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_b10b_bendesc_yn	pbp_b10b_bendesc_trn	pbp_b10b_bendesc_amo_pal	pbp_b10b_bendesc_lim_pal	pbp_b10b_bendesc_amt_pal	pbp_b10b_bendesc_per_pal	pbp_b10b_bendesc_per_pal_d	pbp_b10b_bendesc_tt_pal	pbp_b10b_bendesc_tt_pal_d	pbp_b10b_bendesc_amt_pal_days	pbp_b10b_bendesc_mt_pal	pbp_b10b_bendesc_mt_pal_d	pbp_b10b_bendesc_amo_al	pbp_b10b_bendesc_lim_al	pbp_b10b_bendesc_amt_al	pbp_b10b_bendesc_per_al	pbp_b10b_bendesc_per_al_d	pbp_b10b_bendesc_tt_al	pbp_b10b_bendesc_tt_al_d	pbp_b10b_bendesc_amt_al_days	pbp_b10b_bendesc_mt_al	pbp_b10b_bendesc_mt_al_d	pbp_b10b_maxplan_yn	pbp_b10b_maxplan_amt	pbp_b10b_maxplan_per	pbp_b10b_maxplan_per_d	pbp_b10b_maxenr_yn	pbp_b10b_maxenr_amt	pbp_b10b_maxenr_per	pbp_b10b_maxenr_per_d	pbp_b10b_coins_yn	pbp_b10b_coins_pct_min	pbp_b10b_coins_pct_max	pbp_b10b_ded_yn	pbp_b10b_ded_amt	pbp_b10b_copay_yn	pbp_b10b_copay_amt_min	pbp_b10b_copay_amt_max	pbp_b10b_auth_yn	pbp_b10b_refer_yn
H0028	007	0	1	01	01	H0028_007_0	6	2	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000.00	3		2				2			2		2			1	2
H0028	014	0	1	01	01	H0028_014_0	8	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000	3		2				2			2		2			1	2
H0028	015	0	1	02	01	H0028_015_0	7	2	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000	3		2				2			2		2			1	2
H0028	016	0	1	02	01	H0028_016_0	8	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000	3		2				2			2		2			1	2
H0028	017	0	1	01	01	H0028_017_0	6	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000	3		2				2			2		2			1	2
H0028	041	0	1	01	01	H0028_041_0	7	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000	3		2				2			2		2			1	2
H0028	043	2	1	01	01	H0028_043_2	8	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000	3		2				2			2		2			1	2
H0028	050	0	1	01	01	H0028_050_0	10	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000	3		2				2			2		2			1	2
H0028	051	0	1	01	01	H0028_051_0	8	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000	3		2				2			2		2			1	2
H0028	053	1	1	01	01	H0028_053_1	7	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000.00	3		2				2			2		2			1	2
H0028	053	3	1	01	01	H0028_053_3	7	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000.00	3		2				2			2		2			1	2
H0028	054	1	1	02	01	H0028_054_1	7	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000	3		2				2			2		2			1	2
H0028	054	2	1	02	01	H0028_054_2	6	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000	3		2				2			2		2			1	2
H0028	055	0	1	02	01	H0028_055_0	6	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000	3		2				2			2		2			1	2
H0028	056	0	1	02	01	H0028_056_0	8	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000	3		2				2			2		2			1	2
H0028	057	0	1	01	01	H0028_057_0	6	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000.00	3		2				2			2		2			1	2
H0028	058	0	1	01	01	H0028_058_0	7	2	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	500	3		2				2			2		2			1	2
H0028	064	0	1	01	01	H0028_064_0	7	2	1	1	2	1				1			111111	Air transport via helicopter or plane											1	3000.00	3		2				2			2		2			1	2
H0523	801	0	1	01	01	H0523_801_0	10	2	1	2											2	1				1			011010		2				2				2			2		2			2	1
H0523	801	0	1	01	01	H0523_801_0	10	1	1	1	2	1				1			011010												2				2				2			2		2			2	1
H0523	805	0	1	01	01	H0523_805_0	10	1	1	1	2	1				1			011010												2				2				2			2		2			2	1
H0523	805	0	1	01	01	H0523_805_0	10	2	1	2											2	1				1			011010		2				2				2			2		2			2	1
H0628	001	0	1	02	01	H0628_001_0	8	1	1	1	2	2	48	3		1			011010												2				2				2			2		1	0.00	0.00	2	2
H0628	001	0	1	02	01	H0628_001_0	8	3	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H0628	001	0	1	02	01	H0628_001_0	8	2	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H0628	003	0	1	02	01	H0628_003_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H0628	005	0	1	02	01	H0628_005_0	8	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H0628	005	0	1	02	01	H0628_005_0	8	2	1	1	2	2	48	3		1			011010												2				2				2			2		1	0.00	0.00	2	2
H0628	005	0	1	02	01	H0628_005_0	8	3	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H0628	009	0	1	02	01	H0628_009_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H0628	012	0	1	01	01	H0628_012_0	7	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H0628	013	0	1	01	01	H0628_013_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H0628	014	0	1	01	01	H0628_014_0	3	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H0628	015	0	1	01	01	H0628_015_0	3	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H0628	017	0	1	02	01	H0628_017_0	7	2	1	1	2	2	48	3		1			011010												2				2				2			2		1	0.00	0.00	2	2
H0628	017	0	1	02	01	H0628_017_0	7	3	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H0628	017	0	1	02	01	H0628_017_0	7	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H0628	801	0	1	01	01	H0628_801_0	9	1	1	1	2	1				1			011010												2				2				2			2		2			2	1
H0628	801	0	1	01	01	H0628_801_0	9	2	1	2											2	1				1			011010		2				2				2			2		2			2	1
H0628	802	0	1	01	01	H0628_802_0	7	2	1	2											2	1				1			011010		2				2				2			2		2			2	1
H0628	802	0	1	01	01	H0628_802_0	7	1	1	1	2	1				1			011010												2				2				2			2		2			2	1
H1019	001	0	1	01	01	H1019_001_0	6	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	500	3		2				2			2		2			1	2
H1019	006	0	1	01	01	H1019_006_0	6	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	500	3		2				2			2		2			1	2
H1019	023	0	1	01	01	H1019_023_0	6	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000	3		2				2			2		2			1	2
H1019	026	0	1	01	01	H1019_026_0	6	2	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000	3		2				2			2		2			1	2
H1019	057	0	1	02	01	H1019_057_0	6	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	500	3		2				2			2		2			1	2
H1019	069	0	1	01	01	H1019_069_0	6	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	500	3		2				2			2		2			1	2
H1019	073	0	1	01	01	H1019_073_0	6	2	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000	3		2				2			2		2			1	2
H1019	098	0	1	01	01	H1019_098_0	6	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	500	3		2				2			2		2			1	2
H1019	102	0	1	01	01	H1019_102_0	6	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	500	3		2				2			2		2			1	2
H1019	103	1	1	01	01	H1019_103_1	5	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	500	3		2				2			2		2			1	2
H1019	103	2	1	01	01	H1019_103_2	5	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	500	3		2				2			2		2			1	2
H1019	108	0	1	01	01	H1019_108_0	13	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	500	3		2				2			2		2			1	2
H1019	109	0	1	01	01	H1019_109_0	6	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	500	3		2				2			2		2			1	2
H1019	117	0	1	01	01	H1019_117_0	6	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	500	3		2				2			2		2			1	2
H1019	118	0	1	01	01	H1019_118_0	6	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	500	3		2				2			2		2			1	2
H1019	121	0	1	01	01	H1019_121_0	6	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	500	3		2				2			2		2			1	2
H1019	122	0	1	01	01	H1019_122_0	6	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	500	3		2				2			2		2			1	2
H1019	123	0	1	01	01	H1019_123_0	6	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	500	3		2				2			2		2			1	2
H1019	124	0	1	01	01	H1019_124_0	6	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	500	3		2				2			2		2			1	2
H1019	125	0	1	01	01	H1019_125_0	6	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	500	3		2				2			2		2			1	2
H1019	130	0	1	01	01	H1019_130_0	6	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	500	3		2				2			2		2			1	2
H1019	141	0	1	02	01	H1019_141_0	11	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	500	3		2				2			2		2			1	2
H1019	142	0	1	02	01	H1019_142_0	5	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	500	3		2				2			2		2			1	2
H1019	145	0	1	01	01	H1019_145_0	5	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000	3		2				2			2		2			1	2
H1019	146	0	1	01	01	H1019_146_0	5	2	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000	3		2				2			2		2			1	2
H1036	054	0	1	01	01	H1036_054_0	6	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	500	3		2				2			2		2			1	2
H1036	062	0	1	01	01	H1036_062_0	7	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	500	3		2				2			2		2			1	2
H1036	065	0	1	01	01	H1036_065_0	6	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	500	3		2				2			2		2			1	2
H1036	077	0	1	01	01	H1036_077_0	6	2	1	1	2	1				1			111111	Air Transport via helicopter or plane.											1	1000	3		2				2			2		2			1	2
H1036	102	0	1	01	01	H1036_102_0	6	1	1	1	2	1				1			111111	Air transport via helicopter or plane											1	1000	3		2				2			2		2			1	2
H1036	167	0	1	01	01	H1036_167_0	7	2	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	500	3		2				2			2		2			1	2
H1036	209	0	1	01	01	H1036_209_0	7	2	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000	3		2				2			2		2			1	2
H1036	210	0	1	01	01	H1036_210_0	7	2	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000	3		2				2			2		2			1	2
H1036	213	0	1	01	01	H1036_213_0	7	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000	3		2				2			2		2			1	2
H1036	214	0	1	01	01	H1036_214_0	7	2	1	1	2	1				1			111111	Air transport via helicopter or plane											1	500	3		2				2			2		2			1	2
H1036	230	0	1	01	01	H1036_230_0	7	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	500	3		2				2			2		2			1	2
H1036	234	0	1	01	01	H1036_234_0	7	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000	3		2				2			2		2			1	2
H1036	235	0	1	01	01	H1036_235_0	6	2	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000	3		2				2			2		2			1	2
H1036	236	0	1	01	01	H1036_236_0	7	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000	3		2				2			2		2			1	2
H1036	285	0	1	01	01	H1036_285_0	6	2	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000	3		2				2			2		2			1	2
H1036	301	0	1	01	01	H1036_301_0	7	1	1	1	2	1				1			111111	Air Transport via helicopter or plane.											1	500	3		2				2			2		2			1	2
