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_b16a_bendesc_yn	pbp_b16a_bendesc_ehc	pbp_b16a_bendesc_amo_oe	pbp_b16a_bendesc_lim_oe	pbp_b16a_bendesc_numv_oe	pbp_b16a_bendesc_per_oe	pbp_b16a_bendesc_per_oe_d	pbp_b16a_bendesc_amo_pc	pbp_b16a_bendesc_lim_pc	pbp_b16a_bendesc_numv_pc	pbp_b16a_bendesc_per_pc	pbp_b16a_bendesc_per_pc_d	pbp_b16a_bendesc_amo_ft	pbp_b16a_bendesc_lim_ft	pbp_b16a_bendesc_numv_ft	pbp_b16a_bendesc_per_ft	pbp_b16a_bendesc_per_ft_d	pbp_b16a_bendesc_amo_dx	pbp_b16a_bendesc_lim_dx	pbp_b16a_bendesc_numv_dx	pbp_b16a_bendesc_per_dx	pbp_b16a_bendesc_per_dx_d	pbp_b16a_maxplan_yn	pbp_b16a_maxplan_in_oon	pbp_b16a_maxplan_amt	pbp_b16a_maxplan_per	pbp_b16a_maxplan_per_desc	pbp_b16a_maxenr_yn	pbp_b16a_maxenr_amt	pbp_b16a_maxenr_per	pbp_b16a_maxenr_per_desc	pbp_b16a_coins_yn	pbp_b16a_coins_ehc	pbp_b16a_coins_cserv_sc_pov_yn	pbp_b16a_coins_cserv_sc_pov	pbp_b16a_coins_pct_minov	pbp_b16a_coins_pct_maxov	pbp_b16a_coins_pct_oe	pbp_b16a_coins_pct_maxoe	pbp_b16a_coins_pct_pc	pbp_b16a_coins_pct_maxpc	pbp_b16a_coins_pct_ft	pbp_b16a_coins_pct_maxft	pbp_b16a_coins_pct_dx	pbp_b16a_coins_pct_maxdx	pbp_b16a_ded_yn	pbp_b16a_ded_amt	pbp_b16a_copay_yn	pbp_b16a_copay_ehc	pbp_b16a_copay_cserv_sc_pov_yn	pbp_b16a_copay_cserv_sc_pov	pbp_b16a_copay_amt_ovmin	pbp_b16a_copay_amt_ovmax	pbp_b16a_copay_amt_oemin	pbp_b16a_copay_amt_oemax	pbp_b16a_copay_amt_pcmin	pbp_b16a_copay_amt_pcmax	pbp_b16a_copay_amt_ftmin	pbp_b16a_copay_amt_ftmax	pbp_b16a_copay_amt_dxmin	pbp_b16a_copay_amt_dxmax	pbp_b16a_auth_yn	pbp_b16a_refer_yn	pbp_b16b_bendesc_yn	pbp_b16b_bendesc_ehc	pbp_b16b_bendesc_amo_es	pbp_b16b_bendesc_lim_es	pbp_b16b_bendesc_numv_es	pbp_b16b_bendesc_per_es	pbp_b16b_bendesc_per_es_d	pbp_b16b_bendesc_amo_ds	pbp_b16b_bendesc_lim_ds	pbp_b16b_bendesc_numv_ds	pbp_b16b_bendesc_per_ds	pbp_b16b_bendesc_per_ds_d	pbp_b16b_bendesc_amo_rs	pbp_b16b_bendesc_lim_rs	pbp_b16b_bendesc_numv_rs	pbp_b16b_bendesc_per_rs	pbp_b16b_bendesc_per_rs_d	pbp_b16b_bendesc_amo_end	pbp_b16b_bendesc_lim_end	pbp_b16b_bendesc_num_end	pbp_b16b_bendesc_per_end	pbp_b16b_bendesc_per_end_d	pbp_b16b_bendesc_amo_peri	pbp_b16b_bendesc_lim_peri	pbp_b16b_bendesc_num_peri	pbp_b16b_bendesc_per_peri	pbp_b16b_bendesc_per_peri_d	pbp_b16b_bendesc_amo_ext	pbp_b16b_bendesc_lim_ext	pbp_b16b_bendesc_num_ext	pbp_b16b_bendesc_per_ext	pbp_b16b_bendesc_per_ext_d	pbp_b16b_bendesc_amo_poo	pbp_b16b_bendesc_lim_poo	pbp_b16b_bendesc_numv_poo	pbp_b16b_bendesc_per_poo	pbp_b16b_bendesc_per_poo_d	pbp_b16b_maxplan_yn	pbp_b16b_maxplan_in_oon	pbp_b16b_maxbene_type	pbp_b16b_maxplan_amt	pbp_b16b_maxplan_per	pbp_b16b_maxplan_per_desc	pbp_b16b_maxenr_yn	pbp_b16b_maxenr_type	pbp_b16b_maxenr_amt	pbp_b16b_maxenr_per	pbp_b16b_maxenr_per_desc	pbp_b16b_coins_yn	pbp_b16b_coins_ehc	pbp_b16b_coins_pct_mc_min	pbp_b16b_coins_pct_mc_max	pbp_b16b_coins_pct_es_min	pbp_b16b_coins_pct_es_max	pbp_b16b_coins_pct_ds_min	pbp_b16b_coins_pct_ds_max	pbp_b16b_coins_pct_rs_min	pbp_b16b_coins_pct_rs_max	pbp_b16b_coins_pct_end_min	pbp_b16b_coins_pct_end_max	pbp_b16b_coins_pct_peri_min	pbp_b16b_coins_pct_peri_max	pbp_b16b_coins_pct_ext_min	pbp_b16b_coins_pct_ext_max	pbp_b16b_coins_pct_poo_min	pbp_b16b_coins_pct_poo_max	pbp_b16b_ded_yn	pbp_b16b_ded_amt	pbp_b16b_copay_yn	pbp_b16b_copay_ehc	pbp_b16b_copay_amt_mc_min	pbp_b16b_copay_amt_mc_max	pbp_b16b_copay_amt_es_min	pbp_b16b_copay_amt_es_max	pbp_b16b_copay_amt_ds_min	pbp_b16b_copay_amt_ds_max	pbp_b16b_copay_amt_rs_min	pbp_b16b_copay_amt_rs_max	pbp_b16b_copay_amt_end_min	pbp_b16b_copay_amt_end_max	pbp_b16b_copay_amt_peri_min	pbp_b16b_copay_amt_peri_max	pbp_b16b_copay_amt_ext_min	pbp_b16b_copay_amt_ext_max	pbp_b16b_copay_amt_poo_min	pbp_b16b_copay_amt_poo_max	pbp_b16b_auth_yn	pbp_b16b_refer_yn
H0028	007	0	1	01	01	H0028_007_0	6	2	1	1111	2	1				2	1				2	1				2	1				1		1000.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	1000.00	3							2																		2		2																		1	2
H0028	014	0	1	01	01	H0028_014_0	8	1	1	1111	2	1				2	1				2	1				2	1				1		1000.00	3		2				2		2												2		2		2												2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	1000.00	3							2																		2		2																		1	2
H0028	015	0	1	02	01	H0028_015_0	7	2	1	1111	2	1				2	1				2	1				2	1				1		1000.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	1000.00	3							2																		2		2																		1	2
H0028	016	0	1	02	01	H0028_016_0	8	1	1	1111	2	1				2	1				2	1				2	1				1		1000.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	1000.00	3							2																		2		2																		1	2
H0028	017	0	1	01	01	H0028_017_0	6	1	1	1111	2	1				2	1				2	1				2	1				1		1000	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	1000	3							2																		2		2																		1	2
H0028	041	0	1	01	01	H0028_041_0	7	1	1	1111	2	1				2	1				2	1				2	1				1		1000.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	1000.00	3							2																		2		2																		1	2
H0028	043	2	1	01	01	H0028_043_2	8	1	1	1111	2	1				2	1				2	1				2	1				1		1000	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	1000	3							2																		2		2																		1	2
H0028	050	0	1	01	01	H0028_050_0	10	1	1	1111	2	1				2	1				2	1				2	1				1		1000	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	1000	3							2																		2		2																		1	2
H0028	051	0	1	01	01	H0028_051_0	8	1	1	1111	2	1				2	1				2	1				2	1				1		1000.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	1000.00	3							2																		2		2																		1	2
H0028	053	1	1	01	01	H0028_053_1	7	1	1	1111	2	1				2	1				2	1				2	1				1		1000.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	1000.00	3							2																		2		2																		1	2
H0028	053	3	1	01	01	H0028_053_3	7	1	1	1111	2	1				2	1				2	1				2	1				1		1000.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	1000.00	3							2																		2		2																		1	2
H0028	054	1	1	02	01	H0028_054_1	7	1	1	1111	2	1				2	1				2	1				2	1				1		1000.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	1000.00	3							2																		2		2																		1	2
H0028	054	2	1	02	01	H0028_054_2	6	1	1	1111	2	1				2	1				2	1				2	1				1		1000.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	1000.00	3							2																		2		2																		1	2
H0028	055	0	1	02	01	H0028_055_0	6	1	1	1111	2	1				2	1				2	1				2	1				1		1000.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	1000.00	3							2																		2		2																		1	2
H0028	056	0	1	02	01	H0028_056_0	8	1	1	1111	2	1				2	1				2	1				2	1				1		1000.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	1000.00	3							2																		2		2																		1	2
H0028	057	0	1	01	01	H0028_057_0	6	1	1	1111	2	1				2	1				2	1				2	1				1		1000.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	1000.00	3							2																		2		2																		1	2
H0028	058	0	1	01	01	H0028_058_0	7	2	1	1111	2	1				2	1				2	1				2	1				1		500.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	500.00	3							2																		2		2																		1	2
H0028	064	0	1	01	01	H0028_064_0	7	2	1	1111	2	1				2	1				2	1				2	1				1		3000.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	3000.00	3							2																		2		2																		1	2
H0523	801	0	1	01	01	H0523_801_0	10	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H0523	801	0	1	01	01	H0523_801_0	10	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H0523	805	0	1	01	01	H0523_805_0	10	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H0523	805	0	1	01	01	H0523_805_0	10	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H0628	801	0	1	01	01	H0628_801_0	9	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H0628	801	0	1	01	01	H0628_801_0	9	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H0628	802	0	1	01	01	H0628_802_0	7	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H0628	802	0	1	01	01	H0628_802_0	7	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H1019	001	0	1	01	01	H1019_001_0	6	1	1	1111	2	1				2	1				2	1				2	1				1		500	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	500	3							2																		2		2																		1	2
