemia	Hypertension														2		13b;13i;	1	1	13b;13i;	1	75.00	5	13b;13i1;
H5521	218	0	1	04	01	H5521_218_0	4	1	3								01111111111111111100	Hyperlipidemia	Hypertension														2		13b;13i;	1	1	13b;13i;	1	75.00	5	13b;13i1;
H5521	220	0	1	04	01	H5521_220_0	3	1	3								01111111111111111100	Hyperlipidemia	Hypertension														2		13b;13i;	1	1	13b;13i;	1	75.00	5	13b;13i1;
H5521	222	0	1	04	01	H5521_222_0	3	1	3								01111111111111111100	Hyperlipidemia	Hypertension														2		13b;13i;	1	1	13b;13i;	1	75.00	5	13b;13i1;
H5521	224	0	1	04	01	H5521_224_0	3	1	3								01111111111111111100	Hyperlipidemia	Hypertension														2		13b;13i;	1	1	13b;13i;	1	90.00	5	13b;13i1;
H5521	227	0	1	04	01	H5521_227_0	3	1	3								01111111111111101100	Hyperlipidemia	Hypertension														2		13b;13i;	1	1	13b;13i;	1	75.00	5	13b;13i1;
H5521	229	0	1	04	01	H5521_229_0	2	1	3								01111111111111111100	Hyperlipidemia	Hypertension														2		13b;13i;	1	1	13b;13i;	1	150.00	5	13b;13i1;
H5521	230	0	1	04	01	H5521_230_0	3	1	3								01111111111111111100	Hyperlipidemia	Hypertension														2		13b;13i;	1	1	13b;13i;	1	150.00	5	13b;13i1;
H5521	232	0	1	04	01	H5521_232_0	3	1	3								01111111111111111100	Hyperlipidemia	Hypertension														2		13b;13i;	1	1	13b;13i;	1	90.00	5	13b;13i1;
H5521	233	0	1	04	01	H5521_233_0	3	1	3								01111111111111111100	Hyperlipidemia	Hypertension														2		13b;13i;	1	1	13b;13i;	1	75.00	5	13b;13i1;
H5521	234	0	1	04	01	H5521_234_0	3	1	3								01111111111111111100	Hyperlipidemia	Hypertension														2		13b;13i;	1	1	13b;13i;	1	75.00	5	13b;13i1;
H5521	235	0	1	04	01	H5521_235_0	2	1	3								01111111111111111100	Hyperlipidemia	Hypertension														2		13b;13i;	1	1	13b;13i;	1	120.00	5	13b;13i1;
H5521	260	0	1	04	01	H5521_260_0	4	1	3								01111111111111111100	Hyperlipidemia	Hypertension														2		13i;	1	1	13i;	2			
H5521	266	0	1	04	01	H5521_266_0	4	1	3								01111111111111111100	Hyperlipidemia	Hypertension														2		13i;	1	1	13i;	2			
H5521	324	0	1	04	01	H5521_324_0	2	1	3								01111111111111111100	Hyperlipidemia	Hypertension														2		13b;13i;	1	1	13b;13i;	1	150.00	5	13b;13i1;
H5521	326	0	1	04	01	H5521_326_0	2	1	1	10				01111	238273	238273																	2		13b;13i;	1	1	13b;13i;	1	150.00	5	13b;13i1;
H5521	360	0	1	04	01	H5521_360_0	3	1	3								01111111111111111100	Hyperlipidemia	Hypertension														2		13b;13i;	1	1	13b;13i;	1	75.00	5	13b;13i1;
H5521	364	0	1	04	01	H5521_364_0	2	1	1	10				01111	238273	238273																	2		13b;13i;	1	1	13b;13i;	1	90.00	5	13b;13i1;
H5521	364	0	1	04	01	H5521_364_0	2	2	3								01111111111111111100	Hyperlipidemia	Hypertension														2		13i;	1	1	13i;	2			
H5521	365	0	1	04	01	H5521_365_0	3	1	3								01111111111111111100	Hyperlipidemia	Hypertension														2		13b;13i;	1	1	13b;13i;	1	75.00	5	13b;13i1;
H5521	366	0	1	04	01	H5521_366_0	3	1	3								01111111111111111100	Hyperlipidemia	Hypertension														2		13b;13i;	1	1	13b;13i;	1	75.00	5	13b;13i1;
H5521	801	0	1	04	01	H5521_801_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H5521	802	0	1	04	01	H5521_802_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H5521	805	0	2	04	01	H5521_805_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H5521	806	0	2	04	01	H5521_806_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H5521	809	0	1	04	01	H5521_809_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H5521	810	0	1	04	01	H5521_810_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H5521	812	0	1	04	01	H5521_812_0	3	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H5521	814	0	2	04	01	H5521_814_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H5521	815	0	2	04	01	H5521_815_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H5521	816	0	2	04	01	H5521_816_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H5521	817	0	1	04	01	H5521_817_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H5521	818	0	2	04	01	H5521_818_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H5521	819	0	1	04	01	H5521_819_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H5521	820	0	1	04	01	H5521_820_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H5521	821	0	1	04	01	H5521_821_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H5521	822	0	1	04	01	H5521_822_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H5521	823	0	2	04	01	H5521_823_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H5521	824	0	2	04	01	H5521_824_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H5521	825	0	1	04	01	H5521_825_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H5521	826	0	2	04	01	H5521_826_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H5521	827	0	2	04	01	H5521_827_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H5521	828	0	2	04	01	H5521_828_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H5521	829	0	1	04	01	H5521_829_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H5521	830	0	2	04	01	H5521_830_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H5521	831	0	1	04	01	H5521_831_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H5521	832	0	1	04	01	H5521_832_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H5521	833	0	1	04	01	H5521_833_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H5521	834	0	1	04	01	H5521_834_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H5521	835	0	2	04	01	H5521_835_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H5521	836	0	1	04	01	H5521_836_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H5522	001	0	1	04	01	H5522_001_0	2	1	1	01	0001000000				10756	5382																	1	001	10b;13b;13c;13d;13i;	1	1	10b;13b;13c;13d;13i;	2			
H5522	002	0	1	04	01	H5522_002_0	2	1	2														00000100001000	Hyperlipidemia					2	2			2		10b;13b;	1	1	10b;13b;	2			
H5522	002	0	1	04	01	H5522_002_0	2	2	1	01	0001000000				10756	5382																	1	001	13b;13c;13d;13i;	1	1	13b;13c;13d;13i;	2			
H5522	005	0	1	04	01	H5522_005_0	2	1	1	01	0001000000				10756	5382																	1	001	10b;13b;13c;13d;13i;	1	1	10b;13b;13c;13d;13i;	2			
H5522	802	0	1	04	01	H5522_802_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H5522	803	0	1	04	01	H5522_803_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H5525	005	0	1	04	01	H5525_005_0	4	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5525	006	0	1	04	01	H5525_006_0	4	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5525	017	0	1	04	01	H5525_017_0	4	1	1	01	1111111111	2	2		1174	65																	2		13b;13d;13e;13i;14c;	1	2		1	600	3	13b;13d;13e;13i1;13i3;13i4;13i5;13i6;13i10;14c8;
H5525	017	0	1	04	01	H5525_017_0	4	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5525	026	0	1	04	01	H5525_026_0	3	1	3								00000101000010001000	Depression															1	001	13c;	1	1	13c;	2			
H5525	030	0	1	04	01	H5525_030_0	6	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	1	13d;	2			
H5525	034	0	1	04	01	H5525_034_0	3	1	3								00000101000010001000	Depression															1	001	13c;	1	2		2			
H5525	035	0	1	04	01	H5525_035_0	3	1	3								00000101000010001000	Depression															1	001	13c;	1	1	13c;	2			
H5525	036	0	1	04	01	H5525_036_0	4	2	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13c;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	2		1	500	3	7b1;7f;10b1;13a;13b;13c;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5525	036	0	1	04	01	H5525_036_0	4	1	1	10				01111	100	100																	2		13b;13d;13e;13f;14c;	1	2		1	2100	3	13b;13d;13e;13f;14c8;
H5525	037	0	1	04	01	H5525_037_0	3	1	1	01	1111111111	2	2		224	224																	2		13b;13d;13e;13i;14c;	1	2		1	600	3	13b;13d;13e;13i1;13i3;13i4;13i5;13i6;13i10;14c8;
H5525	041	0	1	04	01	H5525_041_0	5	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	1	13d;	2			
H5525	042	0	1	04	01	H5525_042_0	4	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5525	045	0	1	04	01	H5525_045_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5525	045	0	1	04	01	H5525_045_0	3	2	1	10				01111	6748	6748																	2		13b;13d;13e;13f;14c;	1	1	13b;13d;13e;13f;14c;	1	1200	3	13b;13d;13e;13f;14c8;
H5525	046	0	1	04	01	H5525_046_0	4	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	1	13d;	2			
H5525	046	0	1	04	01	H5525_046_0	4	1	1	10				01111	6283	6439																	2		13b;13d;13e;13f;14c;	1	1	13b;13d;13e;13f;14c;	1	1500	3	13b;13d;13e;13f;14c8;
H5525	048	0	1	04	01	H5525_048_0	4	1	1	10				01111	2443	2443																	2		13b;13d;13e;13f;14c;	1	1	13b;13d;13e;13f;14c;	1	1500	3	13b;13d;13e;13f;14c8;
H5525	049	0	1	04	01	H5525_049_0	3	1	3								00000101000010001000	Depression															1	001	13c;	1	2		2			
H5525	050	0	1	04	01	H5525_050_0	3	1	3								00000101000010001000	Depression															1	001	13c;	1	2		2			
H5525	051	1	1	04	01	H5525_051_1	4	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5525	053	0	1	04	01	H5525_053_0	2	1	1	10				01111	213	213																	2		13b;13d;13e;13f;14c;	1	1	13b;13d;13e;13f;14c;	1	600	3	13b;13d;13e;13f;14c8;
H5525	053	0	1	04	01	H5525_053_0	2	2	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5525	058	0	1	04	01	H5525_058_0	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	1	13d;	2			
H5525	059	0	1	04	01	H5525_059_0	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5525	060	0	1	04	01	H5525_060_0	4	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5525	065	0	1	04	01	H5525_065_0	2	2	3								00000101000010001000	Depression															1	001	13c;	1	2		2			
H5525	065	0	1	04	01	H5525_065_0	2	1	1	01	1111111111	2	2		2074	2074																	2		13b;13d;13e;13i;14c;	1	2		1	600	3	13b;13d;13e;13i1;13i3;13i4;13i5;13i6;13i10;14c8;
H5533	003	0	1	04	01	H5533_003_0	8	1	2														01110000000000						1				2		13c;	1	1	13c;	2			
H5533	005	0	1	04	01	H5533_005_0	8	1	2														01110000000000						1				2		13c;	1	1	13c;	2			
H5533	008	0	1	04	01	H5533_008_0	8	1	2														01110000000000						1				2		13c;	1	1	13c;	2			
H5533	009	0	1	04	01	H5533_009_0	8	1	2														01110000000000						1				2		13c;	1	1	13c;	2			
H5533	011	0	1	04	01	H5533_011_0	8	1	2														01110000000000						1				2		13c;	1	1	13c;	2			
H5533	012	0	1	04	01	H5533_012_0	7	1	2														01110000000000						1				2		13c;	1	1	13c;	2			
H5533	013	0	1	04	01	H5533_013_0	8	1	2														01110000000000						1				2		13c;	1	1	13c;	2			
H5533	014	0	1	04	01	H5533_014_0	8	1	2														01110000000000						1				2		13c;	1	1	13c;	2			
H5549	003	0	1	01	01	H5549_003_0	7	1	3								01111111111111110000																2		13i;		2		1	80.00	7	13i1;
H5549	011	0	1	01	01	H5549_011_0	7	1	3								01111111111111110000																2		13i;		2		1	50.00	7	13i1;
H5576	019	0	1	02	01	H5576_019_0	9	1	1	10				01111	4358	3268																	2		13d;	1	1	13d;	1	100.00	7	13d;
H5577	002	0	1	01	01	H5577_002_0	7	1	3								11111111111111111111	Crohn's disease or Ulcerative colitis	Anemia	Chronic obstructive pulmonary disease (COPD)	Severe mental retardation	Others included in note											2		13i;13i-O;14c;		2		2			
H5577	005	0	1	01	01	H5577_005_0	7	1	3								11111111111111111111	Crohn's disease or Ulcerative colitis	Anemia	Chronic obstructive pulmonary disease (COPD)	Severe mental retardation	Others included in note											2		13i;13i-O;14c;		2		2			
H5577	008	0	1	02	01	H5577_008_0	7	1	3								11111111111111111111	Crohn's disease or Ulcerative colitis	Anemia	Chronic obstructive pulmonary disease (COPD)	Severe mental retardation	Others included in note											2		13i;13i-O;14c;	2	2		2			
H5577	014	0	1	01	01	H5577_014_0	5	1	3								11111111111111111111	Crohn's disease or Ulcerative colitis	Anemia	Chronic obstructive pulmonary disease (COPD)	Severe mental retardation	Others included in note											2		13i;13i-O;14c;		2		2			
H5577	016	0	1	01	01	H5577_016_0	6	1	3								11111111111111111111	Crohn's disease or Ulcerative colitis	Anemia	Chronic obstructive pulmonary disease (COPD)	Severe mental retardation	Others included in note											2		13i;13i-O;14c;		2		2			
H5577	017	0	1	01	01	H5577_017_0	7	1	3								11111111111111111111	Crohn's disease or Ulcerative colitis	Anemia	Chronic obstructive pulmonary disease (COPD)	Severe mental retardation	Others included in note											2		13i;13i-O;14c;		2		2			
H5577	029	0	1	01	01	H5577_029_0	7	1	3								11111111111111111111	Crohn's disease or Ulcerative colitis	Anemia	Chronic obstructive pulmonary disease (COPD)	Severe mental retardation	Others included in note											2		13i;13i-O;14c;		2		2			
H5577	031	0	1	01	01	H5577_031_0	7	1	3								11111111111111111111	Crohn's disease or Ulcerative colitis	Anemia	Chronic obstructive pulmonary disease (COPD)	Severe mental retardation	Others included in note											2		13i;13i-O;14c;		2		2			
H5577	037	0	1	01	01	H5577_037_0	8	1	1	10				10000	2324	2324																	2		13i;13i-O;14c;		2		2			
H5577	038	0	1	01	01	H5577_038_0	8	1	3								11111111111111111111	Crohn's disease or Ulcerative colitis	Anemia	Chronic obstructive pulmonary disease (COPD)	Severe mental retardation	Others included in note											2		13i;13i-O;14c;		2		2			
H5577	039	0	1	01	01	H5577_039_0	7	1	3								11111111111111111111	Crohn's disease or Ulcerative colitis	Anemia	Chronic obstructive pulmonary disease (COPD)	Severe mental retardation	Others included in note											2		13i;13i-O;14c;		2		2			
H5577	041	0	1	01	01	H5577_041_0	7	1	3								11111111111111111111	Crohn's disease or Ulcerative colitis	Anemia	Chronic obstructive pulmonary disease (COPD)	Severe mental retardation	Others included in note											2		13i;13i-O;14c;		2		2			
H5577	042	0	1	01	01	H5577_042_0	7	1	3								11111111111111111111	Crohn's disease or Ulcerative colitis	Anemia	Chronic obstructive pulmonary disease (COPD)	Severe mental retardation	Others included in note											2		13i;13i-O;14c;		2		2			
H5577	043	0	1	01	01	H5577_043_0	7	1	3								11111111111111111111	Crohn's disease or Ulcerative colitis	Anemia	Chronic obstructive pulmonary disease (COPD)	Severe mental retardation	Others included in note											2		13i;13i-O;14c;		2		2			
H5577	044	0	1	01	01	H5577_044_0	7	1	3								11111111111111111111	Crohn's disease or Ulcerative colitis	Anemia	Chronic obstructive pulmonary disease (COPD)	Severe mental retardation	Others included in note											2		13i;13i-O;14c;		2		2			
H5577	045	0	1	01	01	H5577_045_0	8	1	3								11111111111111111111	Crohn's disease or Ulcerative colitis	Anemia	Chronic obstructive pulmonary disease (COPD)	Severe mental retardation	Others included in note											2		13i;13i-O;14c;		2		2			
H5577	046	0	1	01	01	H5577_046_0	7	1	1	10				10000	2324	2324																	2		13i;13i-O;14c;		2		2			
H5577	047	0	1	01	01	H5577_047_0	8	1	3								11111111111111111111	Crohn's disease or Ulcerative colitis	Anemia	Chronic obstructive pulmonary disease (COPD)	Severe mental retardation	Others included in note											2		13i;13i-O;14c;		2		2			
H5577	049	0	1	01	01	H5577_049_0	7	1	3								11111111111111111111	Crohn's disease or Ulcerative colitis	Anemia	Chronic obstructive pulmonary disease (COPD)	Severe mental retardation	Others included in note											2		13i;13i-O;14c;		2		2			
H5577	050	0	1	02	01	H5577_050_0	6	1	3								11111111111111111111	Crohn's disease or Ulcerative colitis	Anemia	Chronic obstructive pulmonary disease (COPD)	Severe mental retardation	Others included in note											2		13i;13i-O;14c;	2	2		2			
H5577	051	0	1	01	01	H5577_051_0	8	1	3								11111111111111111111	Crohn's disease or Ulcerative colitis	Anemia	Chronic obstructive pulmonary disease (COPD)	Severe mental retardation	Others included in note											2		13i;13i-O;14c;		2		2			
H5577	052	0	1	01	01	H5577_052_0	7	1	3								11111111111111111111	Crohn's disease or Ulcerative colitis	Anemia	Chronic obstructive pulmonary disease (COPD)	Severe mental retardation	Others included in note											2		13i;13i-O;14c;		2		2			
H5577	053	0	1	01	01	H5577_053_0	7	1	3								11111111111111111111	Crohn's disease or Ulcerative colitis	Anemia	Chronic obstructive pulmonary disease (COPD)	Severe mental retardation	Others included in note											2		13i;13i-O;14c;		2		2			