H1036	302	0	1	01	01	H1036_302_0	6	1	1	1	2	1				1			111111	Air transport via helicopter and plane.											1	500	3		2				2			2		2			1	2
H1036	304	0	1	01	01	H1036_304_0	5	2	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000	3		2				2			2		2			1	2
H1036	306	0	1	01	01	H1036_306_0	6	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000	3		2				2			2		2			1	2
H1036	307	0	1	01	01	H1036_307_0	5	2	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	500	3		2				2			2		2			1	2
H1036	309	0	1	01	01	H1036_309_0	5	2	1	1	2	1				1			111111	Chronically ill members may receive additional benefits specific to medically-related transportation services. Ground support as well as air support, via plane or helicopter included.											1	500	3		2				2			2		2			1	2
H1036	314	0	1	01	01	H1036_314_0	6	2	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000	3		2				2			2		2			1	2
H1036	315	0	1	01	01	H1036_315_0	6	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	500	3		2				2			2		2			1	2
H1036	316	0	1	01	01	H1036_316_0	6	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	500	3		2				2			2		2			1	2
H1109	801	0	1	01	01	H1109_801_0	8	2	1	2											2	1				1			011010		2				2				2			2		2			2	1
H1109	801	0	1	01	01	H1109_801_0	8	1	1	1	2	1				1			011010												2				2				2			2		2			2	1
H1109	802	0	1	01	01	H1109_802_0	8	2	1	2											2	1				1			011010		2				2				2			2		2			2	1
H1109	802	0	1	01	01	H1109_802_0	8	1	1	1	2	1				1			011010												2				2				2			2		2			2	1
H1206	801	0	1	01	01	H1206_801_0	3	2	1	2											2	1				1			011010		2				2				2			2		2			2	1
H1206	801	0	1	01	01	H1206_801_0	3	1	1	1	2	1				1			011010												2				2				2			2		2			2	1
H1206	802	0	1	01	01	H1206_802_0	3	2	1	2											2	1				1			011010		2				2				2			2		2			2	1
H1206	802	0	1	01	01	H1206_802_0	3	1	1	1	2	1				1			011010												2				2				2			2		2			2	1
H1468	017	0	1	01	01	H1468_017_0	7	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000	3		2				2			2		2			1	2
H1608	062	0	1	04	01	H1608_062_0	7	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H1608	073	0	1	04	01	H1608_073_0	5	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H1608	075	0	1	04	01	H1608_075_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H1608	076	0	1	04	01	H1608_076_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H1608	077	0	1	04	01	H1608_077_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H1608	078	0	1	04	01	H1608_078_0	5	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H1608	801	0	1	04	01	H1608_801_0	8	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H1608	801	0	1	04	01	H1608_801_0	8	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H1608	802	0	1	04	01	H1608_802_0	8	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H1608	802	0	1	04	01	H1608_802_0	8	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H1609	016	0	1	01	01	H1609_016_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H1609	017	0	1	01	01	H1609_017_0	7	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H1609	018	0	1	01	01	H1609_018_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H1609	019	0	1	01	01	H1609_019_0	7	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H1609	020	0	1	01	01	H1609_020_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H1609	021	0	1	01	01	H1609_021_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H1609	022	0	1	01	01	H1609_022_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H1609	025	0	1	01	01	H1609_025_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H1609	027	0	1	01	01	H1609_027_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H1609	042	0	1	01	01	H1609_042_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H1609	043	0	1	01	01	H1609_043_0	7	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H1609	044	0	1	01	01	H1609_044_0	7	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H1609	045	0	1	01	01	H1609_045_0	7	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H1609	046	0	1	01	01	H1609_046_0	7	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H1609	047	0	1	01	01	H1609_047_0	7	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H1609	048	0	1	01	01	H1609_048_0	7	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H1609	049	0	1	01	01	H1609_049_0	7	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H1609	055	0	1	01	01	H1609_055_0	7	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H1609	056	0	1	01	01	H1609_056_0	7	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H1609	059	0	1	01	01	H1609_059_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H1609	061	0	1	01	01	H1609_061_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H1609	062	0	1	01	01	H1609_062_0	8	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H1609	064	0	1	01	01	H1609_064_0	7	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H1609	065	0	1	01	01	H1609_065_0	7	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H1609	066	0	1	01	01	H1609_066_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H1609	067	0	1	01	01	H1609_067_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H1609	801	0	1	01	01	H1609_801_0	7	1	1	1	2	1				1			011010												2				2				2			2		2			2	1
H1609	801	0	1	01	01	H1609_801_0	7	2	1	2											2	1				1			011010		2				2				2			2		2			2	1
H1609	807	0	1	01	01	H1609_807_0	7	2	1	2											2	1				1			011010		2				2				2			2		2			2	1
H1609	807	0	1	01	01	H1609_807_0	7	1	1	1	2	1				1			011010												2				2				2			2		2			2	1
H1610	001	0	1	01	01	H1610_001_0	7	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H1610	002	0	1	01	01	H1610_002_0	7	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H1610	003	0	1	01	01	H1610_003_0	7	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H1692	005	0	1	01	01	H1692_005_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H1692	801	0	1	01	01	H1692_801_0	8	2	1	2											2	1				1			011010		2				2				2			2		2			2	1
H1692	801	0	1	01	01	H1692_801_0	8	1	1	1	2	1				1			011010												2				2				2			2		2			2	1
H1692	802	0	1	01	01	H1692_802_0	8	2	1	2											2	1				1			011010		2				2				2			2		2			2	1
H1692	802	0	1	01	01	H1692_802_0	8	1	1	1	2	1				1			011010												2				2				2			2		2			2	1
H2056	801	0	1	01	01	H2056_801_0	8	2	1	2											2	1				1			011010		2				2				2			2		2			2	1
H2056	801	0	1	01	01	H2056_801_0	8	1	1	1	2	1				1			011010												2				2				2			2		2			2	1
H2056	802	0	1	01	01	H2056_802_0	8	2	1	2											2	1				1			011010		2				2				2			2		2			2	1
H2056	802	0	1	01	01	H2056_802_0	8	1	1	1	2	1				1			011010												2				2				2			2		2			2	1
H2237	001	0	1	01	01	H2237_001_0	7	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	500.00	3		2				2			2		2			1	2
H2256	001	1	1	01	01	H2256_001_1	7	1	1	1	2	2	12	6	Members with ESRD and enrolled in care management are eligible for 3 round trips per week per year. Members with other specified disease states are eligible for 12 round trips per year.	2			001011												2				2				2			2		2			2	2
H2256	001	2	1	01	01	H2256_001_2	7	1	1	1	2	2	12	6	Members with ESRD and enrolled in care management are eligible for 3 round trips per week per year. Members with other specified disease states are eligible for 12 round trips per year.	2			001011												2				2				2			2		2			2	2
H2256	001	6	1	01	01	H2256_001_6	7	1	1	1	2	2	12	6	Members with ESRD and enrolled in care management are eligible for 3 round trips per week per year. Members with other specified disease states are eligible for 12 round trips per year.	2			001011												2				2				2			2		2			2	2
H2256	015	1	1	01	01	H2256_015_1	7	1	1	1	2	2	12	6	Members with ESRD and enrolled in care management are eligible for 3 round trips per week per year. Members with other specified disease states are eligible for 12 round trips per year.	2			001011												2				2				2			2		2			2	2
H2256	015	2	1	01	01	H2256_015_2	7	1	1	1	2	2	12	6	Members with ESRD and enrolled in care management are eligible for 3 round trips per week per year. Members with other specified disease states are eligible for 12 round trips per year.	2			001011												2				2				2			2		2			2	2
H2256	015	6	1	01	01	H2256_015_6	7	1	1	1	2	2	12	6	Members with ESRD and enrolled in care management are eligible for 3 round trips per week per year. Members with other specified disease states are eligible for 12 round trips per year.	2			001011												2				2				2			2		2			2	2
H2256	016	1	1	01	01	H2256_016_1	5	1	1	1	2	2	12	6	Members with ESRD and enrolled in care management are eligible for 3 round trips per week per year. Members with other specified disease states are eligible for 12 round trips per year.	2			001011												2				2				2			2		2			2	2
H2256	016	2	1	01	01	H2256_016_2	5	1	1	1	2	2	12	6	Members with ESRD and enrolled in care management are eligible for 3 round trips per week per year. Members with other specified disease states are eligible for 12 round trips per year.	2			001011												2				2				2			2		2			2	2
H2256	018	1	1	01	01	H2256_018_1	7	1	1	1	2	2	12	6	Members with ESRD and enrolled in care management are eligible for 3 round trips per week per year. Members with other specified disease states are eligible for 12 round trips per year.	2			001011												2				2				2			2		2			2	2
H2256	018	7	1	01	01	H2256_018_7	7	1	1	1	2	2	12	6	Members with ESRD and enrolled in care management are eligible for 3 round trips per week per year. Members with other specified disease states are eligible for 12 round trips per year.	2			001011												2				2				2			2		2			2	2
H2256	018	8	1	01	01	H2256_018_8	6	1	1	1	2	2	12	6	Members with ESRD and enrolled in care management are eligible for 3 round trips per week per year. Members with other specified disease states are eligible for 12 round trips per year.	2			001011												2				2				2			2		2			2	2
H2256	019	1	1	01	01	H2256_019_1	5	1	1	1	2	2	12	6	Members with ESRD and enrolled in care management are eligible for 3 round trips per week per year. Members with other specified disease states are eligible for 12 round trips per year.	2			001011												2				2				2			2		2			2	2