H1019	006	0	1	01	01	H1019_006_0	6	1	1	1111	2	1				2	1				2	1				2	1				1		500	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	500	3							2																		2		2																		1	2
H1019	023	0	1	01	01	H1019_023_0	6	1	1	1111	2	1				2	1				2	1				2	1				1		1000	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	1000	3							2																		2		2																		1	2
H1019	026	0	1	01	01	H1019_026_0	6	2	1	1111	2	1				2	1				2	1				2	1				1		1000	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	1000	3							2																		2		2																		1	2
H1019	057	0	1	02	01	H1019_057_0	6	1	1	1111	2	1				2	1				2	1				2	1				1		500	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	500	3							2																		2		2																		1	2
H1019	069	0	1	01	01	H1019_069_0	6	1	1	1111	2	1				2	1				2	1				2	1				1		500	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	500	3							2																		2		2																		1	2
H1019	073	0	1	01	01	H1019_073_0	6	2	1	1111	2	1				2	1				2	1				2	1				1		1000	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	1000	3							2																		2		2																		1	2
H1019	098	0	1	01	01	H1019_098_0	6	1	1	1111	2	1				2	1				2	1				2	1				1		500	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	500	3							2																		2		2																		1	2
H1019	102	0	1	01	01	H1019_102_0	6	1	1	1111	2	1				2	1				2	1				2	1				1		500	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	500	3							2																		2		2																		1	2
H1019	103	1	1	01	01	H1019_103_1	5	1	1	1111	2	1				2	1				2	1				2	1				1		500	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	500	3							2																		2		2																		1	2
H1019	103	2	1	01	01	H1019_103_2	5	1	1	1111	2	1				2	1				2	1				2	1				1		500	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	500	3							2																		2		2																		1	2
H1019	108	0	1	01	01	H1019_108_0	13	1	1	1111	2	1				2	1				2	1				2	1				1		500	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	500	3							2																		2		2																		1	2
H1019	109	0	1	01	01	H1019_109_0	6	1	1	1111	2	1				2	1				2	1				2	1				1		500	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	500	3							2																		2		2																		1	2
H1019	117	0	1	01	01	H1019_117_0	6	1	1	1111	2	1				2	1				2	1				2	1				1		500	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	500	3							2																		2		2																		1	2
H1019	118	0	1	01	01	H1019_118_0	6	1	1	1111	2	1				2	1				2	1				2	1				1		500	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	500	3							2																		2		2																		1	2
H1019	121	0	1	01	01	H1019_121_0	6	1	1	1111	2	1				2	1				2	1				2	1				1		500	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	500	3							2																		2		2																		1	2
H1019	122	0	1	01	01	H1019_122_0	6	1	1	1111	2	1				2	1				2	1				2	1				1		500	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	500	3							2																		2		2																		1	2
H1019	123	0	1	01	01	H1019_123_0	6	1	1	1111	2	1				2	1				2	1				2	1				1		500	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	500	3							2																		2		2																		1	2
H1019	124	0	1	01	01	H1019_124_0	6	1	1	1111	2	1				2	1				2	1				2	1				1		500	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	500	3							2																		2		2																		1	2
H1019	125	0	1	01	01	H1019_125_0	6	1	1	1111	2	1				2	1				2	1				2	1				1		500	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	500	3							2																		2		2																		1	2
H1019	130	0	1	01	01	H1019_130_0	6	1	1	1111	2	1				2	1				2	1				2	1				1		500	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	500	3							2																		2		2																		1	2
H1019	141	0	1	02	01	H1019_141_0	11	1	1	1111	2	1				2	1				2	1				2	1				1		500	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	500	3							2																		2		2																		1	2
H1019	142	0	1	02	01	H1019_142_0	5	1	1	1111	2	1				2	1				2	1				2	1				1		500	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	500	3							2																		2		2																		1	2
H1019	145	0	1	01	01	H1019_145_0	5	1	1	1111	2	1				2	1				2	1				2	1				1		1000	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	1000	3							2																		2		2																		1	2
H1019	146	0	1	01	01	H1019_146_0	5	2	1	1111	2	1				2	1				2	1				2	1				1		1000	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	1000	3							2																		2		2																		1	2
H1036	054	0	1	01	01	H1036_054_0	6	1	1	1111	2	1				2	1				2	1				2	1				1		500	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	500	3							2																		2		2																		1	2
H1036	062	0	1	01	01	H1036_062_0	7	1	1	1111	2	1				2	1				2	1				2	1				1		500.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	500.00	3							2																		2		2																		1	2
H1036	065	0	1	01	01	H1036_065_0	6	1	1	1111	2	1				2	1				2	1				2	1				1		500.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	500.00	3							2																		2		2																		1	2
H1036	077	0	1	01	01	H1036_077_0	6	2	1	1111	2	1				2	1				2	1				2	1				1		1000	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	1000	3							2																		2		2																		1	2
H1036	102	0	1	01	01	H1036_102_0	6	1	1	1111	2	1				2	1				2	1				2	1				1		1000	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	1000	3							2																		2		2																		1	2
H1036	167	0	1	01	01	H1036_167_0	7	2	1	1111	2	1				2	1				2	1				2	1				1		500.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	500.00	3							2																		2		2																		1	2
H1036	209	0	1	01	01	H1036_209_0	7	2	1	1111	2	1				2	1				2	1				2	1				1		1000	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	1000	3							2																		2		2																		1	2
H1036	210	0	1	01	01	H1036_210_0	7	2	1	1111	2	1				2	1				2	1				2	1				1		1000	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	1000	3							2																		2		2																		1	2
H1036	213	0	1	01	01	H1036_213_0	7	1	1	1111	2	1				2	1				2	1				2	1				1		1000	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	1000	3							2																		2		2																		1	2
H1036	214	0	1	01	01	H1036_214_0	7	2	1	1111	2	1				2	1				2	1				2	1				1		500	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	500	3							2																		2		2																		1	2
H1036	230	0	1	01	01	H1036_230_0	7	1	1	1111	2	1				2	1				2	1				2	1				1		500.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	500.00	3							2																		2		2																		1	2
H1036	234	0	1	01	01	H1036_234_0	7	1	1	1111	2	1				2	1				2	1				2	1				1		1000	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	1000	3							2																		2		2																		1	2
H1036	235	0	1	01	01	H1036_235_0	6	2	1	1111	2	1				2	1				2	1				2	1				1		1000	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	1000	3							2																		2		2																		1	2
H1036	236	0	1	01	01	H1036_236_0	7	1	1	1111	2	1				2	1				2	1				2	1				1		1000	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	1000	3							2																		2		2																		1	2
H1036	285	0	1	01	01	H1036_285_0	6	2	1	1111	2	1				2	1				2	1				2	1				1		1000	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	1000	3							2																		2		2																		1	2
H1036	301	0	1	01	01	H1036_301_0	7	1	1	1111	2	1				2	1				2	1				2	1				1		500.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	500.00	3							2																		2		2																		1	2