H5587	002	0	1	01	01	H5587_002_0	11	1	3								01111111111111111111	Hypertension	Eating Disorders	Obesity	PASC												1	001	13i;14c;		1	13i;14c;	2			
H5590	008	0	1	01	01	H5590_008_0	6	2	1	10				01111	17045	5966																	2		13d;		1	13d;	1	600.00	3	13d;
H5590	008	0	1	01	01	H5590_008_0	6	1	3								01111111111111110000																2		13b;13d;13i;14c;		1	13b;13d;13i;14c;	1	800	3	13b;13d;13i5;13i10;14c8;
H5590	009	0	1	01	01	H5590_009_0	7	2	1	10				01111	5433	1902																	2		13d;		1	13d;	1	600.00	3	13d;
H5590	009	0	1	01	01	H5590_009_0	7	1	3								01111111111111110000																2		13b;13d;13i;14c;		1	13b;13d;13i;14c;	1	800	3	13b;13d;13i5;13i10;14c8;
H5591	003	0	1	01	01	H5591_003_0	4	3	2														00000000001100	History of Falls	Hip Fracture				2	2			2		14c;		2		1	250.00	3	14c1;14c8;
H5591	003	0	1	01	01	H5591_003_0	4	1	2														00000000001100	Opiate Use Disorder	Chronic Pain Syndrome				2	2			2		13a;14c;		2		1	200.00	3	13a;14c18;
H5591	003	0	1	01	01	H5591_003_0	4	2	3								00000100010000000000																2		13i;		2		2			
H5591	005	0	1	02	01	H5591_005_0	4	1	2														00000000001100	Opiate Use DIsorder	Chronic Pain Syndrome				2	2			2		13a;14c;	1	2		1	200.00	3	13a;14c18;
H5591	005	0	1	02	01	H5591_005_0	4	2	3								00000100010000000000																2		13i;	2	2		2			
H5591	005	0	1	02	01	H5591_005_0	4	3	2														00000000001100	History of Falls	Hip Fracture				2	2			2		14c;	1	2		1	250.00	3	14c1;14c8;
H5591	006	1	1	02	01	H5591_006_1	4	2	3								00000100010000000000																2		13i;	2	2		2			
H5591	006	1	1	02	01	H5591_006_1	4	1	2														00000000001100	Opiate Use DIsorder	Chronic Pain Syndrome				2	2			2		13a;14c;	1	2		1	200.00	3	13a;14c18;
H5591	006	1	1	02	01	H5591_006_1	4	3	2														00000000001100	History of Falls	Hip Fracture				2	2			2		14c;	1	2		1	250.00	3	14c1;14c8;
H5591	006	2	1	02	01	H5591_006_2	4	3	2														00000000001100	History of Falls	Hip Fracture				2	2			2		14c;	1	2		1	250.00	3	14c1;14c8;
H5591	006	2	1	02	01	H5591_006_2	4	1	2														00000000001100	Opiate Use DIsorder	Chronic Pain Syndrome				2	2			2		13a;14c;	1	2		1	200.00	3	13a;14c18;
H5591	006	2	1	02	01	H5591_006_2	4	2	3								00000100010000000000																2		13i;	2	2		2			
H5591	006	4	1	02	01	H5591_006_4	4	1	2														00000000001100	Opiate Use DIsorder	Chronic Pain Syndrome				2	2			2		13a;14c;	1	2		1	200.00	3	13a;14c18;
H5591	006	4	1	02	01	H5591_006_4	4	2	3								00000100010000000000																2		13i;	2	2		2			
H5591	006	4	1	02	01	H5591_006_4	4	3	2														00000000001100	History of Falls	Hip Fracture				2	2			2		14c;	1	2		1	250.00	3	14c1;14c8;
H5591	006	5	1	02	01	H5591_006_5	5	2	3								00000100010000000000																2		13i;	2	2		2			
H5591	006	5	1	02	01	H5591_006_5	5	1	2														00000000001100	Opiate Use DIsorder	Chronic Pain Syndrome				2	2			2		13a;14c;	1	2		1	200.00	3	13a;14c18;
H5591	006	5	1	02	01	H5591_006_5	5	3	2														00000000001100	History of Falls	Hip Fracture				2	2			2		14c;	1	2		1	250.00	3	14c1;14c8;
H5591	007	0	1	01	01	H5591_007_0	4	2	3								00000100010000000000																2		13i;		2		2			
H5591	007	0	1	01	01	H5591_007_0	4	3	2														00000000001100	History of Falls	Hip Fracture				2	2			2		14c;		2		1	250.00	3	14c1;14c8;
H5591	007	0	1	01	01	H5591_007_0	4	1	2														00000000001100	Opiate Use Disorder	Chronic Pain Syndrome				2	2			2		13a;14c;		2		1	200.00	3	13a;14c18;
H5591	009	0	1	01	01	H5591_009_0	5	3	2														00000000001100	History of Falls	Hip Fracture				2	2			2		14c;		2		1	250.00	3	14c1;14c8;
H5591	009	0	1	01	01	H5591_009_0	5	2	3								00000100010000000000																2		13i;		2		2			
H5591	009	0	1	01	01	H5591_009_0	5	1	2														00000000001100	Opiate Use DIsorder	Chronic Pain Syndrome				2	2			2		13a;14c;		2		1	200.00	3	13a;14c18;
H5591	013	0	1	01	01	H5591_013_0	5	1	2														00000000001100	Opiate Use DIsorder	Chronic Pain Syndrome				2	2			2		13a;14c;		2		1	200.00	3	13a;14c18;
H5591	013	0	1	01	01	H5591_013_0	5	3	2														00000000001100	History of Falls	Hip Fracture				2	2			2		14c;		2		1	250.00	3	14c1;14c8;
H5591	013	0	1	01	01	H5591_013_0	5	2	3								00000100010000000000																2		13i;		2		2			
H5591	015	1	1	02	01	H5591_015_1	4	2	3								00000100010000000000																2		13i;	2	2		2			
H5591	015	1	1	02	01	H5591_015_1	4	3	2														00000000001100	History of Falls	Hip Fracture				2	2			2		14c;	1	2		1	250.00	3	14c1;14c8;
H5591	015	1	1	02	01	H5591_015_1	4	1	2														00000000001100	Opiate Use DIsorder	Chronic Pain Syndrome				2	2			2		13a;14c;	1	2		1	200.00	3	13a;14c18;
H5591	015	2	1	02	01	H5591_015_2	4	3	2														00000000001100	History of Falls	Hip Fracture				2	2			2		14c;	1	2		1	250.00	3	14c1;14c8;
H5591	015	2	1	02	01	H5591_015_2	4	2	3								00000100010000000000																2		13i;	2	2		2			
H5591	015	2	1	02	01	H5591_015_2	4	1	2														00000000001100	Opiate Use DIsorder	Chronic Pain Syndrome				2	2			2		13a;14c;	1	2		1	200.00	3	13a;14c18;
H5593	001	0	1	01	01	H5593_001_0	4	1	1	10				01111	238273	238273																	2		10b;13i;13i-O;14c;		1	10b;13i;13i-O;14c;	1	300.00	5	10b2;13i1;13i4;13i-O1;
H5593	801	0	1	01	01	H5593_801_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H5593	802	0	1	01	01	H5593_802_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H5594	016	0	1	01	01	H5594_016_0	5	1	1	10				01111	2793	2793																	2		13i;		2		2			
H5594	017	0	1	01	01	H5594_017_0	5	1	1	10				01111	4163	4163																	2		13i;		2		2			
H5594	028	0	1	01	01	H5594_028_0	6	1	3								00001101000000000000																2		13i;		2		2			
H5594	029	0	1	01	01	H5594_029_0	5	1	3								00000000000010000000																2		13i;		2		2			
H5599	001	0	1	01	01	H5599_001_0	6	1	1	10				01111	49958	14987																	2		13d;		1	13d;	1	300.00	3	13d;
H5599	003	0	1	01	01	H5599_003_0	6	2	1	10				01111	1161	348																	2		13d;		1	13d;	1	300.00	3	13d;
H5599	003	0	1	01	01	H5599_003_0	6	1	3								01111111111111110000																2		13i;		1	13i;	1	600.00	3	13i10;
H5599	008	0	1	01	01	H5599_008_0	6	1	3								01111111111111110000																2		13i;		1	13i;	1	600.00	3	13i10;
H5599	008	0	1	01	01	H5599_008_0	6	2	1	10				01111	609	183																	2		13d;		1	13d;	1	300.00	3	13d;
H5608	001	0	1	01	01	H5608_001_0	8	1	3								01111111111111110000																1	001	13b;13i;		1	13b;13i;	2			
H5608	002	0	1	01	01	H5608_002_0	8	1	3								01111111111111110000																1	001	13b;13i;		1	13b;13i;	2			
H5619	001	0	1	01	01	H5619_001_0	2	1	3								00000001000000000000																1	001	13c;		2		2			
H5619	003	0	1	01	01	H5619_003_0	2	1	1	10				01111	4194	4194																	2		13b;13d;13e;13f;14c;		1	13b;13d;13e;13f;14c;	1	1800	3	13b;13d;13e;13f;14c8;
H5619	038	0	1	01	01	H5619_038_0	3	1	1	10				01111	14345	14345																	2		13b;13d;13e;13f;14c;		1	13b;13d;13e;13f;14c;	1	900	3	13b;13d;13e;13f;14c8;
H5619	041	0	1	01	01	H5619_041_0	3	1	3								00000101000010001000	Depression															1	001	13c;		2		2			
H5619	046	0	1	01	01	H5619_046_0	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H5619	046	0	1	01	01	H5619_046_0	3	1	3								00000101000010001000	Depression															1	001	13c;		2		2			
H5619	047	0	1	01	01	H5619_047_0	3	1	3								00000101000010001000	Depression															1	001	13c;		2		2			
H5619	049	0	1	02	01	H5619_049_0	4	1	1	01	1111111111	2	2		21719	21719																	2		13b;13d;13e;13i;14c;	1	2		1	600	3	13b;13d;13e;13i1;13i3;13i4;13i5;13i6;13i10;14c8;
H5619	052	0	1	01	01	H5619_052_0	4	1	1	01	1111111111	2	2		2352	2352																	2		13b;13d;13e;13i;14c;		2		1	600	3	13b;13d;13e;13i1;13i3;13i4;13i5;13i6;13i10;14c8;
H5619	053	0	1	02	01	H5619_053_0	4	1	1	01	1111111111	2	2		2066	2066																	2		13b;13d;13e;13i;14c;	1	2		1	600	3	13b;13d;13e;13i1;13i3;13i4;13i5;13i6;13i10;14c8;
H5619	054	0	1	01	01	H5619_054_0	4	1	1	10				01111	21052	21052																	2		13b;13d;13e;13f;14c;		1	13b;13d;13e;13f;14c;	1	1800	3	13b;13d;13e;13f;14c8;
H5619	055	0	1	01	01	H5619_055_0	5	1	3								01111111111111110000																1	001	13b;13i;13i-O;14c;		2		1	420	3	13b;13i1;13i3;13i4;13i5;13i6;13i10;13i-O1;14c8;
H5619	057	0	1	01	01	H5619_057_0	4	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5619	057	0	1	01	01	H5619_057_0	4	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H5619	059	0	1	01	01	H5619_059_0	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H5619	061	0	1	01	01	H5619_061_0	2	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H5619	061	0	1	01	01	H5619_061_0	2	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5619	063	0	1	01	01	H5619_063_0	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H5619	063	0	1	01	01	H5619_063_0	3	1	3								00000100000010000000																1	001	10b;13i;14c;		2		2			
H5619	065	0	1	01	01	H5619_065_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5619	066	0	1	01	01	H5619_066_0	3	1	3								00000001000000000000																1	001	13c;		1	13c;	2			
H5619	069	0	1	02	01	H5619_069_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5619	071	0	1	01	01	H5619_071_0	4	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5619	075	0	1	01	01	H5619_075_0	3	2	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5619	075	0	1	01	01	H5619_075_0	3	1	1	10				01111	5367	5367																	2		13b;13d;13e;13f;14c;		1	13b;13d;13e;13f;14c;	1	1200	3	13b;13d;13e;13f;14c8;
H5619	076	0	1	01	01	H5619_076_0	3	1	1	10				01111	945	945																	2		13b;13d;13e;13f;14c;		1	13b;13d;13e;13f;14c;	1	1500	3	13b;13d;13e;13f;14c8;
H5619	076	0	1	01	01	H5619_076_0	3	2	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5619	082	0	1	01	01	H5619_082_0	3	1	1	10				01111	20804	20804																	2		13b;13d;13e;13f;14c;		1	13b;13d;13e;13f;14c;	1	2100	3	13b;13d;13e;13f;14c8;
H5619	082	0	1	01	01	H5619_082_0	3	2	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5619	082	0	1	01	01	H5619_082_0	3	3	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		1	13d;	2			
H5619	087	0	1	01	01	H5619_087_0	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H5619	093	0	1	01	01	H5619_093_0	4	1	1	10				01111	19848	19848																	2		13b;13d;13e;13f;14c;		1	13b;13d;13e;13f;14c;	1	1500	3	13b;13d;13e;13f;14c8;
H5619	100	0	1	01	01	H5619_100_0	4	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5619	100	0	1	01	01	H5619_100_0	4	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H5619	111	0	1	02	01	H5619_111_0	4	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13c;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	2		1	1000	3	7b1;7f;10b1;13a;13b;13c;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5619	113	0	1	01	01	H5619_113_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5619	122	0	1	01	01	H5619_122_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5619	123	0	1	02	01	H5619_123_0	3	1	1	10				01111	11569	11569																	2		13b;13d;13e;13f;14c;	1	1	13b;13d;13e;13f;14c;	1	1800	3	13b;13d;13e;13f;14c8;
H5619	123	0	1	02	01	H5619_123_0	3	2	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13c;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13c;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1000	3	7b1;7f;10b1;13a;13b;13c;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5619	126	0	1	01	01	H5619_126_0	3	1	1	10				01111	2290	2290																	2		13b;13d;13e;13f;14c;		1	13b;13d;13e;13f;14c;	1	900	3	13b;13d;13e;13f;14c8;
H5619	126	0	1	01	01	H5619_126_0	3	2	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5619	134	0	1	01	01	H5619_134_0	2	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5619	134	0	1	01	01	H5619_134_0	2	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		1	13d;	2			
H5619	136	1	1	01	01	H5619_136_1	4	2	3								00011101000010001110	Chronic Kidney Disease (CKD)	Respiratory failure	Depression													1	001	13i;		1	13i;	2			
H5619	136	1	1	01	01	H5619_136_1	4	1	1	10				01111	2483	2483																	2		13b;13d;13e;13f;14c;		1	13b;13d;13e;13f;14c;	1	1500	3	13b;13d;13e;13f;14c8;
H5619	136	2	1	01	01	H5619_136_2	5	1	1	10				01111	2028	2028																	2		13b;13d;13e;13f;14c;		1	13b;13d;13e;13f;14c;	1	1500	3	13b;13d;13e;13f;14c8;
H5619	136	2	1	01	01	H5619_136_2	5	3	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		1	13d;	2			
H5619	136	2	1	01	01	H5619_136_2	5	2	3								00000100000010000000																1	001	10b;13i;14c;		1	10b;13i;14c;	2			
H5619	136	3	1	01	01	H5619_136_3	5	2	3								00011101000010001110	Chronic Kidney Disease (CKD)	Respiratory failure	Depression													1	001	14c;		1	14c;	2			
H5619	136	3	1	01	01	H5619_136_3	5	1	1	10				01111	1000	1000																	2		13b;13d;13e;13f;14c;		1	13b;13d;13e;13f;14c;	1	1500	3	13b;13d;13e;13f;14c8;
H5619	136	4	1	01	01	H5619_136_4	3	1	1	10				01111	10506	10506																	2		13b;13d;13e;13f;14c;		1	13b;13d;13e;13f;14c;	1	1500	3	13b;13d;13e;13f;14c8;
H5619	136	4	1	01	01	H5619_136_4	3	2	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5619	136	4	1	01	01	H5619_136_4	3	3	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		1	13d;	2			
H5619	137	0	1	01	01	H5619_137_0	2	1	3								00000001000000000000																1	001	13c;		2		2			
H5619	139	1	1	01	01	H5619_139_1	3	1	3								00000101000011000000																1	001	13c;		2		2			
H5619	139	1	1	01	01	H5619_139_1	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H5619	139	2	1	01	01	H5619_139_2	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H5619	139	2	1	01	01	H5619_139_2	3	1	3								00000101000011000000																1	001	13c;		2		2			
H5619	140	1	1	01	01	H5619_140_1	3	1	3								00000101000010001000	Depression															1	001	13c;		2		2			
H5619	140	2	1	01	01	H5619_140_2	3	1	3								00000101000010001000	Depression															1	001	13c;		2		2			
H5619	141	0	1	02	01	H5619_141_0	4	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13c;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	2		1	1420	3	7b1;7f;10b1;13a;13b;13c;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;13i-O4;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5619	145	0	1	01	01	H5619_145_0	5	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H5619	145	0	1	01	01	H5619_145_0	5	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13c;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	3200	3	7b1;7f;10b1;13a;13b;13c;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;13i-O4;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5619	152	0	1	01	01	H5619_152_0	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H5619	152	0	1	01	01	H5619_152_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5619	153	0	1	01	01	H5619_153_0	3	3	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5619	153	0	1	01	01	H5619_153_0	3	2	1	10				01111	360	360																	1	010	13b;13d;13e;13f;14c;		1	13b;13d;13e;13f;14c;	1	300	3	13b;13d;13e;13f;14c8;
H5619	153	0	1	01	01	H5619_153_0	3	1	1	10				01111	360	288																	2		13b;13d;13e;13f;14c;		1	13b;13d;13e;13f;14c;	1	2400	3	13b;13d;13e;13f;14c8;
H5619	153	0	1	01	01	H5619_153_0	3	4	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		1	13d;	2			
H5628	001	0	1	01	01	H5628_001_0	8	1	3								01111111111111110000																1	001	13d;13e;13i;13i-O;		2		1	1320.00	3	13d;13e;13i1;13i3;13i-O1;
H5628	007	0	1	01	01	H5628_007_0	7	1	3								01111111111111110000																1	001	13d;13e;13i;13i-O;		2		1	960.00	3	13d;13e;13i1;13i3;13i-O1;
H5628	008	0	1	01	01	H5628_008_0	8	1	3								01111111111111110000																1	001	13d;13e;13i;13i-O;		2		1	1920.00	3	13d;13e;13i1;13i3;13i-O1;
H5628	008	0	1	01	01	H5628_008_0	8	2	2														01000000000000										1	001	13c;		2		2			
H5628	010	0	1	01	01	H5628_010_0	7	1	3								01111111111111110000																1	001	13d;13e;13i;13i-O;		2		1	960.00	3	13d;13e;13i1;13i3;13i-O1;
H5628	011	0	1	01	01	H5628_011_0	7	1	3								01111111111111110000																1	001	13d;13e;13i;13i-O;		2		1	1080.00	3	13d;13e;13i1;13i3;13i-O1;