H2256	019	7	1	01	01	H2256_019_7	5	1	1	1	2	2	12	6	Members with ESRD and enrolled in care management are eligible for 3 round trips per week per year. Members with other specified disease states are eligible for 12 round trips per year.	2			001011												2				2				2			2		2			2	2
H2256	026	1	1	01	01	H2256_026_1	7	1	1	1	2	2	12	6	Members with ESRD and enrolled in care management are eligible for 3 round trips per week per year. Members with other specified disease states are eligible for 12 round trips per year.	2			001011												2				2				2			2		2			2	2
H2256	026	2	1	01	01	H2256_026_2	7	1	1	1	2	2	12	6	Members with ESRD and enrolled in care management are eligible for 3 round trips per week per year. Members with other specified disease states are eligible for 12 round trips per year.	2			001011												2				2				2			2		2			2	2
H2256	026	3	1	01	01	H2256_026_3	7	1	1	1	2	2	12	6	Members with ESRD and enrolled in care management are eligible for 3 round trips per week per year. Members with other specified disease states are eligible for 12 round trips per year.	2			001011												2				2				2			2		2			2	2
H2256	028	0	1	01	01	H2256_028_0	5	1	1	1	2	2	12	6	Members with ESRD and enrolled in care management are eligible for 3 round trips per week per year. Members with other specified disease states are eligible for 12 round trips per year.	2			001011												2				2				2			2		2			2	2
H2256	033	0	1	01	01	H2256_033_0	7	1	1	1	2	2	12	6	Members with ESRD and enrolled in care management are eligible for 3 round trips per week per year. Members with other specified disease states are eligible for 12 round trips per year.	2			001011												2				2				2			2		2			2	2
H2256	034	0	1	01	01	H2256_034_0	8	1	1	1	2	2	12	6	Members with ESRD and enrolled in care management are eligible for 3 round trips per week per year. Members with other specified disease states are eligible for 12 round trips per year.	2			001011												2				2				2			2		2			2	2
H2256	036	0	1	01	01	H2256_036_0	8	1	1	1	2	2	12	6	Members with ESRD and enrolled in care management are eligible for 3 round trips per week per year. Members with other specified disease states are eligible for 12 round trips per year.	2			001011												2				2				2			2		2			2	2
H2256	039	0	1	01	01	H2256_039_0	5	1	1	1	2	2	12	6	Members with ESRD and enrolled in care management are eligible for 3 round trips per week per year. Members with other specified disease states are eligible for 12 round trips per year.	2			001011												2				2				2			2		2			2	2
H2256	040	0	1	01	01	H2256_040_0	5	1	1	1	2	2	12	6	Members with ESRD and enrolled in care management are eligible for 3 round trips per week per year. Members with other specified disease states are eligible for 12 round trips per year.	2			001011												2				2				2			2		2			2	2
H2256	041	0	1	01	01	H2256_041_0	5	1	1	1	2	2	12	6	Members with ESRD and enrolled in care management are eligible for 3 round trips per week per year. Members with other specified disease states are eligible for 12 round trips per year.	2			001011												2				2				2			2		2			2	2
H2256	042	0	1	01	01	H2256_042_0	5	1	1	1	2	2	12	6	Members with ESRD and enrolled in care management are eligible for 3 round trips per week per year. Members with other specified disease states are eligible for 12 round trips per year.	2			001011												2				2				2			2		2			2	2
H2256	046	0	1	01	01	H2256_046_0	8	1	1	1	2	2	12	6	Members with ESRD and enrolled in care management are eligible for 3 round trips per week per year. Members with other specified disease states are eligible for 12 round trips per year.	2			001011												2				2				2			2		2			2	2
H2293	001	0	1	04	01	H2293_001_0	5	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline	2				2				2			2		1	0.00	0.00	2	2
H2293	002	0	1	04	01	H2293_002_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H2293	002	0	1	04	01	H2293_002_0	6	2	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H2293	003	0	1	04	01	H2293_003_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H2293	003	0	1	04	01	H2293_003_0	6	2	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H2293	004	0	1	04	01	H2293_004_0	6	2	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H2293	004	0	1	04	01	H2293_004_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H2293	005	0	1	04	01	H2293_005_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H2293	005	0	1	04	01	H2293_005_0	6	2	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H2293	006	0	1	04	01	H2293_006_0	5	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H2293	007	0	1	04	01	H2293_007_0	5	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H2293	007	0	1	04	01	H2293_007_0	5	2	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H2293	008	0	1	04	01	H2293_008_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H2293	009	0	1	04	01	H2293_009_0	2	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H2293	011	0	1	04	01	H2293_011_0	5	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H2293	021	0	1	04	01	H2293_021_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H2293	022	0	1	04	01	H2293_022_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H2293	023	0	1	04	01	H2293_023_0	4	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H2293	023	0	1	04	01	H2293_023_0	4	2	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H2486	006	0	1	01	01	H2486_006_0	6	1	1	1	2	2	3	5		2		3	100011	Car or wheelchair access vehicle											2				2				2			2		2			1	2
H2486	007	0	1	01	01	H2486_007_0	7	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000	3		2				2			2		2			1	2
H2663	067	0	1	01	01	H2663_067_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H2663	067	0	1	01	01	H2663_067_0	6	2	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H2663	805	0	1	01	01	H2663_805_0	8	2	1	2											2	1				1			011010		2				2				2			2		2			2	1
H2663	805	0	1	01	01	H2663_805_0	8	1	1	1	2	1				1			011010												2				2				2			2		2			2	1
H2663	810	0	1	01	01	H2663_810_0	8	1	1	1	2	1				1			011010												2				2				2			2		2			2	1
H2663	810	0	1	01	01	H2663_810_0	8	2	1	2											2	1				1			011010		2				2				2			2		2			2	1
H3146	001	0	1	02	01	H3146_001_0	8	1	1	1	2	2	24	3		1		24	011010												2				2				2			2		1	0.00	0.00	2	2
H3146	002	0	1	01	01	H3146_002_0	8	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H3146	003	0	1	01	01	H3146_003_0	9	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H3146	004	0	1	02	01	H3146_004_0	8	1	1	1	2	2	24	3		1		24	011010												2				2				2			2		1	0.00	0.00	2	2
H3146	006	0	1	01	01	H3146_006_0	8	1	1	1	2	2	24	3		1		24	011010												2				2				2			2		1	0.00	0.00	2	2
H3146	006	0	1	01	01	H3146_006_0	8	2	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H3146	007	0	1	02	01	H3146_007_0	8	1	1	1	2	2	24	3		1		24	011010												2				2				2			2		1	0.00	0.00	2	2
H3146	008	0	1	01	01	H3146_008_0	9	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H3146	009	0	1	01	01	H3146_009_0	9	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H3146	011	0	1	01	01	H3146_011_0	8	2	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H3146	011	0	1	01	01	H3146_011_0	8	1	1	1	2	2	24	3		1		24	011010												2				2				2			2		1	0.00	0.00	2	2
H3146	012	0	1	01	01	H3146_012_0	8	1	1	1	2	2	24	3		1		24	011010												2				2				2			2		1	0.00	0.00	2	2
H3146	012	0	1	01	01	H3146_012_0	8	2	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H3146	013	0	1	01	01	H3146_013_0	8	1	1	1	2	2	24	3		1		24	011010												2				2				2			2		1	0.00	0.00	2	2
H3146	013	0	1	01	01	H3146_013_0	8	2	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H3146	014	0	1	02	01	H3146_014_0	8	1	1	1	2	2	24	3		1		24	011010												2				2				2			2		1	0.00	0.00	2	2
H3146	015	0	1	01	01	H3146_015_0	9	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H3146	016	0	1	01	01	H3146_016_0	9	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H3146	017	0	1	01	01	H3146_017_0	9	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H3146	018	0	1	01	01	H3146_018_0	9	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H3146	019	0	1	01	01	H3146_019_0	9	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H3146	801	0	1	01	01	H3146_801_0	8	2	1	2											2	1				1			011010		2				2				2			2		2			2	1
H3146	801	0	1	01	01	H3146_801_0	8	1	1	1	2	1				1			011010												2				2				2			2		2			2	1
H3146	802	0	1	01	01	H3146_802_0	8	1	1	1	2	1				1			011010												2				2				2			2		2			2	1
H3146	802	0	1	01	01	H3146_802_0	8	2	1	2											2	1				1			011010		2				2				2			2		2			2	1
H3152	801	0	1	01	01	H3152_801_0	8	2	1	2											2	1				1			011010		2				2				2			2		2			2	1
H3152	801	0	1	01	01	H3152_801_0	8	1	1	1	2	1				1			011010												2				2				2			2		2			2	1
H3152	804	0	1	01	01	H3152_804_0	8	1	1	1	2	1				1			011010												2				2				2			2		2			2	1
H3152	804	0	1	01	01	H3152_804_0	8	2	1	2											2	1				1			011010		2				2				2			2		2			2	1
H3192	007	0	1	01	01	H3192_007_0	8	2	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H3192	007	0	1	01	01	H3192_007_0	8	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H3192	801	0	1	01	01	H3192_801_0	8	1	1	1	2	1				1			011010												2				2				2			2		2			2	1
H3192	801	0	1	01	01	H3192_801_0	8	2	1	2											2	1				1			011010		2				2				2			2		2			2	1
H3192	802	0	1	01	01	H3192_802_0	8	2	1	2											2	1				1			011010		2				2				2			2		2			2	1
H3192	802	0	1	01	01	H3192_802_0	8	1	1	1	2	1				1			011010												2				2				2			2		2			2	1