H1036	302	0	1	01	01	H1036_302_0	6	1	1	1111	2	1				2	1				2	1				2	1				1		500	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	500	3							2																		2		2																		1	2
H1036	304	0	1	01	01	H1036_304_0	5	2	1	1111	2	1				2	1				2	1				2	1				1		1000	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	1000	3							2																		2		2																		1	2
H1036	306	0	1	01	01	H1036_306_0	6	1	1	1111	2	1				2	1				2	1				2	1				1		1000.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	1000.00	3							2																		2		2																		1	2
H1036	307	0	1	01	01	H1036_307_0	5	2	1	1111	2	1				2	1				2	1				2	1				1		500	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	500	3							2																		2		2																		1	2
H1036	309	0	1	01	01	H1036_309_0	5	2	1	1111	2	1				2	1				2	1				2	1				1		500	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	500	3							2																		2		2																		1	2
H1036	314	0	1	01	01	H1036_314_0	6	2	1	1111	2	1				2	1				2	1				2	1				1		1000.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	1000.00	3							2																		2		2																		1	2
H1036	315	0	1	01	01	H1036_315_0	6	1	1	1111	2	1				2	1				2	1				2	1				1		500.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	500.00	3							2																		2		2																		1	2
H1036	316	0	1	01	01	H1036_316_0	6	1	1	1111	2	1				2	1				2	1				2	1				1		500.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	500.00	3							2																		2		2																		1	2
H1109	801	0	1	01	01	H1109_801_0	8	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H1109	801	0	1	01	01	H1109_801_0	8	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H1109	802	0	1	01	01	H1109_802_0	8	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H1109	802	0	1	01	01	H1109_802_0	8	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H1206	801	0	1	01	01	H1206_801_0	3	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H1206	801	0	1	01	01	H1206_801_0	3	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H1206	802	0	1	01	01	H1206_802_0	3	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H1206	802	0	1	01	01	H1206_802_0	3	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H1468	017	0	1	01	01	H1468_017_0	7	1	1	1111	2	1				2	1				2	1				2	1				1		1000.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	1000.00	3							2																		2		2																		1	2
H1608	801	0	1	04	01	H1608_801_0	8	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H1608	801	0	1	04	01	H1608_801_0	8	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H1608	802	0	1	04	01	H1608_802_0	8	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H1608	802	0	1	04	01	H1608_802_0	8	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H1609	801	0	1	01	01	H1609_801_0	7	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H1609	801	0	1	01	01	H1609_801_0	7	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H1609	807	0	1	01	01	H1609_807_0	7	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H1609	807	0	1	01	01	H1609_807_0	7	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H1692	801	0	1	01	01	H1692_801_0	8	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H1692	801	0	1	01	01	H1692_801_0	8	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H1692	802	0	1	01	01	H1692_802_0	8	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H1692	802	0	1	01	01	H1692_802_0	8	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H2056	801	0	1	01	01	H2056_801_0	8	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H2056	801	0	1	01	01	H2056_801_0	8	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H2056	802	0	1	01	01	H2056_802_0	8	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H2056	802	0	1	01	01	H2056_802_0	8	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H2237	001	0	1	01	01	H2237_001_0	7	1	1	1111	2	1				2	1				2	1				2	1				1		500.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	500.00	3							2																		2		2																		1	2
H2486	007	0	1	01	01	H2486_007_0	7	1	1	1111	2	1				2	1				2	1				2	1				1		1000	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	1000	3							2																		2		2																		1	2
H2663	805	0	1	01	01	H2663_805_0	8	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H2663	805	0	1	01	01	H2663_805_0	8	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H2663	810	0	1	01	01	H2663_810_0	8	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H2663	810	0	1	01	01	H2663_810_0	8	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H3146	801	0	1	01	01	H3146_801_0	8	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H3146	801	0	1	01	01	H3146_801_0	8	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H3146	802	0	1	01	01	H3146_802_0	8	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H3146	802	0	1	01	01	H3146_802_0	8	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H3152	801	0	1	01	01	H3152_801_0	8	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H3152	801	0	1	01	01	H3152_801_0	8	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H3152	804	0	1	01	01	H3152_804_0	8	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H3152	804	0	1	01	01	H3152_804_0	8	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H3192	801	0	1	01	01	H3192_801_0	8	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H3192	801	0	1	01	01	H3192_801_0	8	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H3192	802	0	1	01	01	H3192_802_0	8	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H3192	802	0	1	01	01	H3192_802_0	8	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H3219	801	0	1	04	01	H3219_801_0	9	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H3219	801	0	1	04	01	H3219_801_0	9	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H3219	802	0	1	04	01	H3219_802_0	9	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H3219	802	0	1	04	01	H3219_802_0	9	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H3288	801	0	1	04	01	H3288_801_0	8	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H3288	801	0	1	04	01	H3288_801_0	8	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H3288	802	0	1	04	01	H3288_802_0	8	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H3288	802	0	1	04	01	H3288_802_0	8	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H3312	801	0	1	01	01	H3312_801_0	8	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H3312	801	0	1	01	01	H3312_801_0	8	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H3312	804	0	1	01	01	H3312_804_0	8	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H3312	804	0	1	01	01	H3312_804_0	8	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H3554	002	0	1	04	01	H3554_002_0	5	1	1	0111	2	2	1	5		2	2	1	5		2	2	1	5							2					2				1	0111	2				50	50	50	50	50	50			2		1	0111	2				0.00	0.00	0.00	0.00	0.00	0.00			2	2	1	0000010																					2	2	1	6	Periodicities for covered services range from every three months to every two years depending on the service.											2											1	00000010											50	50					2		1	00000010											0.00	0.00					2	2
H3554	007	0	1	04	01	H3554_007_0	4	1	1	0111	2	2	1	5		2	2	1	5		2	2	1	5							2					2				1	0111	2				50	50	50	50	50	50			2		1	0111	2				0.00	0.00	0.00	0.00	0.00	0.00			2	2	1	0000010																					2	2	1	6	Periodicities for covered services range from every three months to every two years depending on the service.											2											1	00000010											50	50					2		1	00000010											0.00	0.00					2	2
H3554	011	0	1	04	01	H3554_011_0	2	1	1	0111	2	2	1	5		2	2	1	5		2	2	1	5							2					2				1	0111	2				50	50	50	50	50	50			2		1	0111	2				0.00	0.00	0.00	0.00	0.00	0.00			2	2	1	0000010																					2	2	1	6	Periodicities for covered services range from every three months to every two years depending on the service.											2											1	00000010											50	50					2		1	00000010											0.00	0.00					2	2