H5628	012	0	1	01	01	H5628_012_0	7	1	3								01111111111111110000																1	001	13d;13e;13i;13i-O;		2		1	1620.00	3	13d;13e;13i1;13i3;13i-O1;
H5649	001	0	1	01	01	H5649_001_0	7	1	3								00001111000010010000																2		13b;13i;		1	13b;13i;	2			
H5649	002	0	1	01	01	H5649_002_0	8	1	3								00001111000010010000																2		13b;13i;		1	13b;13i;	2			
H5649	006	0	1	01	01	H5649_006_0	7	1	3								00001111000010010000																2		13b;13i;		1	13b;13i;	2			
H5649	008	0	1	01	01	H5649_008_0	8	1	3								00001111000010010000																2		13b;13i;		1	13b;13i;	2			
H5649	009	0	1	01	01	H5649_009_0	8	1	3								00001111000010010000																2		13b;13i;		1	13b;13i;	2			
H5649	018	0	1	01	01	H5649_018_0	7	1	3								00001111000010010000																2		13b;13i;		1	13b;13i;	2			
H5649	019	0	1	01	01	H5649_019_0	8	1	3								00001111000010010000																2		13b;13i;		1	13b;13i;	2			
H5649	020	1	1	01	01	H5649_020_1	7	1	3								00001111000010010000																2		13b;13i;		1	13b;13i;	2			
H5649	020	2	1	01	01	H5649_020_2	7	1	3								00001111000010010000																2		13b;13i;		1	13b;13i;	2			
H5649	021	1	1	01	01	H5649_021_1	7	1	3								00001111000010010000																2		13b;13i;		1	13b;13i;	2			
H5649	021	2	1	01	01	H5649_021_2	7	1	3								00001111000010010000																2		13b;13i;		1	13b;13i;	2			
H5774	003	0	1	01	01	H5774_003_0	7	1	3								01111111111111110000																2		10b;13b;13i;		2		1	75.00	7	10b1;13b;13i1;13i6;13i10;
H5774	005	0	1	01	01	H5774_005_0	8	1	3								01111111111111110000																2		10b;13b;13i;		2		1	50.00	7	10b1;13b;13i1;13i6;13i10;
H5774	022	0	1	01	01	H5774_022_0	8	1	2														10110000001111	Oncology Patients with Active Chemo by Infusion or systemic radiotherapy	Acute Stroke	Abdominal, Hip, knee or open heart surgery	COPD patients with supplemental oxygen dependency	Bedridden patients	2	2			2		14c;		2		2			
H5774	022	0	1	01	01	H5774_022_0	8	2	2														00000000001000	Bedridden patients with specific essential services requirements									2		14c;		2		2			
H5774	024	0	1	01	01	H5774_024_0	8	1	2														10110000001111	Oncology Patients with Active Chemo by Infusion or systemic radiotherapy	Acute Stroke	Abdominal, Hip, knee or open heart surg	COPD patients with supplemental oxygen dependency	Bedridden patients	2	2			2		14c;		2		2			
H5774	024	0	1	01	01	H5774_024_0	8	2	2														00000000001000	Bedridden patients with specific essential services requirements									2		14c;		2		2			
H5774	025	0	1	01	01	H5774_025_0	8	3	2														00000000001000	Bedridden patients with specific essential services requirements									2		14c;		2		2			
H5774	025	0	1	01	01	H5774_025_0	8	2	3								01111111111111110000																2		10b;13b;13i;		2		1	75.00	7	10b1;13b;13i1;13i6;13i10;
H5774	025	0	1	01	01	H5774_025_0	8	1	2														10110000001111	Oncology Patients with Active Chemo by Infusion or systemic radiotherapy	Acute Stroke	Abdominal, Hip, knee or open heart surgery	COPD patients with supplemental oxygen dependency	Bedridden patients	2	2			2		14c;		2		2			
H5774	026	0	1	01	01	H5774_026_0	8	2	2														00000000001000	Bedridden patients with specific essential services requirements									2		14c;		2		2			
H5774	026	0	1	01	01	H5774_026_0	8	3	1	10				10000	4304	4304																	2		10b;13b;13d;13i;		2		1	50.00	7	10b1;13b;13i1;13i6;13i10;
H5774	026	0	1	01	01	H5774_026_0	8	1	2														10110000001111	Oncology Patients with Active Chemo by Infusion or systemic radiotherapy	Acute Stroke	Abdominal, Hip, knee or open heart surgery	COPD patients with supplemental oxygen dependency	Bedridden patients	2	2			2		14c;		2		2			
H5774	028	0	1	01	01	H5774_028_0	8	1	2														10110000001111	Oncology Patients with Active Chemo by Infusion or systemic radiotherapy	Acute Stroke	Abdominal, Hip, knee or open heart surgery	COPD patients with supplemental oxygen dependency	Bedridden patients	2	2			2		14c;		2		2			
H5774	028	0	1	01	01	H5774_028_0	8	2	2														00000000001000	Bedridden patients with specific essential services requirements									2		14c;		2		2			
H5774	031	0	1	02	01	H5774_031_0	8	1	2														10110000001111	Oncology Patients with Active Chemo by Infusion or systemic radiotherapy	Acute Stroke	Abdominal, Hip, knee or open heart surgery	COPD patients with supplemental oxygen dependency	Bedridden patients	2	2			2		14c;	2	2		2			
H5774	035	0	1	01	01	H5774_035_0	8	1	1	10				10000	830	830																	2		10b;13b;13i;		2		1	150.00	7	10b1;13b;13i1;13i6;13i10;
H5774	036	0	1	01	01	H5774_036_0	8	1	3								01111111111111110000																2		10b;13b;13i;		2		1	75.00	7	10b1;13b;13i1;13i6;13i10;
H5779	007	0	1	01	01	H5779_007_0	4	1	3								01111111111111110000																2		13i;		1	13i;	2			
H5793	017	0	1	02	01	H5793_017_0	7	1	1	10				01111	238273	238273																	2		10b;13i;13i-O;14c;	2	1	10b;13i;13i-O;14c;	1	200.00	5	10b2;13i1;13i4;13i-O1;
H5793	019	0	1	02	01	H5793_019_0	3	1	3								01111111111111111100	Hyperlipidemia	Hypertension														2		13i;	2	1	13i;	1	240.00	5	13i1;
H5793	801	0	1	01	01	H5793_801_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H5793	802	0	1	01	01	H5793_802_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H5810	001	0	1	01	01	H5810_001_0	7	1	3								01111111111111110000																1	001	13d;13e;13i;13i-O;		2		1	1260.00	3	13d;13e;13i1;13i3;13i-O1;
H5810	013	0	1	01	01	H5810_013_0	8	1	3								01111111111111110000																1	001	13d;13e;13i;13i-O;		2		1	1584.00	3	13d;13e;13i1;13i3;13i-O1;
H5810	014	0	1	01	01	H5810_014_0	7	1	3								01111111111111110000																1	001	13d;13e;13i;13i-O;		2		1	960.00	3	13d;13e;13i1;13i3;13i-O1;
H5810	016	0	1	01	01	H5810_016_0	7	1	3								01111111111111110000																1	001	13d;13e;13i;13i-O;		2		1	1560.00	3	13d;13e;13i1;13i3;13i-O1;
H5823	006	0	1	01	01	H5823_006_0	8	1	3								01111111111111110000																1	001	13d;13e;13i;13i-O;		2		1	1620.00	3	13d;13e;13i1;13i3;13i-O1;
H5823	010	0	1	01	01	H5823_010_0	8	1	3								01111111111111110000																1	001	13d;13e;13i;13i-O;		2		1	1080.00	3	13d;13e;13i1;13i3;13i-O1;
H5823	011	0	1	01	01	H5823_011_0	7	1	3								01111111111111110000																1	001	13d;13e;13i;13i-O;		2		1	960.00	3	13d;13e;13i1;13i3;13i-O1;
H5826	006	0	1	01	01	H5826_006_0	4	3	2														10000000001111	Hypertension	Prehypertension	Congestive Heart Failure (CHF)	Morbid obesity	Obesity with co-occurring disorders	2	2			1	001	13b;		2		2			
H5826	006	0	1	01	01	H5826_006_0	4	2	2														00111000011100	Frailty or osteoporosis	History of acute MI or angina or Parkinson's or fall risk or seizures				2	2			1	001	14c;		2		2			
H5826	006	0	1	01	01	H5826_006_0	4	1	2														01000000000000										2		7f;		2		2			
H5826	008	0	1	01	01	H5826_008_0	5	2	2														00111000011100	Frailty or osteoporosis	History of acute MI or angina or Parkinson's or fall risk or seizures				2	2			1	001	14c;		2		2			
H5826	008	0	1	01	01	H5826_008_0	5	3	2														10000000001111	Hypertension	Prehypertension	Congestive Heart Failure (CHF)	Morbid obesity	Obesity with co-occurring disorders	2	2			1	001	13b;		2		2			
H5826	008	0	1	01	01	H5826_008_0	5	1	2														01000000000000										2		7f;		2		2			
H5826	009	0	1	01	01	H5826_009_0	5	1	2														01000000000000										2		7f;		2		2			
H5826	009	0	1	01	01	H5826_009_0	5	3	2														10000000001111	Hypertension	Prehypertension	Congestive Heart Failure (CHF)	Morbid obesity	Obesity with co-occurring disorders	2	2			1	001	13b;		2		2			
H5826	009	0	1	01	01	H5826_009_0	5	2	2														00111000011100	Frailty or osteoporosis	History of acute MI or angina or Parkinson's or fall risk or seizures				2	2			1	001	14c;		2		2			
H5826	010	0	1	01	01	H5826_010_0	5	3	2														01000000000000										2		7f;		2		2			
H5826	010	0	1	01	01	H5826_010_0	5	1	2														10000000001111	Hypertension	Prehypertension	Congestive Heart Failure (CHF)	Morbid obesity	Obesity with co-occurring disorders	2	2			1	001	13b;		2		2			
H5826	010	0	1	01	01	H5826_010_0	5	2	2														00111000011100	Frailty or osteoporosis	History of acute MI or angina or Parkinson's or fall risk or seizures				2	2			1	001	14c;		2		2			
H5826	014	0	1	01	01	H5826_014_0	6	2	2														00111000011100	Frailty or osteoporosis	History of acute MI or angina or Parkinson's or fall risk or seizures				2	2			1	001	14c;		2		2			
H5826	014	0	1	01	01	H5826_014_0	6	1	2														01000000000000										2		7f;		2		2			
H5826	014	0	1	01	01	H5826_014_0	6	3	2														10000000001111	Hypertension	Prehypertension	Congestive Heart Failure (CHF)	Morbid obesity	Obesity with co-occurring disorders	2	2			1	001	13b;		2		2			
H5826	014	0	1	01	01	H5826_014_0	6	4	1	10				01111	9709	9709																	2		13i;		2		1	50.00	7	13i1;
H5826	016	0	1	01	01	H5826_016_0	5	2	2														00111000011100	Frailty or osteoporosis	History of acute MI or angina or Parkinsons or fall risk or seizures				2	2			1	001	14c;		2		2			
H5826	016	0	1	01	01	H5826_016_0	5	1	2														01000000000000										2		7f;		2		2			
H5826	016	0	1	01	01	H5826_016_0	5	3	2														10000000001111	Hypertension	Prehypertension	Congestive Heart Failure (CHF)	Morbid obesity	Obesity with co-occurring disorders	2	2			1	001	13b;		2		2			
H5828	001	0	1	01	01	H5828_001_0	5	1	1	10				01111	291	150																	2		13i;		2		2			
H5828	001	0	1	01	01	H5828_001_0	5	2	1	10				01111	291	291																	2		13i;		2		2			
H5828	001	0	1	01	01	H5828_001_0	5	3	1	10				01111	291	291																	2		13i;		2		2			
H5828	002	0	1	01	01	H5828_002_0	5	1	1	10				01111	14010	7229																	2		13i;		2		2			
H5828	002	0	1	01	01	H5828_002_0	5	4	1	10				01111	14010	14010																	2		13i-O;		2		2			
H5828	002	0	1	01	01	H5828_002_0	5	3	1	10				01111	14010	14010																	2		13i;		2		2			
H5828	002	0	1	01	01	H5828_002_0	5	2	1	10				01111	14010	14010																	2		13i;		2		2			
H5828	005	0	1	02	01	H5828_005_0	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;13i-O;	2	2		2			
H5828	008	0	1	01	01	H5828_008_0	5	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;13i-O;		2		2			
H5843	001	0	1	01	01	H5843_001_0	8	1	1	01	0100000000				865	87																	1	001	13d;		2		2			
H5843	002	0	1	01	01	H5843_002_0	9	1	1	01	0100000000				675	68																	1	001	13d;		2		2			
H5843	005	0	1	01	01	H5843_005_0	9	1	1	01	0100000000				633	63																	1	001	13d;		2		2			
H5852	001	0	1	01	01	H5852_001_0	5	1	2														00000000001000	AIDS-Related Neuropathy									2		14c;		2		2			
H5854	012	0	1	02	01	H5854_012_0	7	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;	2	2		2			
H5854	013	0	1	01	01	H5854_013_0	6	5	1	10				01111	12765	12765																	2		13i-O;		2		2			
H5854	013	0	1	01	01	H5854_013_0	6	4	1	10				01111	12765	12765																	2		13i;		2		2			
H5854	013	0	1	01	01	H5854_013_0	6	3	1	10				01111	12765	12765																	2		13i;		2		2			
H5854	013	0	1	01	01	H5854_013_0	6	2	1	10				01111	12765	12765																	2		13i;		2		2			
H5854	013	0	1	01	01	H5854_013_0	6	1	1	10				01111	12765	6587																	2		13i;		2		2			
H5854	015	0	1	01	01	H5854_015_0	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H5859	001	0	1	02	01	H5859_001_0	13	2	2														00000100000000										2		13b;	2	2		2			
H5859	001	0	1	02	01	H5859_001_0	13	1	1	10				01111	18378	10291																	2		13i;	2	2		2			
H5883	001	1	1	02	01	H5883_001_1	5	1	3								00001101000010011100	Hypertension	Rheumatoid arthritis														2		13i;	2	2		1	0.00	5	13i1;
H5883	001	2	1	02	01	H5883_001_2	5	1	3								00001101000010011100	Hypertension	Rheumatoid arthritis														2		13i;	2	2		1	0.00	5	13i1;
H5883	001	3	1	02	01	H5883_001_3	5	1	3								00001101000010011100	Hypertension	Rheumatoid arthritis														2		13i;	2	2		1	0.00	5	13i1;
H5883	001	4	1	02	01	H5883_001_4	5	1	3								00001101000010011100	Hypertension	Rheumatoid arthritis														2		13i;	2	2		1	0.00	5	13i1;
H5883	001	5	1	02	01	H5883_001_5	5	1	3								00001101000010011100	Hypertension	Rheumatoid arthritis														2		13i;	2	2		1	0.00	5	13i1;
H5883	002	1	1	02	01	H5883_002_1	6	1	3								00001101000010011100	Hypertension	Rheumatoid arthritis														2		13i;	2	2		1	0.00	5	13i1;
H5883	002	2	1	02	01	H5883_002_2	6	1	3								00001101000010011100	Hypertension	Rheumatoid arthritis														2		13i;	2	2		1	0.00	5	13i1;
H5883	002	3	1	02	01	H5883_002_3	6	1	3								00001101000010011100	Hypertension	Rheumatoid arthritis														2		13i;	2	2		1	0.00	5	13i1;
H5883	002	4	1	02	01	H5883_002_4	5	1	3								00001101000010011100	Hypertension	Rheumatoid arthritis														2		13i;	2	2		1	0.00	5	13i1;
H5883	002	7	1	02	01	H5883_002_7	5	1	3								00001101000010011100	Hypertension	Rheumatoid arthritis														2		13i;	2	2		1	0.00	5	13i1;
H5883	003	1	1	02	01	H5883_003_1	5	1	3								00001101000010011100	Hypertension	Rheumatoid Arthritis														2		13i;	2	2		1	0.00	5	13i1;
H5883	003	2	1	02	01	H5883_003_2	6	1	3								00001101000010011100	Hypertension	Rheumatoid Arthritis														2		13i;	2	2		1	0.00	5	13i1;
H5883	003	3	1	02	01	H5883_003_3	5	1	3								00001101000010011100	Hypertension	Rheumatoid Arthritis														2		13i;	2	2		1	0.00	5	13i1;
H5883	003	4	1	02	01	H5883_003_4	5	1	3								00001101000010011100	Hypertension	Rheumatoid Arthritis														2		13i;	2	2		1	0.00	5	13i1;
H5883	003	5	1	02	01	H5883_003_5	5	1	3								00001101000010011100	Hypertension	Rheumatoid Arthritis														2		13i;	2	2		1	0.00	5	13i1;
H5883	007	0	1	01	01	H5883_007_0	5	1	3								00001101000010011100	Hypertension	Rheumatoid arthritis														2		13i;		2		1	0.00	5	13i1;
H5883	012	1	1	02	01	H5883_012_1	5	1	3								00001101000010011100	Hypertension	Rheumatoid arthritis														2		13i;	2	2		1	0.00	5	13i1;
H5883	012	2	1	02	01	H5883_012_2	5	1	3								00001101000010011100	Hypertension	Rheumatoid arthritis														2		13i;	2	2		1	0.00	5	13i1;
H5883	014	1	1	02	01	H5883_014_1	5	1	3								00001101000010011100	Hypertension	Rheumatoid arthritis														2		13i;	2	2		1	0.00	5	13i1;
H5883	014	2	1	02	01	H5883_014_2	5	1	3								00001101000010011100	Hypertension	Rheumatoid arthritis														2		13i;	2	2		1	0.00	5	13i1;
H5883	014	3	1	02	01	H5883_014_3	5	1	3								00001101000010011100	Hypertension	Rheumatoid Arthritis														2		13i;	2	2		1	0.00	5	13i1;
H5883	014	4	1	02	01	H5883_014_4	5	1	3								00001101000010011100	Hypertension	Rheumatoid arthritis														2		13i;	2	2		1	0.00	5	13i1;
H5883	014	5	1	02	01	H5883_014_5	5	1	3								00001101000010011100	Hypertension	Rheumatoid arthritis														2		13i;	2	2		1	0.00	5	13i1;
H5883	015	0	1	01	01	H5883_015_0	6	1	3								00001101000010011100	Hypertension	Rheumatoid Arthritis														2		13i;		2		1	0.00	5	13i1;
H5926	001	0	1	01	01	H5926_001_0	7	1	3								01111111111111110000																1	001	13d;13e;13i;13i-O;		2		1	984.00	3	13d;13e;13i1;13i3;13i-O1;
H5926	005	0	1	01	01	H5926_005_0	9	1	3								01111111111111110000																1	001	13d;13e;13i;13i-O;		2		1	1080.00	3	13d;13e;13i1;13i3;13i-O1;
H5926	006	0	1	01	01	H5926_006_0	7	1	3								01111111111111110000																1	001	13d;13e;13i;13i-O;		2		1	1140.00	3	13d;13e;13i1;13i3;13i-O1;
H5928	054	0	1	01	01	H5928_054_0	5	1	3								00011101010010010000																2		13i;13i-O;		1	13i;13i-O;	2			
H5932	001	0	1	01	01	H5932_001_0	11	3	1	10				01111	35541	24879																	2		13i;		1	13i;	1	100.00	5	13i10;
H5932	001	0	1	01	01	H5932_001_0	11	1	1	10				01111	35541	24879																	2		13i;		1	13i;	1	135.00	7	13i1;
H5932	001	0	1	01	01	H5932_001_0	11	2	1	10				01111	35541	6287																	2		13i;		1	13i;	2			
H5932	012	0	1	01	01	H5932_012_0	11	1	1	10				01111	1460	1022																	2		13i;		1	13i;	1	135.00	7	13i1;
H5932	012	0	1	01	01	H5932_012_0	11	3	1	10				01111	1460	1022																	2		13i;		1	13i;	1	100.00	5	13i10;