H3219	007	0	1	04	01	H3219_007_0	7	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H3219	801	0	1	04	01	H3219_801_0	9	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H3219	801	0	1	04	01	H3219_801_0	9	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H3219	802	0	1	04	01	H3219_802_0	9	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H3219	802	0	1	04	01	H3219_802_0	9	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H3239	001	0	1	01	01	H3239_001_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H3239	002	0	1	01	01	H3239_002_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H3239	003	0	1	01	01	H3239_003_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H3239	005	0	1	01	01	H3239_005_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H3239	006	0	1	01	01	H3239_006_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H3239	007	0	1	01	01	H3239_007_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H3239	008	0	1	01	01	H3239_008_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H3239	010	0	1	01	01	H3239_010_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H3239	011	0	1	01	01	H3239_011_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H3239	012	0	1	01	01	H3239_012_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H3239	013	0	1	01	01	H3239_013_0	6	2	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H3239	013	0	1	01	01	H3239_013_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H3239	015	0	1	01	01	H3239_015_0	6	2	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H3239	015	0	1	01	01	H3239_015_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H3239	016	0	1	01	01	H3239_016_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H3239	016	0	1	01	01	H3239_016_0	6	2	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H3239	017	0	1	01	01	H3239_017_0	6	2	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H3239	017	0	1	01	01	H3239_017_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H3239	018	0	1	01	01	H3239_018_0	6	2	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H3239	018	0	1	01	01	H3239_018_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H3239	019	0	1	01	01	H3239_019_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H3239	019	0	1	01	01	H3239_019_0	6	2	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H3239	020	0	1	01	01	H3239_020_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H3239	020	0	1	01	01	H3239_020_0	6	2	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H3288	034	0	1	04	01	H3288_034_0	3	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H3288	047	0	1	04	01	H3288_047_0	9	1	1	1	2	2	24	3		1		24	011010												2				2				2			2		1	0.00	0.00	2	2
H3288	801	0	1	04	01	H3288_801_0	8	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H3288	801	0	1	04	01	H3288_801_0	8	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H3288	802	0	1	04	01	H3288_802_0	8	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H3288	802	0	1	04	01	H3288_802_0	8	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H3312	069	0	1	01	01	H3312_069_0	7	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H3312	070	0	1	01	01	H3312_070_0	7	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H3312	073	0	1	01	01	H3312_073_0	7	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H3312	801	0	1	01	01	H3312_801_0	8	2	1	2											2	1				1			011010		2				2				2			2		2			2	1
H3312	801	0	1	01	01	H3312_801_0	8	1	1	1	2	1				1			011010												2				2				2			2		2			2	1
H3312	804	0	1	01	01	H3312_804_0	8	2	1	2											2	1				1			011010		2				2				2			2		2			2	1
H3312	804	0	1	01	01	H3312_804_0	8	1	1	1	2	1				1			011010												2				2				2			2		2			2	1
H3443	001	0	1	01	01	H3443_001_0	16	2	1	1	2	1				1			000010												2				2				2			2		2			2	2
H3443	002	0	1	01	01	H3443_002_0	16	2	1	1	2	1				1			000010												2				2				2			2		2			2	2
H3597	011	0	1	02	01	H3597_011_0	8	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H3597	012	0	1	02	01	H3597_012_0	8	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H3597	801	0	1	01	01	H3597_801_0	8	1	1	1	2	1				1			011010												2				2				2			2		2			2	1
H3597	801	0	1	01	01	H3597_801_0	8	2	1	2											2	1				1			011010		2				2				2			2		2			2	1
H3597	802	0	1	01	01	H3597_802_0	8	2	1	2											2	1				1			011010		2				2				2			2		2			2	1
H3597	802	0	1	01	01	H3597_802_0	8	1	1	1	2	1				1			011010												2				2				2			2		2			2	1
H3672	019	0	1	01	01	H3672_019_0	13	2	1	1	2	2	35	3		2			011111												1	1000.00	3		2				2			2		2			1	2
H3748	801	0	1	01	01	H3748_801_0	8	2	1	2											2	1				1			011010		2				2				2			2		2			2	1
H3748	801	0	1	01	01	H3748_801_0	8	1	1	1	2	1				1			011010												2				2				2			2		2			2	1
H3748	802	0	1	01	01	H3748_802_0	8	2	1	2											2	1				1			011010		2				2				2			2		2			2	1
H3748	802	0	1	01	01	H3748_802_0	8	1	1	1	2	1				1			011010												2				2				2			2		2			2	1
H3815	007	0	1	01	01	H3815_007_0	19	2	1	1	2	1				1			000010												2				2				2			2		2			1	1
H3909	001	0	1	04	01	H3909_001_0	6	2	1	1	2	2	24	3		1		24	111010	Transport services also include medical sedan and wheelchair van.											2				2				2			2		2			2	2
H3909	007	0	1	04	01	H3909_007_0	6	2	1	1	2	2	24	3		1		24	111010	Transport services also include medical sedan and wheelchair van.											2				2				2			2		2			2	2
H3909	009	0	1	04	01	H3909_009_0	6	2	1	1	2	2	24	3		1		24	111010	Transport services also include medical sedan and wheelchair van.											2				2				2			2		2			2	2
H3909	014	0	1	04	01	H3909_014_0	7	2	1	1	2	2	24	3		1		24	111010	Transport services also include medical sedan and wheelchair van.											2				2				2			2		2			2	2
H3909	015	0	1	04	01	H3909_015_0	7	2	1	1	2	2	24	3		1		24	111010	Transport services also include medical sedan and wheelchair van.											2				2				2			2		2			2	2
H3909	017	0	1	04	01	H3909_017_0	6	2	1	1	2	2	24	3		1		24	111010	Transport services also include medical sedan and wheelchair van.											2				2				2			2		2			2	2
H3928	001	0	1	01	01	H3928_001_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H3928	801	0	1	01	01	H3928_801_0	8	2	1	2											2	1				1			011010		2				2				2			2		2			2	1
H3928	801	0	1	01	01	H3928_801_0	8	1	1	1	2	1				1			011010												2				2				2			2		2			2	1
H3928	803	0	1	01	01	H3928_803_0	8	1	1	1	2	1				1			011010												2				2				2			2		2			2	1
H3928	803	0	1	01	01	H3928_803_0	8	2	1	2											2	1				1			011010		2				2				2			2		2			2	1
H3931	004	0	1	02	01	H3931_004_0	6	1	1	1	2	2	24	3		1			011010												2				2				2			2		1	0.00	0.00	2	2
H3931	159	0	1	01	01	H3931_159_0	7	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H3931	801	0	1	01	01	H3931_801_0	8	2	1	2											2	1				1			011010		2				2				2			2		2			2	1
H3931	801	0	1	01	01	H3931_801_0	8	1	1	1	2	1				1			011010												2				2				2			2		2			2	1
H3931	804	0	1	01	01	H3931_804_0	8	2	1	2											2	1				1			011010		2				2				2			2		2			2	1
H3931	804	0	1	01	01	H3931_804_0	8	1	1	1	2	1				1			011010												2				2				2			2		2			2	1
H3952	008	0	1	01	01	H3952_008_0	5	2	1	1	2	2	24	3		1		24	111010	Transport services also include medical sedan and wheelchair van.											2				2				2			2		2			2	2
H3952	020	0	1	01	01	H3952_020_0	8	2	1	1	2	2	24	3		1		24	111010	Transport services also include medical sedan and wheelchair van.											2				2				2			2		2			2	2
H3952	044	0	1	01	01	H3952_044_0	5	2	1	1	2	2	24	3		1		24	111010	Transport services also include medical sedan and wheelchair van.											2				2				2			2		2			2	2
H3952	045	0	1	01	01	H3952_045_0	8	2	1	1	2	2	24	3		1		24	111010	Transport services also include medical sedan and wheelchair van.											2				2				2			2		2			2	2
H3952	048	0	1	01	01	H3952_048_0	5	2	1	1	2	2	24	3		1		24	111010	Transport services also include medical sedan and wheelchair van.											2				2				2			2		2			2	2
H3952	049	0	1	01	01	H3952_049_0	8	2	1	1	2	2	24	3		1		24	111010	Transport services also include medical sedan and wheelchair van.											2				2				2			2		2			2	2
H3952	050	0	1	01	01	H3952_050_0	5	2	1	1	2	2	24	3		1		24	111010	Transport services also include medical sedan and wheelchair van.											2				2				2			2		2			2	2
H3952	051	0	1	01	01	H3952_051_0	8	2	1	1	2	2	24	3		1		24	111010	Transport services also include medical sedan and wheelchair van.											2				2				2			2		2			2	2
H3952	053	0	1	02	01	H3952_053_0	9	2	1	1	2	2	24	3		1		24	111010	Transport services also include medical sedan and wheelchair van.											2				2				2			2		2			2	2
H3952	054	0	1	02	01	H3952_054_0	9	2	1	1	2	2	24	3		1		24	111010	Transport services also include medical sedan and wheelchair van.											2				2				2			2		2			2	2
H3952	055	0	1	01	01	H3952_055_0	9	2	1	1	2	2	24	3		1		24	111010	Transport services also include medical sedan and wheelchair van.											2				2				2			2		2			2	2
H3952	056	0	1	01	01	H3952_056_0	10	2	1	1	2	2	24	3		1		24	111010	Transport services also include medical sedan and wheelchair van.											2				2				2			2		2			2	2
H3957	031	0	1	02	01	H3957_031_0	9	1	1	1	2	2	48	3		1		48	100011	Benefit allows up to 50 miles per one way trip. Reservations must be made 48 hours in advance for the request to be considered.											2				2				2			2		2			1	2
H3959	001	0	1	02	01	H3959_001_0	7	1	1	1	2	2	24	3		1		24	011010												2				2				2			2		1	0.00	0.00	2	2
H3959	002	0	1	02	01	H3959_002_0	7	1	1	1	2	2	24	3		1			011010												2				2				2			2		1	0.00	0.00	2	2
H3959	010	0	1	02	01	H3959_010_0	6	1	1	1	2	2	24	3		1		24	011010												2				2				2			2		1	0.00	0.00	2	2
H3959	032	0	1	02	01	H3959_032_0	7	1	1	1	2	2	24	3		1		24	011010												2				2				2			2		1	0.00	0.00	2	2
H3959	033	0	1	02	01	H3959_033_0	7	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H3959	033	0	1	02	01	H3959_033_0	7	2	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H3959	035	0	1	01	01	H3959_035_0	6	2	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H3959	035	0	1	01	01	H3959_035_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H3959	036	0	1	01	01	H3959_036_0	6	2	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H3959	036	0	1	01	01	H3959_036_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H3959	039	0	1	02	01	H3959_039_0	6	1	1	1	2	2	24	3		1		24	011010												2				2				2			2		1	0.00	0.00	2	2
H3959	046	0	1	02	01	H3959_046_0	8	2	1	1	2	2	24	3		1			011010												2				2				2			2		1	0.00	0.00	2	2
H3959	046	0	1	02	01	H3959_046_0	8	1	1	1	2	2	48	3		1			011010												2				2				2			2		1	0.00	0.00	2	2
H3959	047	0	1	02	01	H3959_047_0	8	2	1	1	2	2	24	3		1			011010												2				2				2			2		1	0.00	0.00	2	2
H3959	047	0	1	02	01	H3959_047_0	8	1	1	1	2	2	48	3		1			011010												2				2				2			2		1	0.00	0.00	2	2