H3557	001	0	1	04	01	H3557_001_0	9	1																																																																1	0000010																					2	2	2	3												2											2																		2		2																		1	2
H3597	801	0	1	01	01	H3597_801_0	8	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H3597	801	0	1	01	01	H3597_801_0	8	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H3597	802	0	1	01	01	H3597_802_0	8	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H3597	802	0	1	01	01	H3597_802_0	8	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H3748	801	0	1	01	01	H3748_801_0	8	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H3748	801	0	1	01	01	H3748_801_0	8	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H3748	802	0	1	01	01	H3748_802_0	8	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H3748	802	0	1	01	01	H3748_802_0	8	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H3815	007	0	1	01	01	H3815_007_0	19	2																																																																1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	300.00	5							2																		2		2																		2	2
H3832	007	0	1	04	01	H3832_007_0	7	1	1	0010						2	2	2	3												2					2				2		2												2		1	0010	2						0.00	0.00					2	2																																																																																								
H3832	007	0	1	04	01	H3832_007_0	7	4	1	0010						2	2	1	2												2					2				2		2												2		1	0010	2						0.00	0.00					2	2																																																																																								
H3832	007	0	1	04	01	H3832_007_0	7	3	1	0010						2	2	1	2												2					2				2		2												2		1	0010	2						0.00	0.00					2	2																																																																																								
H3832	007	0	1	04	01	H3832_007_0	7	2	1	0111	2	2	2	3		2	2	2	3		2	2	2	6	Fluoride treatments must be provided at least three months apart.						2					2				2		2												2		1	0111	2				0.00	0.00	0.00	0.00	0.00	0.00			2	2																																																																																								
H3832	008	0	1	04	01	H3832_008_0	7	4	1	0010						2	2	1	2												2					2				2		2												2		1	0010	2						0.00	0.00					2	2																																																																																								
H3832	008	0	1	04	01	H3832_008_0	7	1	1	0010						2	2	2	3												2					2				2		2												2		1	0010	2						0.00	0.00					2	2																																																																																								
H3832	008	0	1	04	01	H3832_008_0	7	2	1	0111	2	2	2	3		2	2	2	3		2	2	2	6	Fluoride treatments must be provided at least three months apart.						2					2				2		2												2		1	0111	2				0.00	0.00	0.00	0.00	0.00	0.00			2	2																																																																																								
H3832	008	0	1	04	01	H3832_008_0	7	3	1	0010						2	2	1	2												2					2				2		2												2		1	0010	2						0.00	0.00					2	2																																																																																								
H3832	009	0	1	04	01	H3832_009_0	7	4	1	0010						2	2	1	2												2					2				2		2												2		1	0010	2						0.00	0.00					2	2																																																																																								
H3832	009	0	1	04	01	H3832_009_0	7	3	1	0010						2	2	1	2												2					2				2		2												2		1	0010	2						0.00	0.00					2	2																																																																																								
H3832	009	0	1	04	01	H3832_009_0	7	2	1	0111	2	2	2	3		2	2	2	3		2	2	2	6	Fluoride treatments must be provided at least three months apart.						2					2				2		2												2		1	0111	2				0.00	0.00	0.00	0.00	0.00	0.00			2	2																																																																																								
H3832	009	0	1	04	01	H3832_009_0	7	1	1	0010						2	2	2	3												2					2				2		2												2		1	0010	2						0.00	0.00					2	2																																																																																								
H3832	010	0	1	04	01	H3832_010_0	7	1	1	0010						2	2	2	3												2					2				2		2												2		1	0010	2						0.00	0.00					2	2																																																																																								
H3832	010	0	1	04	01	H3832_010_0	7	4	1	0010						2	2	1	2												2					2				2		2												2		1	0010	2						0.00	0.00					2	2																																																																																								
H3832	010	0	1	04	01	H3832_010_0	7	3	1	0010						2	2	1	2												2					2				2		2												2		1	0010	2						0.00	0.00					2	2																																																																																								
H3832	010	0	1	04	01	H3832_010_0	7	2	1	0111	2	2	2	3		2	2	2	3		2	2	2	6	Fluoride treatments must be provided at least three months apart.						2					2				2		2												2		1	0111	2				0.00	0.00	0.00	0.00	0.00	0.00			2	2																																																																																								
H3928	801	0	1	01	01	H3928_801_0	8	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H3928	801	0	1	01	01	H3928_801_0	8	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H3928	803	0	1	01	01	H3928_803_0	8	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H3928	803	0	1	01	01	H3928_803_0	8	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H3931	801	0	1	01	01	H3931_801_0	8	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H3931	801	0	1	01	01	H3931_801_0	8	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H3931	804	0	1	01	01	H3931_804_0	8	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H3931	804	0	1	01	01	H3931_804_0	8	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H3957	031	0	1	02	01	H3957_031_0	9	1																																																																1	0000010																					2	2	1	6	Scaling & Root Planing:  every 24 months.Surgical Periodontal Procedures: up to four (4) lifetime.											2											2																		2		2																		1	2
H3959	803	0	1	01	01	H3959_803_0	8	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H3959	803	0	1	01	01	H3959_803_0	8	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H3959	804	0	1	01	01	H3959_804_0	8	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H3959	804	0	1	01	01	H3959_804_0	8	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H4141	003	0	1	01	01	H4141_003_0	8	2	1	1111	2	1				2	1				2	1				2	1				1		500.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	500.00	3							2																		2		2																		1	2
H4141	021	0	1	01	01	H4141_021_0	6	3	1	1111	2	1				2	1				2	1				2	1				1		500	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	500	3							2																		2		2																		1	2
H4152	004	0	1	01	01	H4152_004_0	6	1																																																																1	0000010																					2	2	2	3												2											2																		2		2																		1	2
H4152	005	0	1	01	01	H4152_005_0	7	1																																																																1	0000010																					2	2	2	3												2											2																		2		2																		1	2
H4152	007	0	1	02	01	H4152_007_0	7	1																																																																1	0000010																					2	2	2	3												2											2																		2		2																		1	2
H4152	013	0	1	01	01	H4152_013_0	7	1																																																																1	0000010																					2	2	2	3												2											2																		2		2																		1	2
H4152	018	0	1	02	01	H4152_018_0	7	1																																																																1	0000010																					2	2	2	3												2											2																		2		2																		1	2