H5932	012	0	1	01	01	H5932_012_0	11	2	1	10				01111	1460	258																	2		13i;		1	13i;	2			
H5937	001	0	1	01	01	H5937_001_0	7	1	3								01000001000000001100	Hypertension	Lipid disorder														2		10b;13i;		1	10b;13i;	2			
H5943	001	0	1	02	01	H5943_001_0	9	1	3								00011111010000101000	Peritoneal Dialysis Catheter or Peritoneal Dialysis Prescription															2		13i;13i-O;	2	2		2			
H5943	002	0	1	02	01	H5943_002_0	8	1	3								00011111010000100000																2		13i;	2	2		2			
H5945	001	0	1	01	01	H5945_001_0	5	1	3								00000000010000000000																1	001	13i;		2		1	250.00	7	13i1;
H5945	002	0	1	01	01	H5945_002_0	5	1	3								01111111111111111110	Hypertension	Morbid Obesity	Heart Arrythmias													1	001	13i;		2		1	250.00	7	13i1;
H5945	008	0	1	01	01	H5945_008_0	6	1	3								01111111111111111110	Hypertension	Morbid Obesity	Heart Arrythmias													1	001	13i;		2		1	250.00	7	13i1;
H5945	009	0	1	01	01	H5945_009_0	4	2	1	10				01111	387	309																	1	001	13i;		2		1	25.00	7	13i1;
H5945	009	0	1	01	01	H5945_009_0	4	1	3								01111111111111111110	Hypertension	Morbid Obesity	Heart Arrythmias													1	001	13i;		2		1	250.00	7	13i1;
H5965	002	0	1	04	01	H5965_002_0	4	1	3								01111111111111110000																2		13i;	1	1	13i;	2			
H5965	003	0	1	04	01	H5965_003_0	3	1	3								01111111111111110000																2		13i;	1	1	13i;	2			
H5965	004	0	1	04	01	H5965_004_0	5	2	1	10				01111	566	170																	2		13d;	1	1	13d;	1	300.00	3	13d;
H5965	004	0	1	04	01	H5965_004_0	5	1	3								01111111111111110000																2		13i;	1	1	13i;	1	600.00	3	13i10;
H5969	002	0	1	01	01	H5969_002_0	4	1	1	10				01111	3250	3250																	2		13b;13d;		2		1	50.00	7	13b;13d;
H5970	020	0	1	04	01	H5970_020_0	2	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H5970	020	0	1	04	01	H5970_020_0	2	2	1	10				01111	11580	11580																	2		13b;13d;13e;13f;14c;	1	1	13b;13d;13e;13f;14c;	1	2400	3	13b;13d;13e;13f;14c8;
H5970	024	1	1	04	01	H5970_024_1	2	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5970	024	2	1	04	01	H5970_024_2	2	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H5970	026	0	1	04	01	H5970_026_0	2	1	1	10				01111	2230	2230																	2		13b;13d;13e;13f;14c;	1	1	13b;13d;13e;13f;14c;	1	2400	3	13b;13d;13e;13f;14c8;
H5970	026	0	1	04	01	H5970_026_0	2	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	1	13d;	2			
H5991	010	0	1	01	01	H5991_010_0	11	1	1	10				01111	971	922																	2		13b;		2		1	150.00	7	13b;
H5992	007	0	1	01	01	H5992_007_0	11	1	3								01111111111111110000																1	001	13d;13e;13i;13i-O;		2		1	1480.00	3	13d;13e;13i1;13i3;13i-O1;
H5992	008	0	1	01	01	H5992_008_0	9	1	3								01111111111111110000																1	001	13d;13e;13i;13i-O;		2		1	1200.00	3	13d;13e;13i1;13i3;13i-O1;
H6019	001	0	1	01	01	H6019_001_0	5	1	3								11111111111111111111	Hypertension	Obesity	Arthritis	Glaucoma	Developmental Disorders/Disabilities											2		13i;		2		1	65.00	5	13i1;
H6062	005	0	1	01	01	H6062_005_0	8	1	3								00001101000000000000																2		13b;13i;		2		2			
H6062	006	0	1	01	01	H6062_006_0	8	1	3								00001101000000000000																2		13b;13i;		2		2			
H6062	009	0	1	01	01	H6062_009_0	8	1	1	10				01111	100	60																	2		13b;13i;		2		1	150.00	7	13b;13i1;13i10;
H6062	009	0	1	01	01	H6062_009_0	8	2	1	10				01111	100	60																	2		13c;		2		2			
H6062	010	0	1	01	01	H6062_010_0	8	2	1	10				01111	100	60																	2		13c;		2		2			
H6062	010	0	1	01	01	H6062_010_0	8	1	1	10				01111	100	60																	2		13b;13i;		2		1	150.00	7	13b;13i1;13i10;
H6067	001	1	1	01	01	H6067_001_1	9	1	2														01000000000000										1	001	13b;13d;		2		2			
H6067	001	2	1	01	01	H6067_001_2	10	1	2														01000000000000										1	001	13b;13d;		2		2			
H6067	002	1	1	01	01	H6067_002_1	10	1	2														01000000000000										1	001	13b;13d;		2		2			
H6067	002	2	1	01	01	H6067_002_2	11	1	2														01000000000000										1	001	13b;13d;		2		2			
H6154	001	0	1	02	01	H6154_001_0	5	1	3								00011111111010110000																1	001	13i;14c;	2	2		2			
H6154	002	0	1	02	01	H6154_002_0	4	1	3								00011111111010110000																2		13i;	2	2		2			
H6158	001	0	1	01	01	H6158_001_0	4	1	3								00010001000000011100	Coronary artery disease	Sjgrens Syndrome														2		16a;16b;		2		2			
H6158	003	0	1	01	01	H6158_003_0	4	1	3								00010001000000011100	Coronary artery disease	Sjgrens Syndrome														2		16a;16b;		2		2			
H6237	006	0	1	01	01	H6237_006_0	6	1	2														01000000000000										2		7f;		2		2			
H6237	006	0	1	01	01	H6237_006_0	6	3	3								01111111111111110000																1	001	13i;		2		2			
H6237	006	0	1	01	01	H6237_006_0	6	2	2														00000000001000	Pre-diabetes									2		14c;		2		2			
H6237	007	1	1	01	01	H6237_007_1	9	1	2														01000000000000										2		7f;		2		2			
H6237	007	1	1	01	01	H6237_007_1	9	2	2														00000000001000	Pre-diabetes									2		14c;		2		2			
H6237	007	1	1	01	01	H6237_007_1	9	3	3								01111111111111110000																1	001	13i;		2		2			
H6237	007	3	1	01	01	H6237_007_3	9	3	3								01111111111111110000																1	001	13i;		2		2			
H6237	007	3	1	01	01	H6237_007_3	9	1	2														01000000000000										2		7f;		2		2			
H6237	007	3	1	01	01	H6237_007_3	9	2	2														00000000001000	Pre-diabetes									2		14c;		2		2			
H6237	008	1	1	01	01	H6237_008_1	8	2	2														00000000001000	Pre-diabetes									2		14c;		2		2			
H6237	008	1	1	01	01	H6237_008_1	8	3	3								01111111111111110000																1	001	13i;		2		2			
H6237	008	1	1	01	01	H6237_008_1	8	1	2														01000000000000										2		7f;		2		2			
H6237	008	3	1	01	01	H6237_008_3	8	1	2														01000000000000										2		7f;		2		2			
H6237	008	3	1	01	01	H6237_008_3	8	2	2														00000000001000	Pre-diabetes									2		14c;		2		2			
H6237	008	3	1	01	01	H6237_008_3	8	3	3								01111111111111110000																1	001	13i;		2		2			
H6316	002	0	1	01	01	H6316_002_0	5	1	1	10				01111	30	15																	2		13i;		2		2			
H6316	002	0	1	01	01	H6316_002_0	5	2	1	10				01111	30	30																	2		13i;		2		2			
H6316	002	0	1	01	01	H6316_002_0	5	3	1	10				01111	30	30																	2		13i;		2		2			
H6316	002	0	1	01	01	H6316_002_0	5	4	1	10				01111	30	30																	2		13i-O;		2		2			
H6328	001	0	1	04	01	H6328_001_0	5	1	2														10100000001111	Simple pneumonia & pleurisy	Bronchitis & asthma & other respiratory system diagnoses	Heart Failure & Shock	Cellulitis	Kidney & urinary tract infections	2	2			2		13d;	1	2		2			
H6328	002	0	1	04	01	H6328_002_0	5	1	2														10100000001111	Simple pneumonia & pleurisy	Bronchitis & asthma & other respiratory system diagnoses	Heart Failure & Shock	Cellulitis	Kidney & urinary tract infections	2	2			2		13d;	1	2		2			
H6328	003	0	1	04	01	H6328_003_0	5	1	2														10100000001111	Simple pneumonia & pleurisy	Bronchitis & asthma & other respiratory system diagnoses	Heart Failure & Shock	Cellulitis	Kidney & urinary tract infections	2	2			2		13d;	1	2		2			
H6328	005	0	1	04	01	H6328_005_0	4	1	2														10100000001111	Simple pneumonia & pleurisy	Bronchitis & asthma & other respiratory system diagnoses	Heart Failure & Shock	Cellulitis	Kidney & urinary tract infections	2	2			2		13d;	1	2		2			
H6328	801	0	1	04	01	H6328_801_0	4	1	2														10100000001111	Simple pneumonia & pleurisy	Bronchitis & asthma & other respiratory system diagnoses	Heart Failure & Shock	Cellulitis	Kidney & urinary tract infections	2	2			2		13d;	1	2		2			
H6328	802	0	1	04	01	H6328_802_0	4	1	2														10100000001111	Simple pneumonia & pleurisy	Bronchitis & asthma & other respiratory system diagnoses	Heart Failure & Shock	Cellulitis	Kidney & urinary tract infections	2	2			2		13d;	1	2		2			
H6328	803	0	1	04	01	H6328_803_0	4	1	2														10100000001111	Simple pneumonia & pleurisy	Bronchitis & asthma & other respiratory system diagnoses	Heart Failure & Shock	Cellulitis	Kidney & urinary tract infections	2	2			2		13d;	1	2		2			
H6328	804	0	1	04	01	H6328_804_0	4	1	2														10100000001111	Simple pneumonia & pleurisy	Bronchitis & asthma & other respiratory system diagnoses	Heart Failure & Shock	Cellulitis	Kidney & urinary tract infections	2	2			2		13d;	1	2		2			
H6348	006	0	1	04	01	H6348_006_0	5	1	3								01111111111111110000																2		13i;	1	1	13i;	1	600	3	13i10;
H6348	006	0	1	04	01	H6348_006_0	5	2	1	10				01111	720	216																	2		13d;	1	1	13d;	1	300.00	3	13d;
H6351	004	0	1	01	01	H6351_004_0	5	1	3								00000101010000001000	COPD															2		13i;		2		2			
H6351	005	0	1	01	01	H6351_005_0	5	1	3								00000101010000001000	COPD															2		14c;		2		2			
H6379	001	0	1	01	01	H6379_001_0	6	1	3								00001101000011000000																2		13i;		2		1	55.00	7	13i1;
H6396	005	0	1	01	01	H6396_005_0	9	1	3								11111111111111111111	Obesity	Musculoskeletal Conditions	Traumatic Injury	Traumatic Brain Injury	Sensory Impairment											2		13i;		1	13i;	2			
H6396	014	0	1	01	01	H6396_014_0	8	1	3								11111111111111111111	Obesity	Musculoskeletal Conditions	Traumatic Injury	Traumatic Brain Injury	Sensory Impairment											2		13i;		1	13i;	2			
H6396	015	0	1	01	01	H6396_015_0	8	1	3								11111111111111111111	Obesity	Musculoskeletal Conditions	Traumatic Injury	Traumatic Brain Injury	Sensory Impairment											2		13i;		1	13i;	2			
H6399	001	0	1	01	01	H6399_001_0	4	1	1	10				01111	238273	238273																	2		13i;14c;		1	13i;14c;	2			
H6446	014	0	1	01	01	H6446_014_0	5	1	3								01111111111111110000																2		13i;		1	13i;	1	600	3	13i10;
H6446	014	0	1	01	01	H6446_014_0	5	2	1	10				01111	1625	488																	2		13d;		1	13d;	1	300.00	3	13d;
H6446	016	0	1	01	01	H6446_016_0	5	2	1	10				01111	582	175																	2		13d;		1	13d;	1	300.00	3	13d;
H6446	016	0	1	01	01	H6446_016_0	5	1	3								01111111111111110000																2		13i;		1	13i;	1	600	3	13i10;
H6446	017	0	1	01	01	H6446_017_0	4	1	3								01111111111111110000																2		13i;14c;		1	13i;14c;	2			
H6502	002	0	1	04	01	H6502_002_0	5	1	2														00000000001000	Neuropathy and other circulatory diseases									1	010	7f;	1	2		2			
H6502	003	0	1	04	01	H6502_003_0	8	1	2														00000000001000	Neuropathy and other circulatory diseases									1	010	7f;	1	2		2			
H6502	004	0	1	04	01	H6502_004_0	7	1	2														00000000001000	Neuropathy and other circulatory diseases									1	010	7f;	1	2		2			
H6502	005	0	1	04	01	H6502_005_0	6	1	2														00000000001000	Neuropathy and other circulatory diseases									1	010	7f;	1	2		2			
H6528	038	0	1	04	01	H6528_038_0	2	1	3								00001101000000000000																2		13i;	1	1	13i;	2			
H6528	039	0	1	04	01	H6528_039_0	2	1	3								00001101000000000000																2		13i;	1	1	13i;	2			
H6550	004	0	1	01	01	H6550_004_0	5	2	1	10				01111	2170	651																	2		13d;		1	13d;	1	300.00	3	13d;
H6550	004	0	1	01	01	H6550_004_0	5	1	3								01111111111111110000																2		13i;		1	13i;	2			
H6550	009	0	1	01	01	H6550_009_0	5	2	1	10				01111	455	137																	2		13d;		1	13d;	1	300.00	3	13d;
H6550	009	0	1	01	01	H6550_009_0	5	1	3								01111111111111110000																2		13i;		1	13i;	2			
H6594	003	0	1	04	01	H6594_003_0	4	1	3								01111111111111110000																2		13i;	1	1	13i;	1	1200	3	13i10;
H6594	004	0	1	04	01	H6594_004_0	4	1	3								01111111111111110000																2		13i;	1	1	13i;	1	600	3	13i10;
H6595	003	0	1	02	01	H6595_003_0	2	1	1	10				01111	831	706																	2		13d;	2	1	13d;	2			
H6595	004	0	1	02	01	H6595_004_0	2	1	1	10				01111	14079	11967																	2		13d;	2	1	13d;	2			
H6622	004	0	1	01	01	H6622_004_0	4	1	1	01	1111111111	2	2		22984	22984																	2		13b;13d;13e;13i;14c;		2		1	600	3	13b;13d;13e;13i1;13i3;13i4;13i5;13i6;13i10;14c8;
H6622	004	0	1	01	01	H6622_004_0	4	3	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H6622	004	0	1	01	01	H6622_004_0	4	2	3								00000101000010001000	Depression															1	001	13c;		2		2			
H6622	005	0	1	01	01	H6622_005_0	4	2	3								00000101000010001000	Depression															1	001	13c;		1	13c;	2			
H6622	005	0	1	01	01	H6622_005_0	4	1	1	01	1111111111	2	2		25416	25416																	2		13b;13d;13e;13i;14c;		2		1	600	3	13b;13d;13e;13i1;13i3;13i4;13i5;13i6;13i10;14c8;
H6622	008	0	1	01	01	H6622_008_0	2	1	1	10				01111	4217	4217																	2		13b;13d;13e;13f;14c;		1	13b;13d;13e;13f;14c;	1	900	3	13b;13d;13e;13f;14c8;
H6622	008	0	1	01	01	H6622_008_0	2	2	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H6622	010	0	1	02	01	H6622_010_0	4	1	3								00000101000010001000	Depression															1	001	13c;	1	2		2			
H6622	013	0	1	02	01	H6622_013_0	5	1	1	01	1111111111	2	2		16507	14463																	2		13b;13d;13e;13i;14c;	1	2		1	600	3	13b;13d;13e;13i1;13i3;13i4;13i5;13i6;13i10;14c8;
H6622	013	0	1	02	01	H6622_013_0	5	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H6622	014	0	1	02	01	H6622_014_0	4	1	1	01	1111111111	2	2		11184	9625																	2		13b;13d;13e;13i;14c;	1	2		1	600	3	13b;13d;13e;13i1;13i3;13i4;13i5;13i6;13i10;14c8;
H6622	015	0	1	01	01	H6622_015_0	4	1	1	10				01111	12061	13125																	2		13b;13d;13e;13f;14c;		1	13b;13d;13e;13f;14c;	1	2100	3	13b;13d;13e;13f;14c8;
H6622	015	0	1	01	01	H6622_015_0	4	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		1	13d;	2			
H6622	017	0	1	01	01	H6622_017_0	5	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H6622	017	0	1	01	01	H6622_017_0	5	1	3								01111111111111110000																1	001	13b;13i;13i-O;14c;		2		1	420	3	13b;13i1;13i3;13i4;13i5;13i6;13i10;13i-O1;14c8;
H6622	018	0	1	01	01	H6622_018_0	4	1	1	10				01111	1087	1087																	2		13b;13d;13e;13f;14c;		1	13b;13d;13e;13f;14c;	1	2100	3	13b;13d;13e;13f;14c8;
H6622	019	0	1	01	01	H6622_019_0	4	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H6622	021	1	1	02	01	H6622_021_1	4	1	1	01	1111111111	2	2		2267	2267																	2		13b;13d;13e;13i;14c;	1	2		1	600	3	13b;13d;13e;13i1;13i3;13i4;13i5;13i6;13i10;14c8;
H6622	021	2	1	02	01	H6622_021_2	5	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H6622	021	2	1	02	01	H6622_021_2	5	1	1	01	1111111111	2	2		21678	18681																	2		13b;13d;13e;13i;14c;	1	2		1	600	3	13b;13d;13e;13i1;13i3;13i4;13i5;13i6;13i10;14c8;
H6622	022	0	1	02	01	H6622_022_0	4	1	1	01	1111111111	2	2		5339	5339																	2		13b;13d;13e;13i;14c;	1	2		1	600	3	13b;13d;13e;13i1;13i3;13i4;13i5;13i6;13i10;14c8;
H6622	025	0	1	02	01	H6622_025_0	4	1	3								00000101000010001000	Depression															1	001	13c;	1	2		2			
H6622	026	0	1	02	01	H6622_026_0	3	1	3								00000101000011000000																1	001	13c;	2	2		2			
H6622	027	0	1	02	01	H6622_027_0	3	1	1	10				01111	100	100																	2		13b;13d;13e;13f;14c;	1	2		1	2700	3	13b;13d;13e;13f;14c8;
H6622	027	0	1	02	01	H6622_027_0	3	2	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13c;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	2		1	500	3	7b1;7f;10b1;13a;13b;13c;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H6622	028	0	1	01	01	H6622_028_0	5	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H6622	029	0	1	01	01	H6622_029_0	4	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H6622	029	0	1	01	01	H6622_029_0	4	1	3								01111111111111110000																1	001	13b;13i;13i-O;14c;		2		1	420	3	13b;13i1;13i3;13i4;13i5;13i6;13i10;13i-O1;14c8;
H6622	030	0	1	01	01	H6622_030_0	5	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H6622	032	0	1	01	01	H6622_032_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H6622	032	0	1	01	01	H6622_032_0	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H6622	033	0	1	01	01	H6622_033_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13c;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	1000	3	7b1;7f;10b1;13a;13b;13c;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H6622	035	0	1	01	01	H6622_035_0	4	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H6622	035	0	1	01	01	H6622_035_0	4	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H6622	036	0	1	01	01	H6622_036_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H6622	037	0	1	01	01	H6622_037_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	500	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H6622	048	0	1	01	01	H6622_048_0	3	1	1	10				01111	9071	9071																	2		13b;13d;13e;13f;14c;		1	13b;13d;13e;13f;14c;	1	2100	3	13b;13d;13e;13f;14c8;