H3959	049	0	1	02	01	H3959_049_0	7	1	1	1	2	2	48	3		1			011010												2				2				2			2		1	0.00	0.00	2	2
H3959	049	0	1	02	01	H3959_049_0	7	2	1	1	2	2	24	3		1			011010												2				2				2			2		1	0.00	0.00	2	2
H3959	051	0	1	02	01	H3959_051_0	6	1	1	1	2	2	48	3		1			011010												2				2				2			2		1	0.00	0.00	2	2
H3959	052	0	1	02	01	H3959_052_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H3959	052	0	1	02	01	H3959_052_0	6	2	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H3959	063	0	1	01	01	H3959_063_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H3959	803	0	1	01	01	H3959_803_0	8	2	1	2											2	1				1			011010		2				2				2			2		2			2	1
H3959	803	0	1	01	01	H3959_803_0	8	1	1	1	2	1				1			011010												2				2				2			2		2			2	1
H3959	804	0	1	01	01	H3959_804_0	8	2	1	2											2	1				1			011010		2				2				2			2		2			2	1
H3959	804	0	1	01	01	H3959_804_0	8	1	1	1	2	1				1			011010												2				2				2			2		2			2	1
H4005	001	0	1	04	01	H4005_001_0	4	1	1	2											2	1				1			110010	Other methods of transportation are available, such as an automobile through a contracted provider.	1	75.00	7		2				2			2		2			2	2
H4141	003	0	1	01	01	H4141_003_0	8	2	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	500	3		2				2			2		2			1	2
H4141	021	0	1	01	01	H4141_021_0	6	3	1	1	2	1				1			111111	Chronically ill members, who participate with care management services, may receive additional benefits specific to medically-related transportation services. In addition to ground transport, members may also utilize air transport via helicopter or plane. Benefits are limited to the maximum benefit amount entered, all services combined, per year and must be coordinated and authorized by a Care Manager.											1	500	3		2				2			2		2			1	2
H4461	022	0	1	01	01	H4461_022_0	9	2	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	500	3		2				2			2		2			1	2
H4461	038	0	1	01	01	H4461_038_0	7	2	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	500	3		2				2			2		2			1	2
H4523	801	0	1	01	01	H4523_801_0	8	1	1	1	2	1				1			011010												2				2				2			2		2			2	1
H4523	801	0	1	01	01	H4523_801_0	8	2	1	2											2	1				1			011010		2				2				2			2		2			2	1
H4523	802	0	1	01	01	H4523_802_0	8	2	1	2											2	1				1			011010		2				2				2			2		2			2	1
H4523	802	0	1	01	01	H4523_802_0	8	1	1	1	2	1				1			011010												2				2				2			2		2			2	1
H4623	001	0	1	02	01	H4623_001_0	12	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000	3		2				2			2		2			1	2
H4623	002	0	1	02	01	H4623_002_0	6	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000	3		2				2			2		2			1	2
H4624	010	0	1	01	01	H4624_010_0	9	1	1	1	2	1				1			111010	Mode of Transportation will be taxi, rideshare services, van and wheelchair accessible vehicles.											2				2				2			2		1	0.00	0.00	2	2
H4624	011	0	1	01	01	H4624_011_0	7	1	1	1	2	1				1			111010	Mode of Transportation will be taxi, rideshare services, van and wheelchair accessible vehicles.											2				2				2			2		1	0.00	0.00	2	2
H4624	012	0	1	01	01	H4624_012_0	9	1	1	1	2	1				1			111010	Mode of Transportation will be taxi, rideshare services, van and wheelchair accessible vehicles.											2				2				2			2		1	0.00	0.00	2	2
H4624	016	0	1	01	01	H4624_016_0	10	1	1	1	2	1				1			111010	Mode of Transportation will be taxi, rideshare services, van and wheelchair accessible vehicles.											2				2				2			2		1	0.00	0.00	2	2
H4624	022	0	1	01	01	H4624_022_0	10	1	1	1	2	1				1			110010	Mode of Transportation will be taxi, van and wheelchair accessible vehicles.											2				2				2			2		1	0.00	0.00	2	2
H4624	024	0	1	01	01	H4624_024_0	10	1	1	1	2	1				1			111010	Mode of Transportation will be taxi, rideshare services, van and wheelchair accessible vehicles.											2				2				2			2		1	0.00	0.00	2	2
H4624	026	0	1	01	01	H4624_026_0	10	1	1	1	2	1				1			111010	Mode of Transportation will be taxi, rideshare services, van and wheelchair accessible vehicles.											2				2				2			2		1	0.00	0.00	2	2
H4624	027	0	1	01	01	H4624_027_0	9	1	1	1	2	1				1			111010	Mode of Transportation will be taxi, rideshare services, van and wheelchair accessible vehicles.											2				2				2			2		1	0.00	0.00	2	2
H4624	028	0	1	01	01	H4624_028_0	9	1	1	1	2	1				1			111010	Mode of Transportation will be taxi, rideshare services, van and wheelchair accessible vehicles.											2				2				2			2		1	0.00	0.00	2	2
H4711	011	0	1	01	01	H4711_011_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H4711	012	0	1	01	01	H4711_012_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H4711	013	0	1	01	01	H4711_013_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H4711	801	0	1	01	01	H4711_801_0	8	2	1	2											2	1				1			011010		2				2				2			2		2			2	1
H4711	801	0	1	01	01	H4711_801_0	8	1	1	1	2	1				1			011010												2				2				2			2		2			2	1
H4711	802	0	1	01	01	H4711_802_0	8	1	1	1	2	1				1			011010												2				2				2			2		2			2	1
H4711	802	0	1	01	01	H4711_802_0	8	2	1	2											2	1				1			011010		2				2				2			2		2			2	1
H4835	801	0	1	01	01	H4835_801_0	8	1	1	1	2	1				1			011010												2				2				2			2		2			2	1
H4835	801	0	1	01	01	H4835_801_0	8	2	1	2											2	1				1			011010		2				2				2			2		2			2	1
H4835	802	0	1	01	01	H4835_802_0	8	1	1	1	2	1				1			011010												2				2				2			2		2			2	1
H4835	802	0	1	01	01	H4835_802_0	8	2	1	2											2	1				1			011010		2				2				2			2		2			2	1
H4982	801	0	1	01	01	H4982_801_0	8	2	1	2											2	1				1			011010		2				2				2			2		2			2	1
H4982	801	0	1	01	01	H4982_801_0	8	1	1	1	2	1				1			011010												2				2				2			2		2			2	1
H4982	802	0	1	01	01	H4982_802_0	8	2	1	2											2	1				1			011010		2				2				2			2		2			2	1
H4982	802	0	1	01	01	H4982_802_0	8	1	1	1	2	1				1			011010												2				2				2			2		2			2	1
H5178	002	0	1	01	01	H5178_002_0	5	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	500	3		2				2			2		2			1	2
H5215	001	0	1	04	01	H5215_001_0	7	1	1	1	2	2	24	3		1			100000	Our plan has contracted with a transportation vendor to provide members with transportation to or from dialysis services.											2				2				2			2		2			1	2
H5215	002	0	1	04	01	H5215_002_0	5	1	1	1	2	2	24	3		1			100000	Our plan has contracted with a transportation vendor to provide members with transportation to or from dialysis services.											2				2				2			2		2			1	2
H5215	005	0	1	04	01	H5215_005_0	5	1	1	1	2	2	24	3		1			100000	Plan contracted transportation vendor											2				2				2			2		2			1	2
H5215	006	0	1	04	01	H5215_006_0	7	1	1	1	2	2	24	3		1			100000	Plan contracted transportation vendor											2				2				2			2		2			1	2
H5215	007	0	1	04	01	H5215_007_0	6	1	1	1	2	2	24	3		1			100000	Plan contracted transportation vendor											2				2				2			2		2			1	2
H5215	008	0	1	04	01	H5215_008_0	5	1	1	1	2	2	24	3		1			100000	Plan contracted transportation vendor											2				2				2			2		2			1	2
H5215	009	0	1	04	01	H5215_009_0	5	1	1	1	2	2	24	3		1			100000	Plan contracted transportation vendor											2				2				2			2		2			1	2
H5215	010	0	1	04	01	H5215_010_0	6	1	1	1	2	2	24	3		1			100000	Plan contracted transportation vendor											2				2				2			2		2			1	2
H5215	011	0	1	04	01	H5215_011_0	6	1	1	1	2	2	24	3		1			100000	Plan contracted transportation vendor											2				2				2			2		2			1	2
H5215	012	0	1	04	01	H5215_012_0	8	1	1	1	2	2	24	3		1			100000	Plan contracted transportation vendor											2				2				2			2		2			1	2
H5215	013	0	1	04	01	H5215_013_0	4	1	1	1	2	2	24	3		1			100000	Plan contracted transportation vendor											2				2				2			2		2			1	2
H5215	014	0	1	04	01	H5215_014_0	5	1	1	1	2	2	24	3		1			100000	Plan contracted transportation vendor											2				2				2			2		2			1	2
H5216	014	0	1	04	01	H5216_014_0	8	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000	3		2				2			2		2			1	2
H5216	032	0	1	04	01	H5216_032_0	9	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000	3		2				2			2		2			1	2
H5216	083	0	1	04	01	H5216_083_0	9	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000.00	3		2				2			2		2			1	2
H5216	140	0	1	04	01	H5216_140_0	11	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000	3		2				2			2		2			1	2
H5216	164	0	1	04	01	H5216_164_0	8	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000	3		2				2			2		2			1	2
H5216	205	0	1	04	01	H5216_205_0	11	2	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	500	3		2				2			2		2			1	2
H5216	206	0	1	04	01	H5216_206_0	8	2	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	500	3		2				2			2		2			1	2
H5216	220	0	1	04	01	H5216_220_0	7	2	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	750.00	3		2				2			2		2			1	2
H5216	227	0	1	04	01	H5216_227_0	7	2	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000	3		2				2			2		2			1	2
H5216	242	0	1	04	01	H5216_242_0	7	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	3000.00	3		2				2			2		2			1	2
H5216	243	0	1	04	01	H5216_243_0	7	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	3000.00	3		2				2			2		2			1	2
H5216	254	0	1	04	01	H5216_254_0	7	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000	3		2				2			2		2			1	2
H5216	257	0	1	04	01	H5216_257_0	7	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	500	3		2				2			2		2			1	2
H5216	268	0	1	04	01	H5216_268_0	7	2	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000	3		2				2			2		2			1	2
H5216	277	0	1	04	01	H5216_277_0	7	2	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	500	3		2				2			2		2			1	2
H5216	286	0	1	04	01	H5216_286_0	6	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	500	3		2				2			2		2			1	2
H5216	293	0	1	04	01	H5216_293_0	9	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	500	3		2				2			2		2			1	2
H5216	318	1	1	04	01	H5216_318_1	7	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000	3		2				2			2		2			1	2
H5216	318	2	1	04	01	H5216_318_2	7	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000	3		2				2			2		2			1	2
H5216	318	3	1	04	01	H5216_318_3	6	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000	3		2				2			2		2			1	2
H5216	329	0	1	04	01	H5216_329_0	10	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000	3		2				2			2		2			1	2