H4152	020	0	1	02	01	H4152_020_0	8	1																																																																1	0000010																					2	2	2	3												2											2																		2		2																		1	2
H4152	021	0	1	01	01	H4152_021_0	9	2																																																																1	0000010																					2	2	2	3												2											2																		2		2																		2	2
H4213	016	1	1	09	04	H4213_016_1	2	1	1	0111	2	2	1	5		2	2	1	5		2	2	1	5							2					2				1	0111	2				50	50	50	50	50	50			2		1	0111	2				0.00	0.00	0.00	0.00	0.00	0.00					1	0000010																					2	2	1	6	Periodicities for covered services range from every three months to every two years depending on the service.											2											1	00000010											50	50					2		1	00000010											0.00	0.00						
H4213	016	3	1	09	04	H4213_016_3	2	1	1	0111	2	2	1	5		2	2	1	5		2	2	1	5							2					2				1	0111	2				50	50	50	50	50	50			2		1	0111	2				0.00	0.00	0.00	0.00	0.00	0.00					1	0000010																					2	2	1	6	Periodicities for covered services range from every three months to every two years depending on the service.											2											1	00000010											50	50					2		1	00000010											0.00	0.00						
H4213	016	4	1	09	04	H4213_016_4	2	1	1	0111	2	2	1	5		2	2	1	5		2	2	1	5							2					2				1	0111	2				50	50	50	50	50	50			2		1	0111	2				0.00	0.00	0.00	0.00	0.00	0.00					1	0000010																					2	2	1	6	Periodicities for covered services range from every three months to every two years depending on the service.											2											1	00000010											50	50					2		1	00000010											0.00	0.00						
H4213	017	1	1	09	04	H4213_017_1	3	1	1	0111	2	2	1	5		2	2	1	5		2	2	1	5							2					2				1	0111	2				50	50	50	50	50	50			2		1	0111	2				0.00	0.00	0.00	0.00	0.00	0.00					1	0000010																					2	2	1	6	Periodicities for covered services range from every three months to every two years depending on the service.											2											1	00000010											50	50					2		1	00000010											0.00	0.00						
H4213	017	5	1	09	04	H4213_017_5	3	1	1	0111	2	2	1	5		2	2	1	5		2	2	1	5							2					2				1	0111	2				50	50	50	50	50	50			2		1	0111	2				0.00	0.00	0.00	0.00	0.00	0.00					1	0000010																					2	2	1	6	Periodicities for covered services range from every three months to every two years depending on the service.											2											1	00000010											50	50					2		1	00000010											0.00	0.00						
H4213	017	6	1	09	04	H4213_017_6	3	1	1	0111	2	2	1	5		2	2	1	5		2	2	1	5							2					2				1	0111	2				50	50	50	50	50	50			2		1	0111	2				0.00	0.00	0.00	0.00	0.00	0.00					1	0000010																					2	2	1	6	Periodicities for covered services range from every three months to every two years depending on the service.											2											1	00000010											50	50					2		1	00000010											0.00	0.00						
H4461	022	0	1	01	01	H4461_022_0	9	2	1	1111	2	1				2	1				2	1				2	1				1		500.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	500.00	3							2																		2		2																		1	2
H4461	038	0	1	01	01	H4461_038_0	7	2	1	1111	2	1				2	1				2	1				2	1				1		500.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	500.00	3							2																		2		2																		1	2
H4523	801	0	1	01	01	H4523_801_0	8	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H4523	801	0	1	01	01	H4523_801_0	8	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H4523	802	0	1	01	01	H4523_802_0	8	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H4523	802	0	1	01	01	H4523_802_0	8	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H4623	001	0	1	02	01	H4623_001_0	12	1	1	1111	2	1				2	1				2	1				2	1				1		1000.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	1000.00	3							2																		2		2																		1	2
H4623	002	0	1	02	01	H4623_002_0	6	1	1	1111	2	1				2	1				2	1				2	1				1		1000.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	1000.00	3							2																		2		2																		1	2
H4711	801	0	1	01	01	H4711_801_0	8	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H4711	801	0	1	01	01	H4711_801_0	8	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H4711	802	0	1	01	01	H4711_802_0	8	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H4711	802	0	1	01	01	H4711_802_0	8	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H4835	801	0	1	01	01	H4835_801_0	8	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H4835	801	0	1	01	01	H4835_801_0	8	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H4835	802	0	1	01	01	H4835_802_0	8	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H4835	802	0	1	01	01	H4835_802_0	8	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H4982	801	0	1	01	01	H4982_801_0	8	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H4982	801	0	1	01	01	H4982_801_0	8	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H4982	802	0	1	01	01	H4982_802_0	8	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H4982	802	0	1	01	01	H4982_802_0	8	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H5178	002	0	1	01	01	H5178_002_0	5	1	1	1111	2	1				2	1				2	1				2	1				1		500	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	500	3							2																		2		2																		1	2
H5216	014	0	1	04	01	H5216_014_0	8	1	1	1111	2	1				2	1				2	1				2	1				1	2	1000	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1	2	2	1000	3							2																		2		2																		1	2
H5216	032	0	1	04	01	H5216_032_0	9	1	1	1111	2	1				2	1				2	1				2	1				1	2	1000.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1	2	2	1000.00	3							2																		2		2																		1	2
H5216	083	0	1	04	01	H5216_083_0	9	1	1	1111	2	1				2	1				2	1				2	1				1	2	1000.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1	2	2	1000.00	3							2																		2		2																		1	2
H5216	140	0	1	04	01	H5216_140_0	11	1	1	1111	2	1				2	1				2	1				2	1				1	2	1000.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1	2	2	1000.00	3							2																		2		2																		1	2
H5216	164	0	1	04	01	H5216_164_0	8	1	1	1111	2	1				2	1				2	1				2	1				1	2	1000.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1	2	2	1000.00	3							2																		2		2																		1	2
H5216	205	0	1	04	01	H5216_205_0	11	2	1	1111	2	1				2	1				2	1				2	1				1	2	500.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1	2	2	500.00	3							2																		2		2																		1	2
H5216	206	0	1	04	01	H5216_206_0	8	2	1	1111	2	1				2	1				2	1				2	1				1	2	500.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1	2	2	500.00	3							2																		2		2																		1	2
H5216	220	0	1	04	01	H5216_220_0	7	2	1	1111	2	1				2	1				2	1				2	1				1	2	750.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1	2	2	750.00	3							2																		2		2																		1	2
H5216	227	0	1	04	01	H5216_227_0	7	2	1	1111	2	1				2	1				2	1				2	1				1	2	1000.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1	2	2	1000.00	3							2																		2		2																		1	2
H5216	242	0	1	04	01	H5216_242_0	7	1	1	1111	2	1				2	1				2	1				2	1				1	2	3000.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1	2	2	3000.00	3							2																		2		2																		1	2
H5216	243	0	1	04	01	H5216_243_0	7	1	1	1111	2	1				2	1				2	1				2	1				1	2	3000.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1	2	2	3000.00	3							2																		2		2																		1	2
H5216	254	0	1	04	01	H5216_254_0	10	1	1	1111	2	1				2	1				2	1				2	1				1	2	1000.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1	2	2	1000.00	3							2																		2		2																		1	2
H5216	257	0	1	04	01	H5216_257_0	7	1	1	1111	2	1				2	1				2	1				2	1				1	2	500.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1	2	2	500.00	3							2																		2		2																		1	2
H5216	268	0	1	04	01	H5216_268_0	7	2	1	1111	2	1				2	1				2	1				2	1				1	2	5000.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1	2	2	1000.00	3							2																		2		2																		1	2