H6622	049	0	1	01	01	H6622_049_0	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		1	13d;	2			
H6622	049	0	1	01	01	H6622_049_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13c;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13c;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H6622	051	0	1	01	01	H6622_051_0	4	1	1	10				01111	2644	2644																	2		13b;13d;13e;13f;14c;		1	13b;13d;13e;13f;14c;	1	1800	3	13b;13d;13e;13f;14c8;
H6622	051	0	1	01	01	H6622_051_0	4	2	3								00000101000010001000	Depression															1	001	13c;		1	13c;	2			
H6622	054	0	1	01	01	H6622_054_0	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H6622	055	0	1	01	01	H6622_055_0	4	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H6622	056	0	1	01	01	H6622_056_0	4	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H6622	057	0	1	02	01	H6622_057_0	3	1	3								00000101000011000000																1	001	13c;	1	2		2			
H6622	060	0	1	02	01	H6622_060_0	4	2	3								00000101000011000000																1	001	13c;	1	2		2			
H6622	060	0	1	02	01	H6622_060_0	4	1	1	01	1111111111	2	2		2267	94																	2		13b;13d;13e;13i;14c;	1	2		1	600	3	13b;13d;13e;13i1;13i3;13i4;13i5;13i6;13i10;14c8;
H6622	061	0	1	02	01	H6622_061_0	3	1	3								00000101000011000000																1	001	13c;	2	2		2			
H6622	063	0	1	01	01	H6622_063_0	3	1	3								00000001000000000000																1	001	13c;		2		2			
H6622	071	0	1	01	01	H6622_071_0	4	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H6622	071	0	1	01	01	H6622_071_0	4	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13c;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	1420	3	7b1;7f;10b1;13a;13b;13c;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;13i-O4;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H6622	074	1	1	01	01	H6622_074_1	4	2	3								00000101000011000000																1	001	13c;		2		2			
H6622	074	1	1	01	01	H6622_074_1	4	1	1	01	1111111111	2	2		5062	5062																	2		13b;13d;13e;13i;14c;		2		1	600	3	13b;13d;13e;13i1;13i3;13i4;13i5;13i6;13i10;14c8;
H6622	074	1	1	01	01	H6622_074_1	4	3	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H6622	074	2	1	01	01	H6622_074_2	4	2	3								00000101000011000000																1	001	13c;		2		2			
H6622	074	2	1	01	01	H6622_074_2	4	1	1	01	1111111111	2	2		2445	2445																	2		13b;13d;13e;13i;14c;		2		1	600	3	13b;13d;13e;13i1;13i3;13i4;13i5;13i6;13i10;14c8;
H6622	074	2	1	01	01	H6622_074_2	4	3	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H6622	076	0	1	02	01	H6622_076_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H6622	077	0	1	02	01	H6622_077_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H6622	078	1	1	01	01	H6622_078_1	3	3	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		1	13d;	2			
H6622	078	1	1	01	01	H6622_078_1	3	2	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H6622	078	1	1	01	01	H6622_078_1	3	1	1	10				01111	5099	5099																	2		13b;13d;13e;13f;14c;		1	13b;13d;13e;13f;14c;	1	2100	3	13b;13d;13e;13f;14c8;
H6622	078	2	1	01	01	H6622_078_2	4	2	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H6622	078	2	1	01	01	H6622_078_2	4	1	1	10				01111	5099	5099																	2		13b;13d;13e;13f;14c;		1	13b;13d;13e;13f;14c;	1	1800	3	13b;13d;13e;13f;14c8;
H6622	079	0	1	01	01	H6622_079_0	4	1	1	10				01111	3613	3613																	2		13b;13d;13e;13f;14c;		1	13b;13d;13e;13f;14c;	1	1500	3	13b;13d;13e;13f;14c8;
H6622	079	0	1	01	01	H6622_079_0	4	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		1	13d;	2			
H6622	081	0	1	01	01	H6622_081_0	4	1	3								00000101000010001000	Depression															1	001	13c;		2		2			
H6622	082	0	1	01	01	H6622_082_0	4	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H6672	001	0	1	01	01	H6672_001_0	5	1	3								00001101000011000000																2		13i;		2		1	55.00	7	13i1;
H6672	003	0	1	01	01	H6672_003_0	5	1	3								00001101000011000000																2		13i;		2		1	55.00	7	13i1;
H6672	005	0	1	01	01	H6672_005_0	5	1	3								00001101000011000000																2		13i;		2		1	55.00	7	13i1;
H6678	001	0	1	01	01	H6678_001_0	5	1	3								01111111111111110000																2		13i;		1	13i;	1	600	3	13i10;
H6678	002	0	1	01	01	H6678_002_0	5	1	3								01111111111111110000																2		13i;14c;		1	13i;14c;	1	1200	3	13i10;
H6678	003	0	1	01	01	H6678_003_0	5	1	3								01111111111111110000																2		13i;		1	13i;	1	600	3	13i10;
H6678	004	0	1	01	01	H6678_004_0	5	1	3								01111111111111110000																2		13i;14c;		1	13i;14c;	1	1200	3	13i10;
H6776	001	0	1	01	01	H6776_001_0	8	1	3								01111111111111111111	Osteoarthritis	Hypertension	Endocrine DIsorders	Gastrointestinal Disorders												2		13i;		2		2			
H6776	002	0	1	01	01	H6776_002_0	5	1	3								01111111111111111111	Osteoarthritis	Hypertension	Endocrine Disorders	Gastrointestinal Disorders												2		13i;		2		2			
H6815	037	0	1	01	01	H6815_037_0	4	1	3								01111111111111110000																2		13i;		1	13i;	2			
H6815	038	0	1	01	01	H6815_038_0	4	1	3								01111111111111110000																2		13i;		1	13i;	2			
H6832	002	0	1	01	01	H6832_002_0	4	1	3								00000010000000000000																2		13i;		1	13i;	2			
H6832	003	0	1	01	01	H6832_003_0	6	1	3								00000000010000000000																2		13c;		1	13c;	2			
H6852	001	0	1	01	01	H6852_001_0	10	1	3								01111111111111111000	Other Eligible Chronic Conditions															2		13i;		2		1	25.00	7	13i1;
H6874	001	0	1	04	01	H6874_001_0	9	1	2														00010000000000										2		13c;	1	2		2			
H6874	002	0	1	04	01	H6874_002_0	7	1	2														00010000000000										2		13c;	1	2		2			
H6874	003	0	1	04	01	H6874_003_0	6	1	2														00010000000000										2		13c;	1	2		2			
H6975	002	0	1	01	01	H6975_002_0	5	1	1	10				01111	664	232																	2		13d;		1	13d;	1	600.00	3	13d;
H6975	004	0	1	01	01	H6975_004_0	5	1	1	10				01111	499	150																	2		13d;		1	13d;	1	300.00	3	13d;
H6988	002	0	1	01	01	H6988_002_0	8	1	3								00101101010010111100	Hypertension	Chronic Kidney Disease														1	001	13b;		2		2			
H6988	004	0	1	01	01	H6988_004_0	8	1	3								11111111111111111111	Malnutrition	Inflammatory Bowel Disease	Chronic Kidney Disease	Chronic Liver Disease	Vitamin B12 Deficiency Anemia											1	001	13i;		2		1	0.00	6	13i1;
H7028	001	0	1	04	01	H7028_001_0	9	1	3								01111111111111111000	Other Eligible Chronic Conditions															2		13i;	1	2		1	25.00	7	13i1;
H7123	001	0	1	01	01	H7123_001_0	7	1	1	10				01111	749	749																	2		13b;13i;		1	13b;13i;	1	400.00	5	13b;13i1;
H7147	001	0	1	01	01	H7147_001_0	10	1	3								01111111111111111000	Other Eligible Chronic Conditions															2		13i;		2		1	30.00	7	13i1;
H7147	003	0	1	01	01	H7147_003_0	9	1	1	10				01111	460	368																	2		13i;		1	13i;	1	150.00	7	13i1;
H7147	004	0	1	01	01	H7147_004_0	10	1	3								01111111111111111000	Other Eligible Chronic Conditions															2		13i;		2		1	30.00	7	13i1;
H7149	006	0	1	01	01	H7149_006_0	2	1	1	10				01111	238273	238273																	2		10b;13i;13i-O;14c;		1	10b;13i;13i-O;14c;	1	400.00	5	10b2;13i1;13i4;13i-O1;
H7149	801	0	1	01	01	H7149_801_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H7149	802	0	1	01	01	H7149_802_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H7151	001	0	1	01	01	H7151_001_0	13	1	3								01111111111111111000	Other Eligible Chronic Conditions															2		13i;13i-O;		2		1	660.00	3	13i1;13i-O1;
H7163	003	0	1	02	01	H7163_003_0	9	1	1	10				01111	236	176																	2		13d;	1	1	13d;	1	100.00	7	13d;
H7169	003	0	1	04	01	H7169_003_0	7	2	1	10				01111	701	210																	2		13d;	1	1	13d;	1	300.00	3	13d;
H7169	003	0	1	04	01	H7169_003_0	7	1	3								01111111111111110000																2		13i;	1	1	13i;	1	600	3	13i10;
H7172	001	0	1	48	05	H7172_001_0	5	1	3								01111111111111111100	Hyperlipidemia	Hypertension												1	100000	1	001	13d;		1	13d;	1	150.00	5	13d;
H7175	002	0	1	04	01	H7175_002_0	5	1	1	10				01111	5171	1551																	2		13d;	1	1	13d;	1	300.00	3	13d;
H7199	002	0	1	04	01	H7199_002_0	9	1	3								01111111111111111000	Other Eligible Chronic Conditions															2		13i;	1	2		1	35.00	7	13i1;
H7220	002	0	1	01	01	H7220_002_0	3	1	2														00010000001110	Pneumonia	Kidney and Urinary Tract Infection	Cellulitis and Soft Tissue Infection			2	2			1	011	13d;		2		2			
H7220	004	0	1	02	01	H7220_004_0	4	1	2														00010000001110	Pneumonia	Kidney and Urinary Tract Infection	Cellulitis and Soft Tissue Infection			2	2			1	011	13d;	2	2		2			
H7220	009	1	1	01	01	H7220_009_1	4	1	2														00010000001110	Pneumonia	Kidney and Urinary Tract Infection	Cellulitis and Soft Tissue Infection			2	2			1	011	13d;		2		2			
H7220	009	2	1	01	01	H7220_009_2	4	1	2														00010000001110	Pneumonia	Kidney and Urinary Tract Infection	Cellulitis and Soft Tissue Infection			2	2			1	011	13d;		2		2			
H7220	009	3	1	01	01	H7220_009_3	4	1	2														00010000001110	Pneumonia	Kidney and Urinary Tract Infection	Cellulitis and Soft Tissue Infection			2	2			1	011	13d;		2		2			
H7220	010	0	1	01	01	H7220_010_0	4	1	2														00010000001110	Pneumonia	Kidney and Urinary Tract Infection	Cellulitis and Soft Tissue Infection			2	2			1	011	13d;		2		2			
H7220	011	0	1	02	01	H7220_011_0	4	1	2														00010000001110	Pneumonia	Kidney and Urinary Tract Infection	Cellulitis and Soft Tissue Infection			2	2			1	011	13d;	2	2		2			
H7220	012	0	1	01	01	H7220_012_0	4	1	3								00000000010000001110	CKD3	CKD4	CKD5													1	011	10b;13c;		2		2			
H7220	012	0	1	01	01	H7220_012_0	4	2	2														00010000001110	Pneumonia	Kidney and Urinary Tract Infection	Cellulitis and Soft Tissue Infection			2	2			1	011	13d;		2		2			
H7273	001	0	1	04	01	H7273_001_0	9	1	1	01	0100000000				840	84																	1	001	13d;	1	2		2			
H7273	002	0	1	04	01	H7273_002_0	9	1	1	01	0100000000				690	69																	1	001	13d;	1	2		2			
H7273	005	0	1	04	01	H7273_005_0	9	1	1	01	0100000000				860	86																	1	001	13d;	1	2		2			
H7284	003	0	1	04	01	H7284_003_0	4	1	1	10				01111	1244	1244																	2		13b;13d;13e;13f;14c;	1	2		1	1500	3	13b;13d;13e;13f;14c8;
H7284	007	0	1	04	01	H7284_007_0	3	1	3								00000001000000101110	Chronic Kidney Disease	Peripheral Vascular Disease	Chronic Foot Ulcers													1	001	13i-O;	1	2		2			
H7284	008	0	1	04	01	H7284_008_0	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H7284	008	0	1	04	01	H7284_008_0	3	1	3								00000001000000101110	Chronic Kidney Disease	Peripheral Vascular Disease	Chronic Foot Ulcers													1	001	13i-O;	1	2		2			
H7284	009	0	1	04	01	H7284_009_0	5	1	3								00000001000000101110	Chronic Kidney Disease	Peripheral Vascular Disease	Chronic foot ulcers													1	001	13i-O;	1	2		2			
H7284	010	0	1	04	01	H7284_010_0	4	2	3								00000001000000101110	Chronic Kidney Disease	Peripheral Vascular Disease	Chronic Foot Ulcers													1	001	13i-O;	1	2		2			
H7284	010	0	1	04	01	H7284_010_0	4	1	1	10				01111	1009	1009																	2		13b;13d;13e;13f;14c;	1	2		1	1800	3	13b;13d;13e;13f;14c8;
H7301	002	0	1	04	01	H7301_002_0	5	1	3								01111111111111111100	Hyperlipidemia	Hypertension														2		13i;	1	1	13i;	2			
H7301	002	0	1	04	01	H7301_002_0	5	2	2														00000100001000	Hyperlipidemia					2	2			2		10b;13b;	1	1	10b;13b;	2			
H7301	006	0	1	04	01	H7301_006_0	3	1	3								01111111111111111100	Hyperlipidemia	Hypertension														2		13i;	1	1	13i;	2			
H7301	006	0	1	04	01	H7301_006_0	3	2	2														00000100001000	Hyperlipidemia					2	2			2		10b;13b;	1	1	10b;13b;	2			
H7301	801	0	1	04	01	H7301_801_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H7301	803	0	1	04	01	H7301_803_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H7323	002	0	1	04	01	H7323_002_0	4	1	3								01111111111111110000																2		13i;	1	1	13i;	1	600	3	13i10;
H7323	005	0	1	04	01	H7323_005_0	5	1	3								01111111111111110000																2		13i;	1	1	13i;	1	600.00	3	13i10;
H7323	005	0	1	04	01	H7323_005_0	5	2	1	10				01111	3654	1096																	2		13d;	1	1	13d;	1	300.00	3	13d;
H7326	006	0	1	04	01	H7326_006_0	6	1	3								01111111111111110000																2		13b;13d;13i;14c;	1	1	13b;13d;13i;14c;	1	400	3	13b;13d;13i5;14c8;
H7326	006	0	1	04	01	H7326_006_0	6	2	1	10				01111	1081	324																	2		13d;	1	1	13d;	1	300.00	3	13d;
H7330	001	0	1	01	01	H7330_001_0	8	1	3								01111111111111110000																2		13i;		2		2			
H7330	002	0	1	02	01	H7330_002_0	8	1	3								01111111111111110000																2		13i;	2	2		2			
H7330	003	0	1	01	01	H7330_003_0	8	1	3								01111111111111110000																2		13i;		2		2			
H7330	004	0	1	02	01	H7330_004_0	8	1	3								01111111111111110000																2		13i;	2	2		2			
H7399	001	0	1	01	01	H7399_001_0	5	1	3								01111111111111110000																2		13i;		1	13i;	1	600	3	13i10;
H7399	002	0	1	01	01	H7399_002_0	6	1	3								01111111111111110000																2		13i;14c;		1	13i;14c;	1	900	3	13i10;
H7464	001	0	1	02	01	H7464_001_0	2	1	1	10				01111	20614	17522																	2		13d;	2	1	13d;	2			
H7464	005	0	1	02	01	H7464_005_0	3	1	1	10				01111	501	426																	2		13d;	2	1	13d;	2			
H7464	005	0	1	02	01	H7464_005_0	3	2	1	10				01111	501	38																	2		13f;	2	1	13f;	2			
H7464	006	0	1	02	01	H7464_006_0	2	1	1	10				01111	6498	5523																	2		13d;	2	1	13d;	2			
H7464	007	0	1	02	01	H7464_007_0	2	1	1	10				01111	5424	4610																	2		13d;	2	1	13d;	2			
H7464	008	1	1	02	01	H7464_008_1	2	1	1	10				01111	12014	10212																	2		13d;	2	1	13d;	2			
H7464	008	2	1	02	01	H7464_008_2	2	1	1	10				01111	9267	7877																	2		13d;	2	1	13d;	2			
H7464	010	0	1	01	01	H7464_010_0	5	1	1	10				01111	165	140																	2		13d;		1	13d;	2			
H7464	011	0	1	02	01	H7464_011_0	3	1	1	10				01111	618	525																	2		13d;	2	1	13d;	2			
H7518	001	0	1	04	01	H7518_001_0	4	1	3								01111111111111110000																2		13i;14c;	1	1	13i;14c;	1	900	3	13i10;
H7518	003	0	1	04	01	H7518_003_0	5	1	3								01111111111111110000																2		13i;14c;	1	1	13i;14c;	1	1500.00	3	13i10;
H7518	003	0	1	04	01	H7518_003_0	5	2	1	10				01111	534	160																	2		13d;	1	1	13d;	1	300.00	3	13d;
H7524	001	0	1	01	01	H7524_001_0	9	1	3								01111111111111110000																2		13i;		1	13i;	1	38.00	7	13i1;
H7524	002	0	1	01	01	H7524_002_0	9	1	3								01111111111111110000																2		13i;		1	13i;	1	38.00	7	13i1;
H7524	003	0	1	01	01	H7524_003_0	9	1	3								01111111111111110000																2		13i;		1	13i;	1	38.00	7	13i1;
H7524	004	0	1	01	01	H7524_004_0	9	1	3								01111111111111110000																2		13i;		1	13i;	1	38.00	7	13i1;
H7557	001	0	1	01	01	H7557_001_0	10	1	3								01000110010011100000																2		13i;		2		2			
H7559	001	0	1	01	01	H7559_001_0	9	1	3								01111111111111110000																1	001	13d;13e;13i;13i-O;		2		1	1800.00	3	13d;13e;13i1;13i3;13i-O1;
H7559	002	0	1	01	01	H7559_002_0	7	1	3								01111111111111110000																1	001	13d;13e;13i;13i-O;		2		1	936.00	3	13d;13e;13i1;13i3;13i-O1;
H7559	003	0	1	01	01	H7559_003_0	7	1	3								01111111111111110000																1	001	13d;13e;13i;13i-O;		2		1	936.00	3	13d;13e;13i1;13i3;13i-O1;
H7605	001	0	1	01	01	H7605_001_0	11	1	3								01111111111111111000	Other Eligible Chronic Conditions															2		13i;		2		1	25.00	7	13i1;
H7605	003	0	1	01	01	H7605_003_0	11	1	3								01111111111111111000	Other Eligible Chronic Conditions															2		13i;		2		1	35.00	7	13i1;
H7605	004	0	1	01	01	H7605_004_0	10	1	3								01111111111111111000	Other Eligible Chronic Conditions															2		13i;		2		1	25.00	7	13i1;