H5216	362	0	1	04	01	H5216_362_0	8	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	3000.00	3		2				2			2		2			1	2
H5216	369	0	1	04	01	H5216_369_0	10	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000.00	3		2				2			2		2			1	2
H5216	373	0	1	04	01	H5216_373_0	8	2	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000	3		2				2			2		2			1	2
H5216	377	0	1	04	01	H5216_377_0	6	2	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000.00	3		2				2			2		2			1	2
H5216	400	0	1	04	01	H5216_400_0	6	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	3000.00	3		2				2			2		2			1	2
H5216	401	0	1	04	01	H5216_401_0	7	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	3000.00	3		2				2			2		2			1	2
H5302	012	0	1	01	01	H5302_012_0	6	2	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5302	012	0	1	01	01	H5302_012_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5302	013	0	1	01	01	H5302_013_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5302	014	0	1	01	01	H5302_014_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5302	020	0	1	01	01	H5302_020_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5302	809	0	1	01	01	H5302_809_0	7	1	1	1	2	1				1			011010												2				2				2			2		2			2	1
H5302	809	0	1	01	01	H5302_809_0	7	2	1	2											2	1				1			011010		2				2				2			2		2			2	1
H5302	810	0	1	01	01	H5302_810_0	7	1	1	1	2	1				1			011010												2				2				2			2		2			2	1
H5302	810	0	1	01	01	H5302_810_0	7	2	1	2											2	1				1			011010		2				2				2			2		2			2	1
H5325	001	0	1	01	01	H5325_001_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5325	002	0	1	01	01	H5325_002_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5325	003	0	1	01	01	H5325_003_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5325	004	0	1	01	01	H5325_004_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5325	005	0	1	01	01	H5325_005_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5325	006	0	1	01	01	H5325_006_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5325	007	0	1	01	01	H5325_007_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5325	009	0	1	01	01	H5325_009_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5325	010	0	1	01	01	H5325_010_0	6	2	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5325	010	0	1	01	01	H5325_010_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5325	011	0	1	01	01	H5325_011_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5325	011	0	1	01	01	H5325_011_0	6	2	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5521	116	0	1	04	01	H5521_116_0	7	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5521	169	0	1	04	01	H5521_169_0	8	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5521	171	0	1	04	01	H5521_171_0	7	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5521	178	0	1	04	01	H5521_178_0	7	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5521	216	0	1	04	01	H5521_216_0	7	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5521	218	0	1	04	01	H5521_218_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5521	220	0	1	04	01	H5521_220_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5521	222	0	1	04	01	H5521_222_0	7	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5521	224	0	1	04	01	H5521_224_0	7	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5521	227	0	1	04	01	H5521_227_0	7	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5521	229	0	1	04	01	H5521_229_0	4	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5521	230	0	1	04	01	H5521_230_0	7	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5521	232	0	1	04	01	H5521_232_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5521	233	0	1	04	01	H5521_233_0	7	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5521	234	0	1	04	01	H5521_234_0	7	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5521	302	0	1	04	01	H5521_302_0	7	2	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5521	302	0	1	04	01	H5521_302_0	7	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5521	326	0	1	04	01	H5521_326_0	7	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5521	360	0	1	04	01	H5521_360_0	7	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5521	360	0	1	04	01	H5521_360_0	7	2	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5521	364	0	1	04	01	H5521_364_0	7	2	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5521	364	0	1	04	01	H5521_364_0	7	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5521	365	0	1	04	01	H5521_365_0	7	2	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5521	365	0	1	04	01	H5521_365_0	7	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5521	366	0	1	04	01	H5521_366_0	7	2	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5521	366	0	1	04	01	H5521_366_0	7	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5521	376	0	1	04	01	H5521_376_0	9	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5521	398	0	1	04	01	H5521_398_0	7	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5521	399	0	1	04	01	H5521_399_0	7	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5521	399	0	1	04	01	H5521_399_0	7	2	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5521	447	0	1	04	01	H5521_447_0	9	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5521	448	0	1	04	01	H5521_448_0	9	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5521	449	0	1	04	01	H5521_449_0	8	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5521	462	0	1	04	01	H5521_462_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5521	463	0	1	04	01	H5521_463_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5521	464	0	1	04	01	H5521_464_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5521	465	0	1	04	01	H5521_465_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5521	467	0	1	04	01	H5521_467_0	7	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5521	468	0	1	04	01	H5521_468_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5521	469	0	1	04	01	H5521_469_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5521	470	0	1	04	01	H5521_470_0	7	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5521	471	0	1	04	01	H5521_471_0	7	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5521	472	0	1	04	01	H5521_472_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5521	472	0	1	04	01	H5521_472_0	6	2	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5521	473	0	1	04	01	H5521_473_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5521	473	0	1	04	01	H5521_473_0	6	2	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5521	474	0	1	04	01	H5521_474_0	7	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5521	474	0	1	04	01	H5521_474_0	7	2	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5521	801	0	1	04	01	H5521_801_0	7	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5521	801	0	1	04	01	H5521_801_0	7	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5521	802	0	1	04	01	H5521_802_0	7	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5521	802	0	1	04	01	H5521_802_0	7	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5521	805	0	2	04	01	H5521_805_0	7	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5521	805	0	2	04	01	H5521_805_0	7	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5521	806	0	2	04	01	H5521_806_0	7	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5521	806	0	2	04	01	H5521_806_0	7	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5521	809	0	1	04	01	H5521_809_0	7	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5521	809	0	1	04	01	H5521_809_0	7	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5521	810	0	1	04	01	H5521_810_0	7	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5521	810	0	1	04	01	H5521_810_0	7	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5521	812	0	1	04	01	H5521_812_0	7	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5521	812	0	1	04	01	H5521_812_0	7	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5521	814	0	2	04	01	H5521_814_0	7	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5521	814	0	2	04	01	H5521_814_0	7	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5521	815	0	2	04	01	H5521_815_0	7	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5521	815	0	2	04	01	H5521_815_0	7	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5521	816	0	2	04	01	H5521_816_0	7	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5521	816	0	2	04	01	H5521_816_0	7	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5521	817	0	1	04	01	H5521_817_0	7	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5521	817	0	1	04	01	H5521_817_0	7	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5521	818	0	2	04	01	H5521_818_0	7	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5521	818	0	2	04	01	H5521_818_0	7	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5521	819	0	1	04	01	H5521_819_0	7	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5521	819	0	1	04	01	H5521_819_0	7	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5521	820	0	1	04	01	H5521_820_0	7	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5521	820	0	1	04	01	H5521_820_0	7	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5521	821	0	1	04	01	H5521_821_0	7	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5521	821	0	1	04	01	H5521_821_0	7	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5521	822	0	1	04	01	H5521_822_0	7	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5521	822	0	1	04	01	H5521_822_0	7	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5521	823	0	2	04	01	H5521_823_0	7	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5521	823	0	2	04	01	H5521_823_0	7	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5521	824	0	2	04	01	H5521_824_0	7	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5521	824	0	2	04	01	H5521_824_0	7	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5521	825	0	1	04	01	H5521_825_0	7	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5521	825	0	1	04	01	H5521_825_0	7	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5521	826	0	2	04	01	H5521_826_0	7	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5521	826	0	2	04	01	H5521_826_0	7	