H5216	277	0	1	04	01	H5216_277_0	7	2	1	1111	2	1				2	1				2	1				2	1				1	2	500.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		1									2																		2		2																		1	2
H5216	286	0	1	04	01	H5216_286_0	6	1	1	1111	2	1				2	1				2	1				2	1				1	2	500.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1	2	2	500.00	3							2																		2		2																		1	2
H5216	293	0	1	04	01	H5216_293_0	9	1	1	1111	2	1				2	1				2	1				2	1				1	2	500.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1	2	2	500.00	3							2																		2		2																		1	2
H5216	318	1	1	04	01	H5216_318_1	10	1	1	1111	2	1				2	1				2	1				2	1				1	2	1000	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1	2	2	1000	3							2																		2		2																		1	2
H5216	318	2	1	04	01	H5216_318_2	7	1	1	1111	2	1				2	1				2	1				2	1				1	2	1000.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1	2	2	1000.00	3							2																		2		2																		1	2
H5216	318	3	1	04	01	H5216_318_3	6	1	1	1111	2	1				2	1				2	1				2	1				1	2	1000	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1	2	2	1000	3							2																		2		2																		1	2
H5216	329	0	1	04	01	H5216_329_0	10	1	1	1111	2	1				2	1				2	1				2	1				1	2	1000	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1	2	2	1000	3							2																		2		2																		1	2
H5216	362	0	1	04	01	H5216_362_0	8	1	1	1111	2	1				2	1				2	1				2	1				1	2	3000.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1	2	2	3000.00	3							2																		2		2																		1	2
H5216	369	0	1	04	01	H5216_369_0	10	1	1	1111	2	1				2	1				2	1				2	1				1	2	1000.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1	2	2	1000.00	3							2																		2		2																		1	2
H5216	373	0	1	04	01	H5216_373_0	8	2	1	1111	2	1				2	1				2	1				2	1				1	2	1000.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1	2	2	1000.00	3							2																		2		2																		1	2
H5216	377	0	1	04	01	H5216_377_0	6	2	1	1111	2	1				2	1				2	1				2	1				1	2	1000.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1	2	2	1000.00	3							2																		2		2																		1	2
H5216	400	0	1	04	01	H5216_400_0	6	1	1	1111	2	1				2	1				2	1				2	1				1	2	3000.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1	2	2	3000.00	3							2																		2		2																		1	2
H5216	401	0	1	04	01	H5216_401_0	7	1	1	1111	2	1				2	1				2	1				2	1				1	2	3000.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1	2	2	3000.00	3							2																		2		2																		1	2
H5302	809	0	1	01	01	H5302_809_0	7	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H5302	809	0	1	01	01	H5302_809_0	7	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H5302	810	0	1	01	01	H5302_810_0	7	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H5302	810	0	1	01	01	H5302_810_0	7	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H5521	801	0	1	04	01	H5521_801_0	7	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	801	0	1	04	01	H5521_801_0	7	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	802	0	1	04	01	H5521_802_0	7	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	802	0	1	04	01	H5521_802_0	7	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	805	0	2	04	01	H5521_805_0	7	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	805	0	2	04	01	H5521_805_0	7	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	806	0	2	04	01	H5521_806_0	7	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	806	0	2	04	01	H5521_806_0	7	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	809	0	1	04	01	H5521_809_0	7	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	809	0	1	04	01	H5521_809_0	7	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	810	0	1	04	01	H5521_810_0	7	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	810	0	1	04	01	H5521_810_0	7	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	812	0	1	04	01	H5521_812_0	7	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	812	0	1	04	01	H5521_812_0	7	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	814	0	2	04	01	H5521_814_0	7	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	814	0	2	04	01	H5521_814_0	7	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	815	0	2	04	01	H5521_815_0	7	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	815	0	2	04	01	H5521_815_0	7	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	816	0	2	04	01	H5521_816_0	7	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	816	0	2	04	01	H5521_816_0	7	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	817	0	1	04	01	H5521_817_0	7	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	817	0	1	04	01	H5521_817_0	7	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	818	0	2	04	01	H5521_818_0	7	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	818	0	2	04	01	H5521_818_0	7	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	819	0	1	04	01	H5521_819_0	7	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	819	0	1	04	01	H5521_819_0	7	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	820	0	1	04	01	H5521_820_0	7	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	820	0	1	04	01	H5521_820_0	7	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	821	0	1	04	01	H5521_821_0	7	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	821	0	1	04	01	H5521_821_0	7	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	822	0	1	04	01	H5521_822_0	7	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	822	0	1	04	01	H5521_822_0	7	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	823	0	2	04	01	H5521_823_0	7	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	823	0	2	04	01	H5521_823_0	7	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	824	0	2	04	01	H5521_824_0	7	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	824	0	2	04	01	H5521_824_0	7	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	825	0	1	04	01	H5521_825_0	7	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	825	0	1	04	01	H5521_825_0	7	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	826	0	2	04	01	H5521_826_0	7	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	826	0	2	04	01	H5521_826_0	7	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	827	0	2	04	01	H5521_827_0	7	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	827	0	2	04	01	H5521_827_0	7	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	828	0	2	04	01	H5521_828_0	7	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	828	0	2	04	01	H5521_828_0	7	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	829	0	1	04	01	H5521_829_0	7	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	829	0	1	04	01	H5521_829_0	7	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	830	0	2	04	01	H5521_830_0	7	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	830	0	2	04	01	H5521_830_0	7	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	831	0	1	04	01	H5521_831_0	7	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	831	0	1	04	01	H5521_831_0	7	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	832	0	1	04	01	H5521_832_0	7	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	832	0	1	04	01	H5521_832_0	7	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	833	0	1	04	01	H5521_833_0	7	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	833	0	1	04	01	H5521_833_0	7	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	834	0	1	04	01	H5521_834_0	7	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	834	0	1	04	01	H5521_834_0	7	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	835	0	2	04	01	H5521_835_0	7	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	835	0	2	04	01	H5521_835_0	7	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	836	0	1	04	01	H5521_836_0	7	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	