H7605	006	0	1	01	01	H7605_006_0	10	1	3								01111111111111111000	Other Eligible Chronic Conditions															2		13i;		2		1	900.00	3	13i1;13i10;
H7605	007	0	1	01	01	H7605_007_0	11	1	3								01111111111111111000	Other Eligible Chronic Conditions															2		13i;		2		1	25.00	7	13i1;
H7607	002	1	1	01	01	H7607_002_1	9	1	3								00001111110111110000																1	001	13c;13i;14c;		2		2			
H7607	002	2	1	01	01	H7607_002_2	9	1	3								00001111110111110000																1	001	13c;13i;14c;		2		2			
H7607	002	3	1	01	01	H7607_002_3	9	1	3								00001111110111110000																1	001	13c;13i;14c;		2		2			
H7607	002	4	1	01	01	H7607_002_4	9	1	3								00001111110111110000																1	001	13c;13i;14c;		2		2			
H7607	002	5	1	01	01	H7607_002_5	9	1	3								00001111110111110000																1	001	13c;13i;14c;		2		2			
H7607	007	1	1	01	01	H7607_007_1	10	1	3								00001111110111110000																1	001	13c;13i;14c;		2		2			
H7607	007	2	1	01	01	H7607_007_2	10	1	3								00001111110111110000																1	001	13c;13i;14c;		2		2			
H7607	007	3	1	01	01	H7607_007_3	10	1	3								00001111110111110000																1	001	13c;13i;14c;		2		2			
H7607	007	4	1	01	01	H7607_007_4	10	1	3								00001111110111110000																1	001	13c;13i;14c;		2		2			
H7607	007	5	1	01	01	H7607_007_5	10	1	3								00001111110111110000																1	001	13c;13i;14c;		2		2			
H7607	008	1	1	01	01	H7607_008_1	10	1	3								00001111110111110000																1	001	13c;13i;14c;		2		2			
H7607	008	2	1	01	01	H7607_008_2	10	1	3								00001111110111110000																1	001	13c;13i;14c;		2		2			
H7607	008	3	1	01	01	H7607_008_3	10	1	3								00001111110111110000																1	001	13c;13i;14c;		2		2			
H7607	008	4	1	01	01	H7607_008_4	10	1	3								00001111110111110000																1	001	13c;13i;14c;		2		2			
H7607	008	5	1	01	01	H7607_008_5	10	1	3								00001111110111110000																1	001	13c;13i;14c;		2		2			
H7607	011	1	1	01	01	H7607_011_1	9	1	3								00001111110111110000																1	001	13c;13i;14c;		2		2			
H7607	011	2	1	01	01	H7607_011_2	9	1	3								00001111110111110000																1	001	13c;13i;14c;		2		2			
H7607	011	4	1	01	01	H7607_011_4	9	1	3								00001111110111110000																1	001	13c;13i;14c;		2		2			
H7607	011	5	1	01	01	H7607_011_5	8	1	3								00001111110111110000																1	001	13c;13i;14c;		2		2			
H7621	001	0	1	01	01	H7621_001_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13c;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	500	3	7b1;7f;10b1;13a;13b;13c;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H7621	001	0	1	01	01	H7621_001_0	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H7670	001	0	1	01	01	H7670_001_0	7	1	3								01111111111111110000																2		13i-O;		2		1	50.00	3	13i-O1;
H7670	002	0	1	01	01	H7670_002_0	7	1	3								01111111111111110000																2		13i-O;		2		1	50.00	3	13i-O1;
H7678	001	0	1	01	01	H7678_001_0	7	1	3								01111111111111110000																1	001	13d;13e;13i;13i-O;		2		1	960.00	3	13d;13e;13i1;13i3;13i-O1;
H7678	003	0	1	01	01	H7678_003_0	8	1	3								01111111111111110000																1	001	13d;13e;13i;13i-O;		2		1	936.00	3	13d;13e;13i1;13i3;13i-O1;
H7678	004	0	1	01	01	H7678_004_0	7	1	3								01111111111111110000																1	001	13d;13e;13i;13i-O;		2		1	960.00	3	13d;13e;13i1;13i3;13i-O1;
H7680	001	0	1	01	01	H7680_001_0	5	1	3								01111111111111111110	Hypertension	Morbid Obesity	Heart Arrythmias													1	001	13i;		2		1	250.00	7	13i1;
H7680	002	0	1	01	01	H7680_002_0	5	2	1	10				01111	1750	1400																	1	001	13i;		2		1	25.00	7	13i1;
H7680	002	0	1	01	01	H7680_002_0	5	1	3								01111111111111111110	Hypertension	Morbid Obesity	Heart Arrythmias													1	001	13i;		2		1	250.00	7	13i1;
H7680	007	0	1	01	01	H7680_007_0	4	2	1	10				01111	600	480																	1	001	13i;		2		1	25.00	7	13i1;
H7680	007	0	1	01	01	H7680_007_0	4	1	3								01111111111111111110	Hypertension	Morbid Obesity	Heart Arrythmias													1	001	13i;		2		1	250.00	7	13i1;
H7728	011	0	1	04	01	H7728_011_0	6	2	1	10				01111	3945	3945																	2		13i;	1	1	13i;	2			
H7728	011	0	1	04	01	H7728_011_0	6	1	1	10				01111	3945	3945																	2		13i;	1	1	13i;	2			
H7728	012	0	1	04	01	H7728_012_0	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;	1	2		2			
H7778	001	0	1	02	01	H7778_001_0	5	1	1	10				01111	31	26																	2		13d;	2	1	13d;	2			
H7778	002	0	1	02	01	H7778_002_0	6	1	1	10				01111	43	37																	2		13d;	2	1	13d;	2			
H7787	002	0	1	04	01	H7787_002_0	3	1	3								00000000000000001000	Vision loss, Hearing loss, PTSD															2		13i-O;	1	2		2			
H7849	086	0	1	04	01	H7849_086_0	3	1	3								00000000000000001000	Vision loss, Hearing loss, PTSD															2		13i-O;	1	2		2			
H7849	089	0	1	04	01	H7849_089_0	3	1	3								00000000000000001000	Vision loss, Hearing loss, PTSD															2		13i-O;	1	2		2			
H7849	090	0	1	04	01	H7849_090_0	3	1	3								00000000000000001000	Vision loss, Hearing loss, PTSD															2		13i-O;	1	2		2			
H7925	001	0	1	01	01	H7925_001_0	5	1	3								01111111111111110000																2		13i;		1	13i;	1	600	3	13i10;
H7925	002	0	1	01	01	H7925_002_0	5	1	3								01111111111111110000																2		13i;14c;		1	13i;14c;	1	1500	3	13i10;
H7925	003	0	1	01	01	H7925_003_0	6	1	3								01111111111111110000																2		13i;14c;		1	13i;14c;	1	1500	3	13i10;
H7993	001	0	1	01	01	H7993_001_0	10	1	3								01111111111111111000	Other Eligible Chronic Conditions															2		13i-O;		2		1	240.00	3	13i-O1;
H7993	002	0	1	01	01	H7993_002_0	12	1	3								01111111111111111000	Other Eligible Chronic Conditions															2		13i-O;		2		1	240.00	3	13i-O1;
H7993	003	0	1	01	01	H7993_003_0	10	1	3								01111111111111111000	Other Eligible Chronic Conditions															2		13i-O;		2		1	240.00	3	13i-O1;
H7993	004	0	1	01	01	H7993_004_0	10	1	3								01111111111111111000	Other Eligible Chronic Conditions															2		13i;13i-O;		2		1	540.00	3	13i1;13i-O1;
H7993	005	0	1	01	01	H7993_005_0	9	1	3								01111111111111111000	Other Eligible Chronic Conditions															2		13i;13i-O;		2		1	1440.00	3	13i1;13i10;13i-O1;
H7993	007	0	1	01	01	H7993_007_0	10	1	3								01111111111111111000	Other Eligible Chronic Conditions															2		13i;		2		1	30.00	7	13i1;
H7993	009	0	1	01	01	H7993_009_0	9	1	3								01111111111111111000	Other Eligible Chronic Conditions															2		13i;		2		1	1080.00	3	13i1;13i10;
H8014	001	0	1	04	01	H8014_001_0	7	1	3								00001101000011000000																2		13i;	1	2		1	55.00	7	13i1;
H8014	002	0	1	04	01	H8014_002_0	6	1	3								00001101000011000000																2		13i;	1	2		1	55.00	7	13i1;
H8026	001	0	1	48	05	H8026_001_0	9	1	3								01111111111111111100	Hyperlipidemia	Hypertension												1	100000	1	001	13d;		1	13d;	1	150.00	5	13d;
H8087	003	0	1	04	01	H8087_003_0	4	1	1	10				01111	23216	23216																	2		13b;13d;13e;13f;14c;	1	1	13b;13d;13e;13f;14c;	1	1500	3	13b;13d;13e;13f;14c8;
H8093	002	0	1	01	01	H8093_002_0	4	1	3								01111111111111110000																1	001	13i;		1	13i;	2			
H8130	001	0	1	01	01	H8130_001_0	7	1	3								01111111111111110000																1	001	13d;13e;13i;13i-O;		2		1	1380.00	3	13d;13e;13i1;13i3;13i-O1;
H8130	008	0	1	01	01	H8130_008_0	7	1	3								01111111111111110000																1	001	13d;13e;13i;13i-O;		2		1	2760.00	3	13d;13e;13i1;13i3;13i-O1;
H8130	009	0	1	01	01	H8130_009_0	9	1	3								01111111111111110000																1	001	13d;13e;13i;13i-O;		2		1	1380.00	3	13d;13e;13i1;13i3;13i-O1;
H8130	010	0	1	01	01	H8130_010_0	8	1	3								01111111111111110000																1	001	13d;13e;13i;13i-O;		2		1	960.00	3	13d;13e;13i1;13i3;13i-O1;
H8145	004	0	1	09	04	H8145_004_0	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		1	13d;	2			
H8145	032	0	1	09	04	H8145_032_0	5	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H8145	042	0	1	09	04	H8145_042_0	2	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		1	13d;	2			
H8145	052	0	1	09	04	H8145_052_0	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H8145	055	0	1	09	04	H8145_055_0	2	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H8145	069	0	1	09	04	H8145_069_0	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H8145	069	0	1	09	04	H8145_069_0	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H8145	084	0	1	09	04	H8145_084_0	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H8145	084	0	1	09	04	H8145_084_0	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H8145	120	0	1	09	04	H8145_120_0	6	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		1	13d;	2			
H8145	122	0	1	09	04	H8145_122_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13c;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		2		1	500	3	7b1;7f;10b1;13a;13b;13c;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H8145	122	0	1	09	04	H8145_122_0	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H8145	123	0	1	09	04	H8145_123_0	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H8145	125	0	1	09	04	H8145_125_0	4	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H8145	126	0	1	09	04	H8145_126_0	2	2	2														01000000000000										1	010	13d;		2		2			
H8145	126	0	1	09	04	H8145_126_0	2	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;		2		2			
H8173	001	0	1	01	01	H8173_001_0	10	1	3								01111111111111111000	Other Eligible Chronic Conditions															2		13i-O;		2		1	240.00	3	13i-O1;
H8173	002	0	1	01	01	H8173_002_0	10	1	3								01111111111111111000	Other Eligible Chronic Conditions															2		13i;13i-O;		2		1	540.00	3	13i1;13i-O1;
H8173	005	0	1	01	01	H8173_005_0	10	1	3								01111111111111111000	Other Eligible Chronic Conditions															2		13i-O;		2		1	240.00	3	13i-O1;
H8173	007	0	1	01	01	H8173_007_0	10	1	3								01111111111111111000	Other Eligible Chronic Conditions															2		13i-O;		2		1	240.00	3	13i-O1;
H8173	008	0	1	01	01	H8173_008_0	10	1	3								01111111111111111000	Other Eligible Chronic Conditions															2		13i;13i-O;		2		1	660.00	3	13i1;13i-O1;
H8173	011	0	1	01	01	H8173_011_0	9	1	3								01111111111111111000	Other Eligible Chronic Conditions															2		13i;13i-O;		2		1	960.00	3	13i1;13i10;13i-O1;
H8173	014	0	1	01	01	H8173_014_0	9	1	3								01111111111111111000	Other Eligible Chronic Conditions															2		13i;13i-O;		2		1	1140.00	3	13i1;13i10;13i-O1;
H8173	015	0	1	01	01	H8173_015_0	5	1	3								01111111111111111000	Other Eligible Chronic Conditions															2		13i;13i-O;		2		1	960.00	3	13i1;13i10;13i-O1;
H8176	001	0	1	01	01	H8176_001_0	8	1	3								01111111111111110000																1	001	13d;13e;13i;13i-O;		2		1	1320.00	3	13d;13e;13i1;13i-O1;
H8176	003	0	1	01	01	H8176_003_0	6	1	3								01111111111111110000																1	001	13d;13e;13i;13i-O;		2		1	960.00	3	13d;13e;13i1;13i3;13i-O1;
H8189	001	0	1	01	01	H8189_001_0	6	2	1	10				01111	4785	1675																	2		13d;		1	13d;	1	600.00	3	13d;
H8189	001	0	1	01	01	H8189_001_0	6	1	3								01111111111111110000																2		13i;14c;		1	13i;14c;	1	1500	3	13i10;
H8225	001	0	1	01	01	H8225_001_0	5	1	3								01111111111111110000																2		13i;		1	13i;	1	600	3	13i10;
H8225	003	0	1	01	01	H8225_003_0	5	1	3								01111111111111110000																2		13i;14c;		1	13i;14c;	1	1200	3	13i10;
H8225	004	0	1	01	01	H8225_004_0	5	1	3								01111111111111110000																2		13i;14c;		1	13i;14c;	1	1200	3	13i10;
H8225	005	0	1	01	01	H8225_005_0	5	1	3								01111111111111110000																2		13i;14c;		1	13i;14c;	1	1500	3	13i10;
H8225	006	0	1	01	01	H8225_006_0	5	1	3								01111111111111110000																2		13i;14c;		1	13i;14c;	1	1500	3	13i10;
H8244	001	0	1	04	01	H8244_001_0	3	1	3								01111111111111110000																2		13i;	1	2		2			
H8293	001	0	1	01	01	H8293_001_0	5	1	3								00001101000011000000																2		13i;		2		1	55.00	7	13i1;
H8298	001	0	1	01	01	H8298_001_0	6	1	3								11111111111111111111	Prediabetes	COPD	Hypertension/ Heart Disease	Anemia	Chronic Kidney Disease											1	001	13i;		1	13i;	2			
H8332	001	0	1	01	01	H8332_001_0	3	1	2														00000100001000	Hyperlipidemia					2	2			2		10b;13b;		1	10b;13b;	2			
H8332	002	0	1	01	01	H8332_002_0	2	1	2														00000100001000	Hyperlipidemia					2	2			2		10b;13b;		1	10b;13b;	2			
H8332	003	0	1	01	01	H8332_003_0	2	1	2														00000100001000	Hyperlipidemia					2	2			2		10b;13b;		1	10b;13b;	2			
H8332	004	0	1	01	01	H8332_004_0	2	2	3								01111111111111111100	Hyperlipidemia	Hypertension														2		13i;		1	13i;	2			
H8332	004	0	1	01	01	H8332_004_0	2	1	2														00000100001000	Hyperlipidemia					2	2			2		10b;13b;		1	10b;13b;	2			
H8332	801	0	1	01	01	H8332_801_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H8332	802	0	1	01	01	H8332_802_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H8379	002	0	1	01	01	H8379_002_0	16	1	3								01111111111111110000																2		13i;		1	13i;	2			
H8385	001	0	1	04	01	H8385_001_0	5	1	3								00000101010000000000																2		13c;	1	2		2			
H8385	002	0	1	04	01	H8385_002_0	6	1	3								00000101010000000000																2		13c;	1	2		2			
H8385	003	0	1	04	01	H8385_003_0	5	1	3								00000101010000000000																2		13c;	1	2		2			
H8385	004	0	1	04	01	H8385_004_0	5	1	3								00000101010000000000																2		13c;	1	2		2			
H8432	028	0	1	01	01	H8432_028_0	5	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H8432	034	0	1	01	01	H8432_034_0	6	1	1	10				01111	220	114																	2		13i;		2		2			
H8432	034	0	1	01	01	H8432_034_0	6	2	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;13i-O;		2		2			
H8432	035	0	1	01	01	H8432_035_0	7	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H8432	038	1	1	01	01	H8432_038_1	5	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;13i-O;		2		2			
H8432	038	2	1	01	01	H8432_038_2	5	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;13i-O;		2		2			
H8452	001	0	1	48	05	H8452_001_0	4	1	3								11111111111111111111	Obesity	Musculoskeletal Conditions	Traumatic Injury	Traumatic Brain Injury (TBI)	Sensory Impairment									2		2		13i;		1	13i;	2			
H8457	001	0	1	01	01	H8457_001_0	5	1	3								00000110010011101000	Chronic alcohol and drug dependence															2		13i;		2		2			
H8597	001	0	1	01	01	H8597_001_0	3	1	1	10				01111	238273	238273																	2		13i;13i-O;14c;		1	13i;13i-O;14c;	1	210.00	5	13i1;13i-O1;
H8597	002	0	1	01	01	H8597_002_0	2	1	1	10				01111	238273	238273																	2		13i;13i-O;14c;		1	13i;13i-O;14c;	1	150.00	5	13i1;13i-O1;
H8597	003	0	1	01	01	H8597_003_0	2	1	1	10				01111	238273	238273																	2		13i;13i-O;14c;		1	13i;13i-O;14c;	1	150.00	5	13i1;13i-O1;
H8649	010	0	1	01	01	H8649_010_0	3	1	1	10				01111	238273	238273																	2		13i;13i-O;14c;		1	13i;13i-O;14c;	1	240.00	5	13i1;13i-O1;
H8649	801	0	1	01	01	H8649_801_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H8649	803	0	1	01	01	H8649_803_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;		1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H8764	001	0	1	01	01	H8764_001_0	7	1	3								00010101010011100000																1	001	10b;13i;		2		2			
H8764	002	0	1	02	01	H8764_002_0	8	1	3								00010101010011100000																1	001	10b;13i;	2	2		2			
H8764	003	0	1	01	01	H8764_003_0	9	1	3								00010101010011100000																1	001	10b;13i;		2		2			
H8783	001	0	1	04	01	H8783_001_0	9	1	2														00010000000000										2		13c;	1	2		2			
H8783	002	0	1	04	01	H8783_002_0	12	1	2														00010000000000										2		13c;	1	2		2			
H8783	003	0	1	04	01	H8783_003_0	10	1	2														00010000000000										2		13c;	1	2		2			
H8797	003	0	1	01	01	H8797_003_0	4	1	3								01111111111111110000																2		13i;		1	13i;	2			
H8845	001	0	1	01	01	H8845_001_0	9	1	3								01111111111111110000																1	001	13d;13e;13i;13i-O;		2		1	1920.00	3	13d;13e;13i1;13i-O1;
H8845	002	0	1	01	01	H8845_002_0	7	1	3								01111111111111110000																1	001	13d;13e;13i;13i-O;		2		1	960.00	3	13d;13e;13i1;13i3;13i-O1;