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5521	827	0	2	04	01	H5521_827_0	7	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5521	827	0	2	04	01	H5521_827_0	7	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5521	828	0	2	04	01	H5521_828_0	7	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5521	828	0	2	04	01	H5521_828_0	7	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5521	829	0	1	04	01	H5521_829_0	7	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5521	829	0	1	04	01	H5521_829_0	7	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5521	830	0	2	04	01	H5521_830_0	7	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5521	830	0	2	04	01	H5521_830_0	7	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5521	831	0	1	04	01	H5521_831_0	7	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5521	831	0	1	04	01	H5521_831_0	7	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5521	832	0	1	04	01	H5521_832_0	7	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5521	832	0	1	04	01	H5521_832_0	7	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5521	833	0	1	04	01	H5521_833_0	7	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5521	833	0	1	04	01	H5521_833_0	7	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5521	834	0	1	04	01	H5521_834_0	7	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5521	834	0	1	04	01	H5521_834_0	7	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5521	835	0	2	04	01	H5521_835_0	7	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5521	835	0	2	04	01	H5521_835_0	7	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5521	836	0	1	04	01	H5521_836_0	7	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5521	836	0	1	04	01	H5521_836_0	7	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5521	837	0	1	04	01	H5521_837_0	7	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5521	837	0	1	04	01	H5521_837_0	7	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5522	001	0	1	04	01	H5522_001_0	7	1	1	1	2	2	24	3		1		24	011010												2				2				2			2		1	0.00	0.00	2	2
H5522	002	0	1	04	01	H5522_002_0	7	2	1	1	2	2	24	3		1			011010												2				2				2			2		1	0.00	0.00	2	2
H5522	005	0	1	04	01	H5522_005_0	7	1	1	1	2	2	24	3		1		24	011010												2				2				2			2		1	0.00	0.00	2	2
H5522	013	0	1	04	01	H5522_013_0	6	2	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5522	013	0	1	04	01	H5522_013_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5522	024	0	1	04	01	H5522_024_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5522	802	0	1	04	01	H5522_802_0	6	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5522	802	0	1	04	01	H5522_802_0	6	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5522	803	0	1	04	01	H5522_803_0	6	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5522	803	0	1	04	01	H5522_803_0	6	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5522	808	0	2	04	01	H5522_808_0	5	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5522	808	0	2	04	01	H5522_808_0	5	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5522	809	0	2	04	01	H5522_809_0	6	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5522	809	0	2	04	01	H5522_809_0	6	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5522	810	0	1	04	01	H5522_810_0	6	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5522	810	0	1	04	01	H5522_810_0	6	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5522	811	0	1	04	01	H5522_811_0	6	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5522	811	0	1	04	01	H5522_811_0	6	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5522	813	0	2	04	01	H5522_813_0	6	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5522	813	0	2	04	01	H5522_813_0	6	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5522	814	0	2	04	01	H5522_814_0	6	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5522	814	0	2	04	01	H5522_814_0	6	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5522	815	0	1	04	01	H5522_815_0	6	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5522	815	0	1	04	01	H5522_815_0	6	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5522	816	0	1	04	01	H5522_816_0	6	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5522	816	0	1	04	01	H5522_816_0	6	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5522	817	0	2	04	01	H5522_817_0	6	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5522	817	0	2	04	01	H5522_817_0	6	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5522	818	0	2	04	01	H5522_818_0	6	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5522	818	0	2	04	01	H5522_818_0	6	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5522	819	0	1	04	01	H5522_819_0	6	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5522	819	0	1	04	01	H5522_819_0	6	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5522	820	0	1	04	01	H5522_820_0	6	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5522	820	0	1	04	01	H5522_820_0	6	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5522	821	0	1	04	01	H5522_821_0	6	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5522	821	0	1	04	01	H5522_821_0	6	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5522	822	0	2	04	01	H5522_822_0	6	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5522	822	0	2	04	01	H5522_822_0	6	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5522	823	0	1	04	01	H5522_823_0	6	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5522	823	0	1	04	01	H5522_823_0	6	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5522	824	0	2	04	01	H5522_824_0	6	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5522	824	0	2	04	01	H5522_824_0	6	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5522	825	0	2	04	01	H5522_825_0	6	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5522	825	0	2	04	01	H5522_825_0	6	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5522	826	0	2	04	01	H5522_826_0	6	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5522	826	0	2	04	01	H5522_826_0	6	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5522	827	0	2	04	01	H5522_827_0	6	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5522	827	0	2	04	01	H5522_827_0	6	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5522	828	0	1	04	01	H5522_828_0	5	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5522	828	0	1	04	01	H5522_828_0	5	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5522	829	0	2	04	01	H5522_829_0	5	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5522	829	0	2	04	01	H5522_829_0	5	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5522	830	0	1	04	01	H5522_830_0	5	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5522	830	0	1	04	01	H5522_830_0	5	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5522	831	0	1	04	01	H5522_831_0	5	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5522	831	0	1	04	01	H5522_831_0	5	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5522	832	0	1	04	01	H5522_832_0	5	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5522	832	0	1	04	01	H5522_832_0	5	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5522	833	0	1	04	01	H5522_833_0	5	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5522	833	0	1	04	01	H5522_833_0	5	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5522	834	0	2	04	01	H5522_834_0	5	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5522	834	0	2	04	01	H5522_834_0	5	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5522	835	0	1	04	01	H5522_835_0	5	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5522	835	0	1	04	01	H5522_835_0	5	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5522	836	0	1	04	01	H5522_836_0	5	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H5522	836	0	1	04	01	H5522_836_0	5	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H5525	036	0	1	04	01	H5525_036_0	6	2	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	500	3		2				2			2		2			1	2
H5525	045	0	1	04	01	H5525_045_0	6	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000	3		2				2			2		2			1	2
H5525	053	0	1	04	01	H5525_053_0	7	2	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	500	3		2				2			2		2			1	2
H5525	072	0	1	04	01	H5525_072_0	7	2	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	500	3		2				2			2		2			1	2
H5525	073	0	1	04	01	H5525_073_0	7	2	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	500	3		2				2			2		2			1	2
H5593	001	0	1	01	01	H5593_001_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5593	801	0	1	01	01	H5593_801_0	5	2	1	2											2	1				1			011010		2				2				2			2		2			2	1
H5593	801	0	1	01	01	H5593_801_0	5	1	1	1	2	1				1			011010												2				2				2			2		2			2	1
H5593	802	0	1	01	01	H5593_802_0	5	1	1	1	2	1				1			011010												2				2				2			2		2			2	1
H5593	802	0	1	01	01	H5593_802_0	5	2	1	2											2	1				1			011010		2				2				2			2		2			2	1
H5619	054	0	1	02	01	H5619_054_0	5	2	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000.00	3		2				2			2		2			1	2
H5619	057	0	1	01	01	H5619_057_0	8	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	500	3		2				2			2		2			1	2
H5619	061	0	1	01	01	H5619_061_0	5	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	500	3		2				2			2		2			1	2
H5619	063	0	1	01	01	H5619_063_0	5	1	1	1	2	2	3	5		2		3	100011	Car or wheelchair access vehicle											2				2				2			2		2			1	2
H5619	065	0	1	01	01	H5619_065_0	8	1	1	1	2	1				1			111111	Air transport via helicopter or plane.Manager.											1	1000	3		2				2			2		2			1	2
H5619	071	0	1	01	01	H5619_071_0	7	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	500	3		2				2			2		2			1	2
H5619	075	0	1	01	01	H5619_075_0	5	2	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000	3		2				2			2		2			1	2
H5619	082	0	1	01	01	H5619_082_0	7	2	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	500	3		2				2			2		2			1	2
H5619	100	0	1	01	01	H5619_100_0	7	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	500	3		2				2			2		2			1	2
H5619	113	0	1	02	01	H5619_113_0	5	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	500	3		2				2			2		2			1	2
H5619	126	0	1	02	01	H5619_126_0	7	2	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000.00	3		2				2			2		2			1	2