836	0	1	04	01	H5521_836_0	7	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	837	0	1	04	01	H5521_837_0	7	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5521	837	0	1	04	01	H5521_837_0	7	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5522	802	0	1	04	01	H5522_802_0	6	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5522	802	0	1	04	01	H5522_802_0	6	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5522	803	0	1	04	01	H5522_803_0	6	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5522	803	0	1	04	01	H5522_803_0	6	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5522	808	0	2	04	01	H5522_808_0	5	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5522	808	0	2	04	01	H5522_808_0	5	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5522	809	0	2	04	01	H5522_809_0	6	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5522	809	0	2	04	01	H5522_809_0	6	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5522	810	0	1	04	01	H5522_810_0	6	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5522	810	0	1	04	01	H5522_810_0	6	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5522	811	0	1	04	01	H5522_811_0	6	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5522	811	0	1	04	01	H5522_811_0	6	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5522	813	0	2	04	01	H5522_813_0	6	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5522	813	0	2	04	01	H5522_813_0	6	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5522	814	0	2	04	01	H5522_814_0	6	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5522	814	0	2	04	01	H5522_814_0	6	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5522	815	0	1	04	01	H5522_815_0	6	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5522	815	0	1	04	01	H5522_815_0	6	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5522	816	0	1	04	01	H5522_816_0	6	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5522	816	0	1	04	01	H5522_816_0	6	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5522	817	0	2	04	01	H5522_817_0	6	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5522	817	0	2	04	01	H5522_817_0	6	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5522	818	0	2	04	01	H5522_818_0	6	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5522	818	0	2	04	01	H5522_818_0	6	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5522	819	0	1	04	01	H5522_819_0	6	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5522	819	0	1	04	01	H5522_819_0	6	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5522	820	0	1	04	01	H5522_820_0	6	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5522	820	0	1	04	01	H5522_820_0	6	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5522	821	0	1	04	01	H5522_821_0	6	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5522	821	0	1	04	01	H5522_821_0	6	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5522	822	0	2	04	01	H5522_822_0	6	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5522	822	0	2	04	01	H5522_822_0	6	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5522	823	0	1	04	01	H5522_823_0	6	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5522	823	0	1	04	01	H5522_823_0	6	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5522	824	0	2	04	01	H5522_824_0	6	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5522	824	0	2	04	01	H5522_824_0	6	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5522	825	0	2	04	01	H5522_825_0	6	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5522	825	0	2	04	01	H5522_825_0	6	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5522	826	0	2	04	01	H5522_826_0	6	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5522	826	0	2	04	01	H5522_826_0	6	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5522	827	0	2	04	01	H5522_827_0	6	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5522	827	0	2	04	01	H5522_827_0	6	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5522	828	0	1	04	01	H5522_828_0	5	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5522	828	0	1	04	01	H5522_828_0	5	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5522	829	0	2	04	01	H5522_829_0	5	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5522	829	0	2	04	01	H5522_829_0	5	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5522	830	0	1	04	01	H5522_830_0	5	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5522	830	0	1	04	01	H5522_830_0	5	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5522	831	0	1	04	01	H5522_831_0	5	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5522	831	0	1	04	01	H5522_831_0	5	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5522	832	0	1	04	01	H5522_832_0	5	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5522	832	0	1	04	01	H5522_832_0	5	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5522	833	0	1	04	01	H5522_833_0	5	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5522	833	0	1	04	01	H5522_833_0	5	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5522	834	0	2	04	01	H5522_834_0	5	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5522	834	0	2	04	01	H5522_834_0	5	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5522	835	0	1	04	01	H5522_835_0	5	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5522	835	0	1	04	01	H5522_835_0	5	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5522	836	0	1	04	01	H5522_836_0	5	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5522	836	0	1	04	01	H5522_836_0	5	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H5525	036	0	1	04	01	H5525_036_0	6	2	1	1111	2	1				2	1				2	1				2	1				1	2	500.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		1									2																		2		2																		1	2
H5525	045	0	1	04	01	H5525_045_0	6	1	1	1111	2	1				2	1				2	1				2	1				1	2	1000	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1	2	2	1000	3							2																		2		2																		1	2
H5525	053	0	1	04	01	H5525_053_0	7	2	1	1111	2	1				2	1				2	1				2	1				1	2	500.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1	2	2	500.00	3							2																		2		2																		1	2
H5525	072	0	1	04	01	H5525_072_0	7	2	1	1111	2	1				2	1				2	1				2	1				1	2	500.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1	2	2	500.00	3							2																		2		2																		1	2
H5525	073	0	1	04	01	H5525_073_0	7	2	1	1111	2	1				2	1				2	1				2	1				1	2	500.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1	2	2	500.00	3							2																		2		2																		1	2
H5593	801	0	1	01	01	H5593_801_0	5	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H5593	801	0	1	01	01	H5593_801_0	5	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H5593	802	0	1	01	01	H5593_802_0	5	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H5593	802	0	1	01	01	H5593_802_0	5	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H5619	054	0	1	02	01	H5619_054_0	5	2	1	1111	2	1				2	1				2	1				2	1				1		1000.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	1000.00	3							2																		2		2																		1	2
H5619	057	0	1	01	01	H5619_057_0	8	1	1	1111	2	1				2	1				2	1				2	1				1		500.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	500.00	3							2																		2		2																		1	2
H5619	061	0	1	01	01	H5619_061_0	5	1	1	1111	2	1				2	1				2	1				2	1				1		500	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	500	3							2																		2		2																		1	2
H5619	065	0	1	01	01	H5619_065_0	8	1	1	1111	2	1				2	1				2	1				2	1				1		1000.00	3		2				2		2												2		2		2												1	2	1	0100000	2	1																																		1		2	1000.00	3							2																		2		2																		1	2
H5619	071	0	1	01	01	H5619_071_0	7	1	1	1111	2	1				2	1				2	1				2	1				1		500.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	500.00	3							2																		2		2																		1	2
H5619	075	0	1	01	01	H5619_075_0	5	2	1	1111	2	1				2	1				2	1				2	1				1		1000	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	1000	3							2																		2		2																		1	2