H8849	001	0	1	01	01	H8849_001_0	5	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H8849	006	0	1	01	01	H8849_006_0	5	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H8849	008	2	1	01	01	H8849_008_2	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H8849	008	4	1	01	01	H8849_008_4	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H8849	008	5	1	01	01	H8849_008_5	7	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H8849	009	0	1	01	01	H8849_009_0	6	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H8849	010	1	1	01	01	H8849_010_1	6	4	1	10				01111	15892	15892																	2		13i;		2		2			
H8849	010	1	1	01	01	H8849_010_1	6	3	1	10				01111	15892	15892																	2		13i;		2		2			
H8849	010	1	1	01	01	H8849_010_1	6	2	1	10				01111	15892	15892																	2		13i;		2		2			
H8849	010	1	1	01	01	H8849_010_1	6	1	1	10				01111	15892	8200																	2		13i;		2		2			
H8849	010	2	1	01	01	H8849_010_2	5	2	1	10				01111	5921	5921																	2		13i;		2		2			
H8849	010	2	1	01	01	H8849_010_2	5	1	1	10				01111	5921	3055																	2		13i;		2		2			
H8849	010	2	1	01	01	H8849_010_2	5	4	1	10				01111	5921	5921																	2		13i;		2		2			
H8849	010	2	1	01	01	H8849_010_2	5	3	1	10				01111	5921	5921																	2		13i;		2		2			
H8849	010	3	1	01	01	H8849_010_3	5	3	1	10				01111	4917	4917																	2		13i;		2		2			
H8849	010	3	1	01	01	H8849_010_3	5	4	1	10				01111	4917	4917																	2		13i;		2		2			
H8849	010	3	1	01	01	H8849_010_3	5	2	1	10				01111	4917	4917																	2		13i;		2		2			
H8849	010	3	1	01	01	H8849_010_3	5	1	1	10				01111	4917	2537																	2		13i;		2		2			
H8849	010	4	1	01	01	H8849_010_4	5	1	1	10				01111	2292	1183																	2		13i;		2		2			
H8849	010	4	1	01	01	H8849_010_4	5	2	1	10				01111	2292	2292																	2		13i;		2		2			
H8849	010	4	1	01	01	H8849_010_4	5	3	1	10				01111	2292	2292																	2		13i;		2		2			
H8849	010	4	1	01	01	H8849_010_4	5	4	1	10				01111	2292	2292																	2		13i;		2		2			
H8849	010	5	1	01	01	H8849_010_5	5	4	1	10				01111	1710	1710																	2		13i;		2		2			
H8849	010	5	1	01	01	H8849_010_5	5	3	1	10				01111	1710	1710																	2		13i;		2		2			
H8849	010	5	1	01	01	H8849_010_5	5	2	1	10				01111	1710	1710																	2		13i;		2		2			
H8849	010	5	1	01	01	H8849_010_5	5	1	1	10				01111	1710	883																	2		13i;		2		2			
H8849	010	6	1	01	01	H8849_010_6	5	4	1	10				01111	1660	1660																	2		13i;		2		2			
H8849	010	6	1	01	01	H8849_010_6	5	3	1	10				01111	1660	1660																	2		13i;		2		2			
H8849	010	6	1	01	01	H8849_010_6	5	2	1	10				01111	1660	1660																	2		13i;		2		2			
H8849	010	6	1	01	01	H8849_010_6	5	1	1	10				01111	1660	856																	2		13i;		2		2			
H8849	011	1	1	01	01	H8849_011_1	5	4	1	10				01111	1428	1428																	2		13i;		2		2			
H8849	011	1	1	01	01	H8849_011_1	5	3	1	10				01111	1428	1428																	2		13i;		2		2			
H8849	011	1	1	01	01	H8849_011_1	5	2	1	10				01111	1428	1428																	2		13i;		2		2			
H8849	011	1	1	01	01	H8849_011_1	5	1	1	10				01111	1428	737																	2		13i;		2		2			
H8849	011	2	1	01	01	H8849_011_2	5	4	1	10				01111	1026	1026																	2		13i;		2		2			
H8849	011	2	1	01	01	H8849_011_2	5	3	1	10				01111	1026	1026																	2		13i;		2		2			
H8849	011	2	1	01	01	H8849_011_2	5	1	1	10				01111	1026	529																	2		13i;		2		2			
H8849	011	2	1	01	01	H8849_011_2	5	2	1	10				01111	1026	1026																	2		13i;		2		2			
H8849	011	3	1	01	01	H8849_011_3	5	4	1	10				01111	506	506																	2		13i;		2		2			
H8849	011	3	1	01	01	H8849_011_3	5	3	1	10				01111	506	506																	2		13i;		2		2			
H8849	011	3	1	01	01	H8849_011_3	5	2	1	10				01111	506	506																	2		13i;		2		2			
H8849	011	3	1	01	01	H8849_011_3	5	1	1	10				01111	506	261																	2		13i;		2		2			
H8849	011	4	1	01	01	H8849_011_4	5	2	1	10				01111	161	161																	2		13i;		2		2			
H8849	011	4	1	01	01	H8849_011_4	5	4	1	10				01111	161	161																	2		13i;		2		2			
H8849	011	4	1	01	01	H8849_011_4	5	1	1	10				01111	161	83																	2		13i;		2		2			
H8849	011	4	1	01	01	H8849_011_4	5	3	1	10				01111	161	161																	2		13i;		2		2			
H8849	011	5	1	01	01	H8849_011_5	5	1	1	10				01111	189	98																	2		13i;		2		2			
H8849	011	5	1	01	01	H8849_011_5	5	2	1	10				01111	189	189																	2		13i;		2		2			
H8849	011	5	1	01	01	H8849_011_5	5	3	1	10				01111	189	189																	2		13i;		2		2			
H8849	011	5	1	01	01	H8849_011_5	5	4	1	10				01111	189	189																	2		13i;		2		2			
H8849	011	6	1	01	01	H8849_011_6	5	4	1	10				01111	209	209																	2		13i;		2		2			
H8849	011	6	1	01	01	H8849_011_6	5	3	1	10				01111	209	209																	2		13i;		2		2			
H8849	011	6	1	01	01	H8849_011_6	5	2	1	10				01111	209	209																	2		13i;		2		2			
H8849	011	6	1	01	01	H8849_011_6	5	1	1	10				01111	209	108																	2		13i;		2		2			
H8849	012	0	1	01	01	H8849_012_0	5	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H8849	013	0	1	01	01	H8849_013_0	5	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H8854	002	0	1	01	01	H8854_002_0	11	1	2														01110000001000	ESRD					2	2			2		13c;14c;		2		2			
H8854	002	0	1	01	01	H8854_002_0	11	2	3								01111111111111111100	Underweight, Overweight, Obese	Physical Disability														2		13i;		2		1	0.00	7	13i1;13i10;
H8889	001	0	1	04	01	H8889_001_0	7	1	3								00011111111010111000	Osteoporosis															1	001	10b;13c;13d;13i;14c;	1	2		2			
H8889	002	0	1	04	01	H8889_002_0	7	1	3								00011111111010110000																1	001	10b;13c;13i;14c;	1	2		2			
H8889	003	0	1	04	01	H8889_003_0	7	1	3								00011111111010111000	Osteoporosis															1	001	10b;13c;13d;13i;14c;	1	2		2			
H8889	004	0	1	04	01	H8889_004_0	7	1	3								00011111111010110000																1	001	10b;13c;13i;14c;	1	2		2			
H8889	005	0	1	04	01	H8889_005_0	6	1	3								00011111111010110000																1	001	10b;13c;13i;14c;	1	2		2			
H8889	008	0	1	04	01	H8889_008_0	6	1	3								00011111111010110000																1	001	10b;13c;13i;14c;	1	2		2			
H8889	009	0	1	04	01	H8889_009_0	4	1	3								00011111111010110000																1	001	10b;13c;13i;14c;	1	2		2			
H8894	001	0	1	01	01	H8894_001_0	6	1	3								01111111111111110000																2		13i;		2		1	40.00	7	13i10;
H8902	002	0	1	01	01	H8902_002_0	8	1	3								00011111010000100000																2		13i;		2		2			
H8902	003	0	1	01	01	H8902_003_0	8	1	3								00011111010000100000																2		13i;		2		2			
H8902	006	0	1	01	01	H8902_006_0	8	1	3								00011111010000100000																2		13i;		2		2			
H8902	007	0	1	01	01	H8902_007_0	8	1	3								00011111010000100000																2		13i;		2		2			
H8908	005	0	1	01	01	H8908_005_0	4	1	1	10				01111	11432	11432																	2		13b;13d;13e;13f;14c;		1	13b;13d;13e;13f;14c;	1	2100	3	13b;13d;13e;13f;14c8;
H9003	001	0	1	02	01	H9003_001_0	6	1	2														00000000001000	Meets clinical criteria for hospital care in home based on health status									2		13d;	2	2		2			
H9003	006	0	1	02	01	H9003_006_0	6	1	2														00000000001000	Meets clinical criteria for hospital care in home based on health status									2		13d;	2	2		2			
H9003	009	0	1	02	01	H9003_009_0	6	1	2														00000000001000	Meets clinical criteria for hospital care in home based on health status									2		13d;	2	2		2			
H9065	001	0	1	01	01	H9065_001_0	5	2	1	10				01111	9865	9865																	2		13i;		2		2			
H9065	001	0	1	01	01	H9065_001_0	5	3	1	10				01111	9865	9865																	2		13i;		2		2			
H9065	001	0	1	01	01	H9065_001_0	5	4	1	10				01111	9865	9865																	2		13i;		2		2			
H9065	001	0	1	01	01	H9065_001_0	5	5	1	10				01111	9865	9865																	2		13i-O;		2		2			
H9065	001	0	1	01	01	H9065_001_0	5	1	1	10				01111	9865	5090																	2		13i;		2		2			
H9065	002	0	1	02	01	H9065_002_0	5	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;13i-O;	2	2		2			
H9065	003	0	1	02	01	H9065_003_0	5	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;13i-O;	2	2		2			
H9065	004	0	1	02	01	H9065_004_0	5	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;13i-O;	2	2		2			
H9065	008	0	1	01	01	H9065_008_0	7	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;13i-O;		2		2			
H9066	001	0	1	01	01	H9066_001_0	6	1	3								01111111111111110000																2		13i;		2		2			
H9066	003	0	1	01	01	H9066_003_0	6	1	3								01111111111111110000																2		13i;		2		2			
H9070	003	0	1	04	01	H9070_003_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13c;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H9070	003	0	1	04	01	H9070_003_0	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H9070	004	0	1	04	01	H9070_004_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13c;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	2		1	500	3	7b1;7f;10b1;13a;13b;13c;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H9070	005	0	1	04	01	H9070_005_0	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H9070	006	1	1	04	01	H9070_006_1	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H9070	006	2	1	04	01	H9070_006_2	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
H9070	006	2	1	04	01	H9070_006_2	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H9070	006	3	1	04	01	H9070_006_3	3	1	3								01111111111111110000																1	001	7b;7f;10b;13a;13b;13d;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	2		1	1000	3	7b1;7f;10b1;13a;13b;13d;13i1;13i2;13i3;13i4;13i5;13i6;13i7;13i8;13i10;13i-O1;13i-O2;13i-O3;14c8;14c11;14c15;14c16;14c17;14c18;14c19;14c21;14c22;16a1;16a2;16a3;16a4;16b1;16b2;16b3;16b4;16b5;16b6;16b7;17a1;17b1;17b2;18a1;18a2;18b1;
H9082	010	0	1	01	01	H9082_010_0	7	1	3								01111111111111110000																1	001	13d;13e;13i;13i-O;		2		1	960.00	3	13d;13e;13i1;13i3;13i-O1;
H9147	001	0	1	01	01	H9147_001_0	7	2	1	10				01111	4450	4450																	2		10b;13i;		2		2			
H9147	001	0	1	01	01	H9147_001_0	7	1	1	10				01111	4450	4450																	2		13i;		2		2			
H9207	004	0	1	01	01	H9207_004_0	10	1	1	10				01111	10775	10775																	2		13i;		2		1	305.00	6	13i1;
H9306	004	0	1	01	01	H9306_004_0	7	1	3								01111111111111110000																2		13i;		2		1	50.00	7	13i10;
H9335	003	0	1	01	01	H9335_003_0	5	1	3								01111111111111110000																2		13i;		1	13i;	2			
H9335	003	0	1	01	01	H9335_003_0	5	2	1	10				01111	67	20																	2		13d;		1	13d;	1	300.00	3	13d;
H9364	002	0	1	01	01	H9364_002_0	5	1	3								01111111111111110000																2		13i;		1	13i;	1	1200	3	13i10;
H9364	002	0	1	01	01	H9364_002_0	5	2	1	10				01111	4547	1364																	2		13d;		1	13d;	1	300.00	3	13d;
H9364	003	0	1	01	01	H9364_003_0	5	2	1	10				01111	2852	998																	2		13d;		1	13d;	1	600.00	3	13d;
H9364	003	0	1	01	01	H9364_003_0	5	1	3								01111111111111110000																2		13i;		1	13i;	1	1200	3	13i10;
H9387	004	0	1	04	01	H9387_004_0	5	2	1	10				01111	78	23																	2		13d;	1	1	13d;	1	300.00	3	13d;
H9387	004	0	1	04	01	H9387_004_0	5	1	3								01111111111111110000																2		13i;	1	1	13i;	2			
H9403	001	0	1	01	01	H9403_001_0	6	1	3								00001101000011000000																2		13i;		2		1	55.00	7	13i1;
H9403	003	0	1	01	01	H9403_003_0	5	1	3								00001101000011000000																2		13i;		2		1	55.00	7	13i1;
H9403	004	0	1	01	01	H9403_004_0	5	1	3								00001101000011000000																2		13i;		2		1	55.00	7	13i1;
H9414	001	0	1	04	01	H9414_001_0	5	1	3								01111111111111110000																2		13i-O;	1	2		2			
H9414	002	0	1	04	01	H9414_002_0	5	1	3								01111111111111110000																2		13i;13i-O;	1	2		2			
H9414	003	0	1	04	01	H9414_003_0	4	1	3								01111111111111110000																2		13i;13i-O;14c;	1	2		2			
H9431	801	0	1	04	01	H9431_801_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H9431	802	0	1	04	01	H9431_802_0	1	1	3								01111111111111111000	at plan sponsor discretion															1	001	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	1	1	7b;7f;10b;13a;13b;13c;13i;13i-O;14c;16a;16b;17a;17b;18a;18b;	2			
H9455	001	0	1	01	01	H9455_001_0	6	1	3								01111111111111111000	Epilepsy															2		10b;13i;14c;		1	10b;13i;14c;	2			
H9525	003	0	1	01	01	H9525_003_0	5	4	1	10				01111	11507	11507																	2		13i-O;		2		2			
H9525	003	0	1	01	01	H9525_003_0	5	3	1	10				01111	11507	11507																	2		13i;		2		2			
H9525	003	0	1	01	01	H9525_003_0	5	2	1	10				01111	11507	11507																	2		13i;		2		2			
H9525	003	0	1	01	01	H9525_003_0	5	1	1	10				01111	11507	5938																	2		13i;		2		2			
H9525	004	0	1	01	01	H9525_004_0	5	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;13i-O;		2		2			
H9525	006	0	1	01	01	H9525_006_0	5	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;13i-O;		2		2			
H9525	007	0	1	01	01	H9525_007_0	6	3	1	10				01111	24774	24774																	2		13i;		2		2			
H9525	007	0	1	01	01	H9525_007_0	6	2	1	10				01111	24774	24774																	2		13i;		2		2			
H9525	007	0	1	01	01	H9525_007_0	6	1	1	10				01111	24774	12783																	2		13i;		2		2			
H9525	007	0	1	01	01	H9525_007_0	6	4	1	10				01111	24774	24774																	2		13i-O;		2		2			
H9525	010	0	1	01	01	H9525_010_0	6	1	1	10				01111	1782	920																	2		13i;		2		2			
H9525	010	0	1	01	01	H9525_010_0	6	3	1	10				01111	1782	1782																	2		13i;		2		2			
H9525	010	0	1	01	01	H9525_010_0	6	2	1	10				01111	1782	1782																	2		13i;		2		2			
H9525	010	0	1	01	01	H9525_010_0	6	4	1	10				01111	1782	1782																	2		13i;		2		2			
H9525	011	0	1	01	01	H9525_011_0	7	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;		2		2			
H9525	012	0	1	01	01	H9525_012_0	5	1	1	10				01111	324	167																	2		13i;		2		2			
H9525	012	0	1	01	01	H9525_012_0	5	2	1	10				01111	324	324																	2		13i;		2		2			
H9525	013	1	1	01	01	H9525_013_1	5	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;13i-O;		2		2			
H9525	013	2	1	01	01	H9525_013_2	5	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;13i-O;		2		2			
H9525	013	3	1	01	01	H9525_013_3	5	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;13i-O;		2		2			
H9525	013	4	1	01	01	H9525_013_4	5	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;13i-O;		2		2			
H9525	015	0	1	01	01	H9525_015_0	5	1	3								11111111111111111111	Scleroderma, Ischemic Heart Disease, Hypertension, Alzheimers	Pre-diabetes, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis	Cerebral Palsy, Traumatic brain injury, Obesity	Crohns disease, Ankylosing spondylitis, Osteoarthritis	Osteoporosis, Chronic back pain, Blindness											2		13i;13i-O;		2		2			
H9572	001	1	1	04	01	H9572_001_1	7	1	3								00001101000010011100	Hypertension	Rheumatoid arthritis														2		13i;	1	2		1	0.00	5	13i1;
H9572	001	2	1	04	01	H9572_001_2	7	1	3								00001101000010011100	Hypertension	Rheumatoid arthritis														2		13i;	1	2		1	0.00	5	13i1;
H9572	001	3	1	04	01	H9572_001_3	7	1	3								00001101000010011100	Hypertension	Rheumatoid arthritis														2		13i;	1	2		1	0.00	5	13i1;
H9572	001	4	1	04	01	H9572_001_4	7	1	3								00001101000010011100	Hypertension	Rheumatoid arthritis														2		13i;	1	2		1	0.00	5	13i1;
H9572	001	6	1	04	01	H9572_001_6	7	1	3								00001101000010011100	Hypertension	Rheumatoid arthritis														2		13i;	1	2		1	0.00	5	13i1;
H9572	002	1	1	04	01	H9572_002_1	7	1	3								00001101000010011100	Hypertension	Rheumatoid arthritis														2		13i;	1	2		1	0.00	5	13i1;
H9572	002	2	1	04	01	H9572_002_2	7	1	3								00001101000010011100	Hypertension	Rheumatoid arthritis														2		13i;	1	2		1	0.00	5	13i1;
H9572	002	3	1	04	01	H9572_002_3	7	1	3								00001101000010011100	Hypertension	Rheumatoid arthritis														2		13i;	1	2		1	0.00	5	13i1;
H9572	002	4	1	04	01	H9572_002_4	7	1	3								00001101000010011100	Hypertension	Rheumatoid arthritis														2		13i;	1	2		1	0.00	5	13i1;