H5619	134	0	1	01	01	H5619_134_0	7	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000	3		2				2			2		2			1	2
H5619	136	2	1	01	01	H5619_136_2	5	2	1	1	2	2	3	5		2		3	100011	Car or wheelchair access vehicle											2				2				2			2		2			1	2
H5619	136	4	1	01	01	H5619_136_4	7	2	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000.00	3		2				2			2		2			1	2
H5619	145	0	1	01	01	H5619_145_0	8	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	500	3		2				2			2		2			1	2
H5619	152	0	1	01	01	H5619_152_0	6	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	500	3		2				2			2		2			1	2
H5619	153	0	1	01	01	H5619_153_0	7	3	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	500	3		2				2			2		2			1	2
H5619	154	0	1	01	01	H5619_154_0	5	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000.00	3		2				2			2		2			1	2
H5619	160	0	1	01	01	H5619_160_0	7	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	3000.00	3		2				2			2		2			1	2
H5619	162	0	1	02	01	H5619_162_0	5	2	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000.00	3		2				2			2		2			1	2
H5619	163	0	1	01	01	H5619_163_0	5	2	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000	3		2				2			2		2			1	2
H5774	003	0	1	01	01	H5774_003_0	4	1	1	2											2	1				1			110010	Other methods of transportation are available, such as an automobile through a contracted provider.	1	75.00	7		2				2			2		2			2	2
H5774	005	0	1	01	01	H5774_005_0	5	1	1	2											2	1				1			110010	Other methods of transportation are available, such as an automobile through a contracted provider.	1	50.00	7		2				2			2		2			2	2
H5774	026	0	1	01	01	H5774_026_0	4	3	1	2											2	1				1			110010	Allowance is cumulative and is restricted additional transportation to medical destinations, through contracted vendors (besides the transportation benefit in section 10b).	1	165.00	7		2				2			2		2			2	2
H5774	035	0	1	01	01	H5774_035_0	5	1	1	2											2	1				1			110010	Other methods of transportation are available, such as an automobile through a contracted provider.	1	150.00	7		2				2			2		2			2	2
H5774	036	0	1	01	01	H5774_036_0	5	1	1	2											2	1				1			110010	Other methods of transportation are available, such as an automobile through a contracted provider.	1	75.00	7		2				2			2		2			2	2
H5774	040	0	1	01	01	H5774_040_0	4	1	1	2											2	1				1			110010	Other methods of transportation are available, such as an automobile through a contracted provider.	1	50.00	7		2				2			2		2			2	2
H5793	017	0	1	02	01	H5793_017_0	9	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5793	019	0	1	02	01	H5793_019_0	9	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline	2				2				2			2		1	0.00	0.00	2	2
H5793	019	0	1	02	01	H5793_019_0	9	2	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5793	020	0	1	02	01	H5793_020_0	8	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H5793	801	0	1	01	01	H5793_801_0	5	2	1	2											2	1				1			011010		2				2				2			2		2			2	1
H5793	801	0	1	01	01	H5793_801_0	5	1	1	1	2	1				1			011010												2				2				2			2		2			2	1
H5793	802	0	1	01	01	H5793_802_0	5	2	1	2											2	1				1			011010		2				2				2			2		2			2	1
H5793	802	0	1	01	01	H5793_802_0	5	1	1	1	2	1				1			011010												2				2				2			2		2			2	1
H5970	020	0	1	04	01	H5970_020_0	7	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000	3		2				2			2		2			1	2
H6399	001	0	1	01	01	H6399_001_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H6622	008	0	1	01	01	H6622_008_0	8	2	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000	3		2				2			2		2			1	2
H6622	027	0	1	02	01	H6622_027_0	8	2	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	500	3		2				2			2		2			1	2
H6622	035	0	1	01	01	H6622_035_0	7	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	500	3		2				2			2		2			1	2
H6622	036	0	1	01	01	H6622_036_0	5	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	500	3		2				2			2		2			1	2
H6622	037	0	1	01	01	H6622_037_0	7	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	500	3		2				2			2		2			1	2
H6622	078	1	1	01	01	H6622_078_1	8	2	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000	3		2				2			2		2			1	2
H6622	078	2	1	01	01	H6622_078_2	8	2	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	1000	3		2				2			2		2			1	2
H6622	088	0	1	02	01	H6622_088_0	7	1	1	1	2	1				1			111111	Air transport via helicopter or plane.											1	3000.00	3		2				2			2		2			1	2
H6876	001	0	1	04	01	H6876_001_0	12	1	1	1	2	1				1			111010	Mode of Transportation will be taxi, rideshare services, van and wheelchair accessible vehicles.											2				2				2			2		2			2	2
H6876	003	0	1	04	01	H6876_003_0	10	2	1	1	2	1				1			111010	Mode of Transportation will be taxi, rideshare services, van and wheelchair accessible vehicles.											2				2				2			2		1	0.00	0.00	2	2
H6876	005	0	1	04	01	H6876_005_0	7	2	1	1	2	1				1			111010	Mode of Transportation will be taxi, rideshare services, van and wheelchair accessible vehicles.											2				2				2			2		1	0.00	0.00	2	2
H6876	006	0	1	04	01	H6876_006_0	9	2	1	1	2	1				1			111010	Mode of Transportation will be taxi, rideshare services, van and wheelchair accessible vehicles.											2				2				2			2		1	0.00	0.00	2	2
H7149	006	0	1	01	01	H7149_006_0	6	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H7149	801	0	1	01	01	H7149_801_0	5	1	1	1	2	1				1			011010												2				2				2			2		2			2	1
H7149	801	0	1	01	01	H7149_801_0	5	2	1	2											2	1				1			011010		2				2				2			2		2			2	1
H7149	802	0	1	01	01	H7149_802_0	5	1	1	1	2	1				1			011010												2				2				2			2		2			2	1
H7149	802	0	1	01	01	H7149_802_0	5	2	1	2											2	1				1			011010		2				2				2			2		2			2	1
H7220	012	0	1	01	01	H7220_012_0	3	1	1	1	2	1				1			001011												2				2				2			2		2			2	2
H7301	002	0	1	04	01	H7301_002_0	7	1	1	1	2	2	24	3		1		24	011010												2				2				2			2		1	0.00	0.00	2	2
H7301	006	0	1	04	01	H7301_006_0	7	1	1	1	2	2	24	3		1		24	011010												2				2				2			2		1	0.00	0.00	2	2
H7301	014	0	1	04	01	H7301_014_0	7	2	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H7301	014	0	1	04	01	H7301_014_0	7	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H7301	801	0	1	04	01	H7301_801_0	5	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H7301	801	0	1	04	01	H7301_801_0	5	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H7301	803	0	1	04	01	H7301_803_0	5	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H7301	803	0	1	04	01	H7301_803_0	5	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H7330	007	0	1	01	01	H7330_007_0	9	1	1	1	2	1				1			111010	Mode of Transportation will be taxi, rideshare services, van and wheelchair accessible vehicles.											2				2				2			2		1	0.00	0.00	2	2
H8332	001	0	1	01	01	H8332_001_0	8	1	1	1	2	2	24	3		1		24	011010												2				2				2			2		1	0.00	0.00	2	2
H8332	002	0	1	01	01	H8332_002_0	8	1	1	1	2	2	24	3		1		24	011010												2				2				2			2		1	0.00	0.00	2	2
H8332	003	0	1	01	01	H8332_003_0	8	1	1	1	2	2	24	3		1		24	011010												2				2				2			2		1	0.00	0.00	2	2
H8332	004	0	1	01	01	H8332_004_0	8	1	1	1	2	2	24	3		1		24	011010												2				2				2			2		1	0.00	0.00	2	2
H8332	801	0	1	01	01	H8332_801_0	5	1	1	1	2	1				1			011010												2				2				2			2		2			2	1
H8332	801	0	1	01	01	H8332_801_0	5	2	1	2											2	1				1			011010		2				2				2			2		2			2	1
H8332	802	0	1	01	01	H8332_802_0	5	1	1	1	2	1				1			011010												2				2				2			2		2			2	1
H8332	802	0	1	01	01	H8332_802_0	5	2	1	2											2	1				1			011010		2				2				2			2		2			2	1
H8597	001	0	1	01	01	H8597_001_0	9	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H8597	002	0	1	01	01	H8597_002_0	8	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H8597	002	0	1	01	01	H8597_002_0	8	2	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H8597	003	0	1	01	01	H8597_003_0	8	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H8597	003	0	1	01	01	H8597_003_0	8	2	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H8649	010	0	1	01	01	H8649_010_0	7	1	1	2											2	1				2			111111	This benefit will also cover the cost of gasoline.	2				2				2			2		1	0.00	0.00	2	2
H8649	801	0	1	01	01	H8649_801_0	5	2	1	2											2	1				1			011010		2				2				2			2		2			2	1
H8649	801	0	1	01	01	H8649_801_0	5	1	1	1	2	1				1			011010												2				2				2			2		2			2	1
H8649	803	0	1	01	01	H8649_803_0	5	1	1	1	2	1				1			011010												2				2				2			2		2			2	1
H8649	803	0	1	01	01	H8649_803_0	5	2	1	2											2	1				1			011010		2				2				2			2		2			2	1
H8764	001	0	1	01	01	H8764_001_0	7	1	1	1	2	1				1		12	011001												2				2				2			2		2			1	2
H8764	002	0	1	02	01	H8764_002_0	7	1	1	1	2	1				1		12	011001												2				2				2			2		2			1	2
H8764	003	0	1	01	01	H8764_003_0	7	1	1	1	2	1				1		12	011001												2				2				2			2		2			1	2
H8764	004	0	1	01	01	H8764_004_0	7	1	1	1	2	1				1		12	011001												2				2				2			2		2			1	2
H8889	001	0	1	04	01	H8889_001_0	6	1	1	1	2	2	48	3		1		48	010010												2				2				2			2		2			2	2
H8889	002	0	1	04	01	H8889_002_0	5	1	1	1	2	2	48	3		1		48	010010												2				2				2			2		2			2	2
H8889	003	0	1	04	01	H8889_003_0	6	1	1	1	2	2	48	3		1		48	010010												2				2				2			2		2			2	2
H8889	004	0	1	04	01	H8889_004_0	5	1	1	1	2	2	48	3		1		48	010010												2				2				2			2		2			2	2
H8889	005	0	1	04	01	H8889_005_0	5	1	1	1	2	2	48	3		1		48	010010												2				2				2			2		2			2	2
H8889	008	0	1	04	01	H8889_008_0	5	1	1	1	2	2	48	3		1		48	010010												2				2				2			2		2			2	2
H9431	801	0	1	04	01	H9431_801_0	5	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H9431	801	0	1	04	01	H9431_801_0	5	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H9431	802	0	1	04	01	H9431_802_0	5	1	1	1	2	1				1			011010												2				2				2			2		2			2	2
H9431	802	0	1	04	01	H9431_802_0	5	2	1	2											2	1				1			011010		2				2				2			2		2			2	2
H9907	001	0	1	04	01	H9907_001_0	7	1	1	1	2	2	12	6	Members with ESRD and enrolled in care management are eligible for 3 round trips per week per year. Members with other specified disease states are eligible for 12 round trips per year.	2			001011												2				2				2			2		2			2	2