H5619	082	0	1	01	01	H5619_082_0	7	2	1	1111	2	1				2	1				2	1				2	1				1		500.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	500.00	3							2																		2		2																		1	2
H5619	100	0	1	01	01	H5619_100_0	7	1	1	1111	2	1				2	1				2	1				2	1				1		500.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	500.00	3							2																		2		2																		1	2
H5619	113	0	1	02	01	H5619_113_0	5	1	1	1111	2	1				2	1				2	1				2	1				1		500	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	500	3							2																		2		2																		1	2
H5619	126	0	1	02	01	H5619_126_0	7	2	1	1111	2	1				2	1				2	1				2	1				1		1000.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	1000.00	3							2																		2		2																		1	2
H5619	134	0	1	01	01	H5619_134_0	7	1	1	1111	2	1				2	1				2	1				2	1				1		1000.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	1000.00	3							2																		2		2																		1	2
H5619	136	4	1	01	01	H5619_136_4	7	2	1	1111	2	1				2	1				2	1				2	1				1		1000.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	1000.00	3							2																		2		2																		1	2
H5619	145	0	1	01	01	H5619_145_0	8	1	1	1111	2	1				2	1				2	1				2	1				1		500.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	500.00	3							2																		2		2																		1	2
H5619	152	0	1	01	01	H5619_152_0	6	1	1	1111	2	1				2	1				2	1				2	1				1		500	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	500	3							2																		2		2																		1	2
H5619	153	0	1	01	01	H5619_153_0	7	3	1	1111	2	1				2	1				2	1				2	1				1		500.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	500.00	3							2																		2		2																		1	2
H5619	154	0	1	01	01	H5619_154_0	5	1	1	1111	2	1				2	1				2	1				2	1				1		1000.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	1000.00	3							2																		2		2																		1	2
H5619	160	0	1	01	01	H5619_160_0	7	1	1	1111	2	1				2	1				2	1				2	1				1		3000.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	3000.00	3							2																		2		2																		1	2
H5619	162	0	1	02	01	H5619_162_0	5	2	1	1111	2	1				2	1				2	1				2	1				1		1000.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	1000.00	3							2																		2		2																		1	2
H5619	163	0	1	01	01	H5619_163_0	5	2	1	1111	2	1				2	1				2	1				2	1				1		1000	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	1000	3							2																		2		2																		1	2
H5793	801	0	1	01	01	H5793_801_0	5	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H5793	801	0	1	01	01	H5793_801_0	5	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H5793	802	0	1	01	01	H5793_802_0	5	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H5793	802	0	1	01	01	H5793_802_0	5	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H5970	020	0	1	04	01	H5970_020_0	7	1	1	1111	2	1				2	1				2	1				2	1				1	2	1000.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1	2	2	1000.00	3							2																		2		2																		1	2
H6158	001	0	1	01	01	H6158_001_0	4	1	1	0111	2	2	1	5		2	2	1	5		2	2	1	5							2					2				2		2												2		1	0111	2				0.00	0.00	0.00	0.00	0.00	0.00			2	2	1	0000010																					2	2	1	6	Periodicities for covered services range from every three months to every two years depending on the service.											2											2																		2		1	00000010											0.00	0.00					2	2
H6158	003	0	1	01	01	H6158_003_0	3	1	1	0111	2	2	1	5		2	2	1	5		2	2	1	5							2					2				2		2												2		1	0111	2				0.00	0.00	0.00	0.00	0.00	0.00			2	2	1	0000010																					2	2	1	6	Periodicities for covered services range from every three months to every two years depending on the service.											2											2																		2		1	00000010											0.00	0.00					2	2
H6622	008	0	1	01	01	H6622_008_0	8	2	1	1111	2	1				2	1				2	1				2	1				1		1000.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	1000.00	3							2																		2		2																		1	2
H6622	027	0	1	02	01	H6622_027_0	8	2	1	1111	2	1				2	1				2	1				2	1				1		500.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	500.00	3							2																		2		2																		1	2
H6622	035	0	1	01	01	H6622_035_0	7	1	1	1111	2	1				2	1				2	1				2	1				1		500.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	500.00	3							2																		2		2																		1	2
H6622	036	0	1	01	01	H6622_036_0	5	1	1	1111	2	1				2	1				2	1				2	1				1		500	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	500	3							2																		2		2																		1	2
H6622	037	0	1	01	01	H6622_037_0	7	1	1	1111	2	1				2	1				2	1				2	1				1		500.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	500.00	3							2																		2		2																		1	2
H6622	078	1	1	01	01	H6622_078_1	8	2	1	1111	2	1				2	1				2	1				2	1				1		1000.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	1000.00	3							2																		2		2																		1	2
H6622	078	2	1	01	01	H6622_078_2	8	2	1	1111	2	1				2	1				2	1				2	1				1		1000.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	1000.00	3							2																		2		2																		1	2
H6622	088	0	1	02	01	H6622_088_0	7	1	1	1111	2	1				2	1				2	1				2	1				1		3000.00	3		2				2		2												2		2		2												1	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				1		2	3000.00	3							2																		2		2																		1	2
H7149	801	0	1	01	01	H7149_801_0	5	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H7149	801	0	1	01	01	H7149_801_0	5	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H7149	802	0	1	01	01	H7149_802_0	5	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H7149	802	0	1	01	01	H7149_802_0	5	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H7301	801	0	1	04	01	H7301_801_0	5	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H7301	801	0	1	04	01	H7301_801_0	5	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H7301	803	0	1	04	01	H7301_803_0	5	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H7301	803	0	1	04	01	H7301_803_0	5	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H8332	801	0	1	01	01	H8332_801_0	5	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H8332	801	0	1	01	01	H8332_801_0	5	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H8332	802	0	1	01	01	H8332_802_0	5	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H8332	802	0	1	01	01	H8332_802_0	5	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H8649	801	0	1	01	01	H8649_801_0	5	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H8649	801	0	1	01	01	H8649_801_0	5	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H8649	803	0	1	01	01	H8649_803_0	5	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H8649	803	0	1	01	01	H8649_803_0	5	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	1	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	1
H9431	801	0	1	04	01	H9431_801_0	5	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H9431	801	0	1	04	01	H9431_801_0	5	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H9431	802	0	1	04	01	H9431_802_0	5	1	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H9431	802	0	1	04	01	H9431_802_0	5	2	1	1111	2	1				2	1				2	1				2	1				2					2				2														2		2														2	2	1	1111111	2	1				2	1				2	1				2	1				2	1				2	1				2	1				2											2																		2		2																		2	2
H9699	007	0	1	01	01	H9699_007_0	3	1	1	0111	2	2	1	5		2	2	1	5		2	2	1	5							2					2				2		2												2		1	0111	2				0.00	0.00	0.00	0.00	0.00	0.00			2	2	1	0000010																					2	2	1	6	Periodicities for covered services range from every three months to every two years depending on the service.											2											2																		2		1	00000010											0.00	0.00					2	2