H9572	002	6	1	04	01	H9572_002_6	8	1	3								00001101000010011100	Hypertension	Rheumatoid arthritis														2		13i;	1	2		1	0.00	5	13i1;
H9572	003	1	1	04	01	H9572_003_1	8	1	3								00001101000010011100	Hypertension	Rheumatoid arthritis														2		13i;	1	2		1	0.00	5	13i1;
H9572	003	2	1	04	01	H9572_003_2	8	1	3								00001101000010011100	Hypertension	Rheumatoid arthritis														2		13i;	1	2		1	0.00	5	13i1;
H9572	003	3	1	04	01	H9572_003_3	8	1	3								00001101000010011100	Hypertension	Rheumatoid arthritis														2		13i;	1	2		1	0.00	5	13i1;
H9572	003	4	1	04	01	H9572_003_4	7	1	3								00001101000010011100	Hypertension	Rheumatoid arthritis														2		13i;	1	2		1	0.00	5	13i1;
H9572	003	6	1	04	01	H9572_003_6	7	1	3								00001101000010011100	Hypertension	Rheumatoid arthritis														2		13i;	1	2		1	0.00	5	13i1;
H9572	004	1	1	04	01	H9572_004_1	7	1	3								00001101000010011100	Hypertension	Rheumatoid arthritis														2		13i;	1	2		1	0.00	5	13i1;
H9572	004	2	1	04	01	H9572_004_2	7	1	3								00001101000010011100	Hypertension	Rheumatoid arthritis														2		13i;	1	2		1	0.00	5	13i1;
H9572	004	3	1	04	01	H9572_004_3	7	1	3								00001101000010011100	Hypertension	Rheumatoid arthritis														2		13i;	1	2		1	0.00	5	13i1;
H9572	004	4	1	04	01	H9572_004_4	7	1	3								00001101000010011100	Hypertension	Rheumatoid arthritis														2		13i;	1	2		1	0.00	5	13i1;
H9572	004	6	1	04	01	H9572_004_6	7	1	3								00001101000010011100	Hypertension	Rheumatoid arthritis														2		13i;	1	2		1	0.00	5	13i1;
H9585	001	0	1	01	01	H9585_001_0	10	1	3								01111111111111110000																2		13i;		1	13i;	2			
H9589	003	0	1	04	01	H9589_003_0	5	1	3								00001101000011000000																2		13i;	1	2		1	55.00	7	13i1;
H9590	001	0	1	01	01	H9590_001_0	5	1	3								00000110010011101000	Chronic alcohol and drug dependence															2		13i;		2		2			
H9615	007	0	1	04	01	H9615_007_0	8	1	2														00000100000000										2		13b;	1	1	13b;	2			
H9615	007	0	1	04	01	H9615_007_0	8	3	2														00000000101000	Osteoarthritis					2	2			2		14c;	1	1	14c;	2			
H9615	007	0	1	04	01	H9615_007_0	8	2	2														00001000000000										2		14c;	1	1	14c;	1	250.00	3	14c8;
H9615	008	0	1	04	01	H9615_008_0	8	1	2														00000100000000										2		13b;	1	1	13b;	2			
H9615	008	0	1	04	01	H9615_008_0	8	2	2														00001000000000										2		14c;	1	1	14c;	1	250.00	3	14c8;
H9615	008	0	1	04	01	H9615_008_0	8	3	2														00000000101000	Osteoarthritis					2	2			2		14c;	1	1	14c;	2			
H9615	009	0	1	04	01	H9615_009_0	8	3	2														00000000101000	Osteoarthritis					2	2			2		14c;	1	1	14c;	2			
H9615	009	0	1	04	01	H9615_009_0	8	1	2														00000100000000										2		13b;	1	1	13b;	2			
H9615	009	0	1	04	01	H9615_009_0	8	2	2														00001000000000										2		14c;	1	1	14c;	1	250.00	3	14c8;
H9615	010	0	1	04	01	H9615_010_0	8	2	2														00001000000000										2		14c;	1	1	14c;	1	250.00	3	14c8;
H9615	010	0	1	04	01	H9615_010_0	8	3	2														00000000101000	Osteoarthritis					2	2			2		14c;	1	1	14c;	2			
H9615	010	0	1	04	01	H9615_010_0	8	1	2														00000100000000										2		13b;	1	1	13b;	2			
H9615	012	0	1	04	01	H9615_012_0	8	2	2														00001000000000										2		14c;	1	1	14c;	1	250.00	3	14c8;
H9615	012	0	1	04	01	H9615_012_0	8	1	2														00000100000000										2		13b;	1	1	13b;	2			
H9615	012	0	1	04	01	H9615_012_0	8	3	2														00000000101000	Osteoarthritis					2	2			2		14c;	1	1	14c;	2			
H9615	014	0	1	04	01	H9615_014_0	8	2	2														00001000000000										2		14c;	1	1	14c;	1	250.00	3	14c8;
H9615	014	0	1	04	01	H9615_014_0	8	1	2														00000100000000										2		13b;	1	1	13b;	2			
H9615	014	0	1	04	01	H9615_014_0	8	3	2														00000000101000	Osteoarthritis					2	2			2		14c;	1	1	14c;	2			
H9615	015	0	1	04	01	H9615_015_0	9	5	2														00000000101000	Osteoarthritis					2	2			2		14c;	1	1	14c;	2			
H9615	015	0	1	04	01	H9615_015_0	9	4	2														01000000000000										2		13b;	1	1	13b;	2			
H9615	015	0	1	04	01	H9615_015_0	9	3	2														00010000000000										2		13b;	1	1	13b;	2			
H9615	015	0	1	04	01	H9615_015_0	9	2	2														00001000000000										2		14c;	1	1	14c;	1	250.00	3	14c8;
H9615	015	0	1	04	01	H9615_015_0	9	1	2														00000100000000										2		13b;	1	1	13b;	2			
H9615	016	0	1	04	01	H9615_016_0	9	2	2														00001000000000										2		14c;	1	1	14c;	1	250.00	3	14c8;
H9615	016	0	1	04	01	H9615_016_0	9	3	2														00010000000000										2		13b;	1	1	13b;	2			
H9615	016	0	1	04	01	H9615_016_0	9	1	2														00000100000000										2		13b;	1	1	13b;	2			
H9615	016	0	1	04	01	H9615_016_0	9	4	2														01000000000000										2		13b;	1	1	13b;	2			
H9615	016	0	1	04	01	H9615_016_0	9	5	2														00000000101000	Osteoarthritis					2	2			2		14c;	1	1	14c;	2			
H9615	017	0	1	04	01	H9615_017_0	9	2	2														00001000000000										2		14c;	1	1	14c;	1	250.00	3	14c8;
H9615	017	0	1	04	01	H9615_017_0	9	1	2														00000100000000										2		13b;	1	1	13b;	2			
H9615	017	0	1	04	01	H9615_017_0	9	3	2														00010000000000										2		13b;	1	1	13b;	2			
H9615	017	0	1	04	01	H9615_017_0	9	5	2														00000000101000	Osteoarthritis					2	2			2		14c;	1	1	14c;	2			
H9615	017	0	1	04	01	H9615_017_0	9	4	2														01000000000000										2		13b;	1	1	13b;	2			
H9615	018	0	1	04	01	H9615_018_0	7	2	2														00001000000000										2		14c;	1	1	14c;	1	250.00	3	14c8;
H9615	018	0	1	04	01	H9615_018_0	7	1	2														00000100000000										2		13b;	1	1	13b;	2			
H9615	018	0	1	04	01	H9615_018_0	7	3	2														00000000101000	Osteoarthritis					2	2			2		14c;	1	1	14c;	2			
H9630	010	0	1	01	01	H9630_010_0	6	1	3								01111111111111110000																2		13i;		1	13i;	1	600	3	13i10;
H9630	010	0	1	01	01	H9630_010_0	6	2	1	10				01111	1514	454																	2		13d;		1	13d;	1	300.00	3	13d;
H9630	011	0	1	01	01	H9630_011_0	6	2	1	10				01111	3645	1276																	2		13d;		1	13d;	1	600.00	3	13d;
H9630	011	0	1	01	01	H9630_011_0	6	1	3								01111111111111110000																2		13i;		1	13i;	1	600	3	13i10;
H9686	001	0	1	01	01	H9686_001_0	4	1	3								01111111111111110000																2		13i;		2		2			
H9686	003	0	1	01	01	H9686_003_0	7	1	3								01111111111111110000																2		13i;13i-O;		2		2			
H9686	004	0	1	01	01	H9686_004_0	5	1	3								01111111111111110000																2		13i;13i-O;		2		2			
H9686	005	0	1	01	01	H9686_005_0	3	1	3								01111111111111110000																2		13i;		2		2			
H9699	004	1	1	01	01	H9699_004_1	3	1	3								00010001000000011100	Coronary artery disease	Sjgrens Syndrome														2		16a;16b;		2		2			
H9699	004	2	1	01	01	H9699_004_2	3	1	3								00010001000000011100	Coronary artery disease	Sjgrens Syndrome														2		16a;16b;		2		2			
H9699	004	3	1	01	01	H9699_004_3	3	1	3								00010001000000011100	Coronary artery disease	Sjgrens Syndrome														2		16a;16b;		2		2			
H9699	006	0	1	01	01	H9699_006_0	3	1	3								00010001000000011100	Coronary artery disease	Sjgrens Syndrome														2		16a;16b;		2		2			
H9725	003	0	1	01	01	H9725_003_0	4	1	1	10				01111	1190	714																	2		13i;		2		2			
H9725	013	0	1	01	01	H9725_013_0	4	1	1	10				01111	937	562																	2		13i;		2		2			
H9730	003	0	1	01	01	H9730_003_0	6	2	1	10				01111	9859	2958																	2		13d;		1	13d;	1	300.00	3	13d;
H9730	003	0	1	01	01	H9730_003_0	6	1	3								01111111111111110000																2		13i;		1	13i;	1	600.00	3	13i10;
H9730	004	0	1	01	01	H9730_004_0	6	2	1	10				01111	17214	6025																	2		13d;		1	13d;	1	600.00	3	13d;
H9730	004	0	1	01	01	H9730_004_0	6	1	3								01111111111111110000																2		13i;		1	13i;	1	1200	3	13i10;
H9730	010	0	1	01	01	H9730_010_0	5	1	3								01111111111111110000																2		13i;		1	13i;	1	600	3	13i10;
H9811	006	0	1	01	01	H9811_006_0	6	1	1	10				01111	442	133																	2		13d;		1	13d;	1	300.00	3	13d;
H9826	002	1	1	01	01	H9826_002_1	9	1	3								01111111111111110000																2		13i;14c;		1	13i;14c;	1	150.00	5	13i1;13i10;
H9826	002	2	1	01	01	H9826_002_2	9	1	3								01111111111111110000																2		13i;14c;		1	13i;14c;	1	250.00	5	13i1;13i10;
H9826	002	3	1	01	01	H9826_002_3	9	1	3								01111111111111110000																2		13i;14c;		1	13i;14c;	1	100.00	5	13i1;13i10;
H9834	001	0	1	01	01	H9834_001_0	3	1	2														10110000001111	Pneumonia	UTI	Cellulitis	Asthma	Deep Vein Thrombosis/ Pulmonary Embolism	2	2			1	001	13d;		2		2			
H9834	001	0	1	01	01	H9834_001_0	3	2	3								00000101000000001100	Hypertension	Pre-Diabetes/ Obesity														1	001	13b;13i;		2		2			
H9834	003	0	1	01	01	H9834_003_0	3	1	2														10110000001111	Pneumonia	UTI	Cellulitis	Asthma	Deep Vein Thrombosis/ Pulmonary Embolism	2	2			1	001	13d;		2		2			
H9834	003	0	1	01	01	H9834_003_0	3	2	3								00000101000000001100	Hypertension	Pre-Diabetes/ Obesity														1	001	13b;13i;		2		2			
H9834	004	0	1	01	01	H9834_004_0	3	2	3								00000101000000001100	Hypertension	Pre-Diabetes/ Obesity														1	001	13b;13i;		2		2			
H9834	004	0	1	01	01	H9834_004_0	3	1	2														10110000001111	Pneumonia	UTI	Cellulitis	Asthma	Deep Vein Thrombosis/ Pulmonary Embolism	2	2			1	001	13d;		2		2			
H9834	005	0	1	01	01	H9834_005_0	3	2	3								00000101000000001100	Hypertension	Pre-Diabetes/ Obesity														1	001	13b;13i;		2		2			
H9834	005	0	1	01	01	H9834_005_0	3	1	2														10110000001111	Pneumonia	UTI	Cellulitis	Asthma	Deep Vein Thrombosis/ Pulmonary Embolism	2	2			1	001	13d;		2		2			
H9834	006	0	1	01	01	H9834_006_0	3	2	3								00000101000000001100	Hypertension	Pre-Diabetes/ Obesity														1	001	13b;13i;		2		2			
H9834	006	0	1	01	01	H9834_006_0	3	1	2														10110000001111	Pneumonia	UTI	Cellulitis	Asthma	Deep Vein Thrombosis/ Pulmonary Embolism	2	2			1	001	13d;		2		2			
H9861	003	0	1	01	01	H9861_003_0	6	1	3								01111111111111110000																2		13i;13i-O;		2		2			
H9876	001	0	1	04	01	H9876_001_0	6	1	3								01111111111111110000																2		13i-O;	1	2		2			
H9876	002	0	1	04	01	H9876_002_0	7	1	3								01111111111111110000																2		13i;13i-O;	1	2		2			
H9877	001	0	1	01	01	H9877_001_0	9	1	3								01111111111111110000																2		13i;		2		2			
H9884	011	0	1	04	01	H9884_011_0	10	1	3								01111111111111111000	Other Eligible Chronic Conditions															2		13i;	1	2		1	25.00	7	13i1;
H9900	002	0	1	01	01	H9900_002_0	6	1	3								01111111111111110000																2		13i;		1	13i;	1	600	3	13i10;
H9900	002	0	1	01	01	H9900_002_0	6	2	1	10				01111	150	45																	2		13d;		1	13d;	1	300.00	3	13d;
H9900	003	0	1	01	01	H9900_003_0	6	1	3								01111111111111110000																2		13i;		1	13i;	1	900	3	13i10;
H9900	003	0	1	01	01	H9900_003_0	6	2	1	10				01111	1171	351																	2		13d;		1	13d;	1	300.00	3	13d;
H9900	004	0	1	01	01	H9900_004_0	5	1	3								01111111111111110000																2		13i;		1	13i;	1	600	3	13i10;
H9900	005	0	1	01	01	H9900_005_0	5	1	3								01111111111111110000																2		13i;		1	13i;	1	600	3	13i10;
H9900	006	0	1	01	01	H9900_006_0	5	1	3								01111111111111110000																2		13i;		1	13i;	1	600	3	13i10;
H9900	007	0	1	01	01	H9900_007_0	5	1	3								01111111111111110000																2		13i;		1	13i;	1	600	3	13i10;
H9900	008	0	1	01	01	H9900_008_0	4	1	3								01111111111111110000																2		13i;		1	13i;	1	600	3	13i10;
H9917	001	0	1	01	01	H9917_001_0	6	1	3								01111111111111110000																2		13i;		1	13i;	2			
H9917	002	0	1	01	01	H9917_002_0	5	1	3								00000010000000000000																2		13i;		1	13i;	2			
H9917	003	0	1	01	01	H9917_003_0	7	1	3								00000000010000000000																2		13c;		1	13c;	2			
H9940	001	0	1	01	01	H9940_001_0	9	1	3								01000110010011100000																2		13i;		2		2			
H9942	001	0	1	04	01	H9942_001_0	5	1	3								00000110010011101000	Chronic alcohol and other drug dependence															2		13i;	1	2		2			
H9943	001	0	1	02	01	H9943_001_0	5	1	3								01111111111111110000																2		13i;13i-O;	2	2		2			
H9943	002	0	1	02	01	H9943_002_0	5	1	3								01111111111111110000																2		13i;13i-O;	2	2		2			
H9943	003	0	1	01	01	H9943_003_0	6	1	3								01111111111111110000																2		13i;13i-O;		2		2			
H9943	004	0	1	01	01	H9943_004_0	4	1	3								01111111111111110000																2		13i;13i-O;		2		2			
H9952	001	0	1	01	01	H9952_001_0	7	1	3								00001101000000000000																2		13i;		2		2			
H9955	001	0	1	01	01	H9955_001_0	7	1	3								01111111111111110000																1	001	13d;13e;13i;13i-O;		2		1	1200.00	3	13d;13e;13i1;13i-O1;
H9955	002	0	1	01	01	H9955_002_0	7	1	3								01111111111111110000																1	001	13d;13e;13i;13i-O;		2		1	1140.00	3	13d;13e;13i1;13i3;13i-O1;
H9955	003	0	1	01	01	H9955_003_0	8	1	3								01111111111111110000																1	001	13d;13e;13i;13i-O;		2		1	1080.00	3	13d;13e;13i1;13i3;13i-O1;
H9976	001	0	1	04	01	H9976_001_0	4	1	3								01111111111111110000																2		13i;	1	1	13i;	1	600	3	13i10;
H9986	001	0	1	01	01	H9986_001_0	6	1	3								01111111111111110000																2		13i;		2		2			
H9986	002	0	1	01	01	H9986_002_0	7	1	3								01111111111111110000																2		13c;13i;		2		2			
R0923	001	0	1	31	11	R0923_001_0	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
R0923	002	0	1	31	11	R0923_002_0	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	1	13d;	2			
R1390	001	0	1	31	11	R1390_001_0	4	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
R1390	002	0	1	31	11	R1390_002_0	4	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
R1390	003	0	1	31	11	R1390_003_0	3	1	3								00000101000010001000	Depression															1	001	13c;	1	2		2			
R1390	003	0	1	31	11	R1390_003_0	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
R1532	001	0	1	31	11	R1532_001_0	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
R1532	002	0	1	31	11	R1532_002_0	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
R3392	001	0	1	31	11	R3392_001_0	4	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
R3392	001	0	1	31	11	R3392_001_0	4	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
R3392	002	0	1	31	11	R3392_002_0	4	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
R3392	002	0	1	31	11	R3392_002_0	4	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
R3392	004	0	1	31	11	R3392_004_0	4	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
R3392	004	0	1	31	11	R3392_004_0	4	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
R4182	001	0	1	31	11	R4182_001_0	4	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
R4182	001	0	1	31	11	R4182_001_0	4	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
R4182	003	0	1	31	11	R4182_003_0	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	1	13d;	2			
R4182	003	0	1	31	11	R4182_003_0	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	1	13d;	2			
R4182	004	0	1	31	11	R4182_004_0	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	1	13d;	2			
R4182	004	0	1	31	11	R4182_004_0	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	1	13d;	2			
R4845	001	0	1	31	11	R4845_001_0	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
R4845	002	0	1	31	11	R4845_002_0	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	1	13d;	2			
R5495	001	0	1	31	11	R5495_001_0	4	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	1	13d;	2			
R5495	002	0	1	31	11	R5495_002_0	4	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
R6801	011	0	1	31	11	R6801_011_0	3	1	1	10				01111	46956	39913																	2		13d;	1	1	13d;	2			
R7220	001	0	1	31	11	R7220_001_0	4	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
R7220	001	0	1	31	11	R7220_001_0	4	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
R7220	002	0	1	31	11	R7220_002_0	3	2	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
R7220	002	0	1	31	11	R7220_002_0	3	1	2														01111111111111	UTI	Cellulitis	Nutritional & Metabolic Disorders	Respiratory Diseases		2	2			1	010	13d;	1	2		2			
