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_b13a_bendesc_yn	pbp_b13a_bendesc_ehc	pbp_b13a_bendesc_amo	pbp_b13a_bendesc_lim	pbp_b13a_bendesc_numv	pbp_b13a_bendesc_per	pbp_b13a_bendesc_per_d	pbp_b13a_maxplan_yn	pbp_b13a_maxplan_amt	pbp_b13a_maxplan_per	pbp_b13a_maxplan_per_d	pbp_b13a_maxenr_yn	pbp_b13a_maxenr_amt	pbp_b13a_maxenr_per	pbp_b13a_maxenr_per_d	pbp_b13a_coins_yn	pbp_b13a_coins_pct_min	pbp_b13a_coins_pct_max	pbp_b13a_ded_yn	pbp_b13a_ded_amt	pbp_b13a_copay_yn	pbp_b13a_copay_amt_min	pbp_b13a_copay_amt_max	pbp_b13a_auth_yn	pbp_b13a_refer_yn	pbp_b13b_bendesc_otc	pbp_b13b_bendesc_amo	pbp_b13b_maxplan_yn	pbp_b13b_maxplan_amt	pbp_b13b_otc_maxplan_per	pbp_b13b_maxplan_prd_yn	pbp_b13b_maxenr_yn	pbp_b13b_maxenr_amt	pbp_b13b_maxenr_per	pbp_b13b_maxenr_per_d	pbp_b13b_nrt_yn	pbp_b13b_nrt_attestation	pbp_b13b_naloxone_yn	pbp_b13b_coins_yn	pbp_b13b_coins_pct_min	pbp_b13b_coins_pct_max	pbp_b13b_ded_yn	pbp_b13b_ded_amt	pbp_b13b_copay_yn	pbp_b13b_copay_amt_min	pbp_b13b_copay_amt_max	pbp_b13b_cms_otc_list_yn	pbp_b13c_bendesc_service	pbp_b13c_bendesc_amo	pbp_b13c_meal_type_chk	pbp_b13c_maxplan_yn	pbp_b13c_maxplan_amt	pbp_b13c_maxplan_per	pbp_b13c_maxplan_per_d	pbp_b13c_maxenr_yn	pbp_b13c_maxenr_amt	pbp_b13c_maxenr_per	pbp_b13c_maxenr_per_d	pbp_b13c_coins_yn	pbp_b13c_coins_pct_min	pbp_b13c_coins_pct_max	pbp_b13c_ded_yn	pbp_b13c_ded_amt	pbp_b13c_copay_yn	pbp_b13c_copay_amt_min	pbp_b13c_copay_amt_max	pbp_b13c_auth_yn	pbp_b13c_refer_yn	pbp_b13d_bendesc_service	pbp_b13d_bendesc_amo	pbp_b13d_maxplan_yn	pbp_b13d_maxplan_amt	pbp_b13d_maxplan_per	pbp_b13d_maxplan_per_d	pbp_b13d_maxenr_yn	pbp_b13d_maxenr_amt	pbp_b13d_maxenr_per	pbp_b13d_maxenr_per_d	pbp_b13d_coins_yn	pbp_b13d_coins_pct_min	pbp_b13d_coins_pct_max	pbp_b13d_ded_yn	pbp_b13d_ded_amt	pbp_b13d_copay_yn	pbp_b13d_copay_amt_min	pbp_b13d_copay_amt_max	pbp_b13d_auth_yn	pbp_b13d_refer_yn	pbp_b13e_bendesc_service	pbp_b13e_bendesc_amo	pbp_b13e_maxplan_yn	pbp_b13e_maxplan_amt	pbp_b13e_maxplan_per	pbp_b13e_maxplan_per_d	pbp_b13e_maxenr_yn	pbp_b13e_maxenr_amt	pbp_b13e_maxenr_per	pbp_b13e_maxenr_per_d	pbp_b13e_coins_yn	pbp_b13e_coins_pct_min	pbp_b13e_coins_pct_max	pbp_b13e_ded_yn	pbp_b13e_ded_amt	pbp_b13e_copay_yn	pbp_b13e_copay_amt_min	pbp_b13e_copay_amt_max	pbp_b13e_auth_yn	pbp_b13e_refer_yn	pbp_b13f_bendesc_service	pbp_b13f_bendesc_amo	pbp_b13f_maxplan_yn	pbp_b13f_maxplan_amt	pbp_b13f_maxplan_per	pbp_b13f_maxplan_per_d	pbp_b13f_maxenr_yn	pbp_b13f_maxenr_amt	pbp_b13f_maxenr_per	pbp_b13f_maxenr_per_d	pbp_b13f_coins_yn	pbp_b13f_coins_pct_min	pbp_b13f_coins_pct_max	pbp_b13f_ded_yn	pbp_b13f_ded_amt	pbp_b13f_copay_yn	pbp_b13f_copay_amt_min	pbp_b13f_copay_amt_max	pbp_b13f_auth_yn	pbp_b13f_refer_yn
H0028	007	0	1	01	01	H0028_007_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H0028	015	0	1	02	01	H0028_015_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H0028	031	0	1	01	01	H0028_031_0	5	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H0028	032	0	1	01	01	H0028_032_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H0028	033	0	1	01	01	H0028_033_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H0028	034	0	1	01	01	H0028_034_0	5	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H0028	036	0	1	01	01	H0028_036_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H0028	044	0	1	01	01	H0028_044_0	5	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H0028	045	0	1	01	01	H0028_045_0	5	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H0028	068	0	1	02	01	H0028_068_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H0028	078	0	1	01	01	H0028_078_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H0028	079	0	1	01	01	H0028_079_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H0104	012	0	1	04	01	H0104_012_0	3	1																																																1	2	010	2				2				2			2		2			2	2																																																												
H0104	014	0	1	04	01	H0104_014_0	4	1																																																1	2	010	2				2				2			2		2			2	2																																																												
H0104	015	0	1	04	01	H0104_015_0	5	1																																																1	2	010	2				2				2			2		2			2	2																																																												
H0363	001	0	1	01	01	H0363_001_0	8	1																																																																					Non-Medicare Covered Restorative Nursing	2	2				2				2			2		2			2	1																																								
H0523	074	0	1	02	01	H0523_074_0	4	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H0523	076	0	1	02	01	H0523_076_0	4	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H0523	078	0	1	02	01	H0523_078_0	4	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H0523	080	0	1	02	01	H0523_080_0	4	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H0523	801	0	1	01	01	H0523_801_0	1	1	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1																																																												
H0523	801	0	1	01	01	H0523_801_0	1	2	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1																				
H0523	805	0	1	01	01	H0523_805_0	1	2	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1																				
H0523	805	0	1	01	01	H0523_805_0	1	1	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1																																																												
H0524	008	0	1	01	01	H0524_008_0	7	1																																																																																																													Advanced Care At Home	2	2				2				2			2		1	0.00	0.00	1	1
H0524	033	0	1	01	01	H0524_033_0	7	1																																																																																																													Advanced Care At Home	2	2				2				2			2		1	0.00	0.00	1	1
H0524	059	0	1	01	01	H0524_059_0	7	1																																																																																																													Advanced Care At Home	2	2				2				2			2		1	0.00	0.00	1	1
H0524	061	0	1	01	01	H0524_061_0	7	1																																																																																																													Advanced Care At Home	2	2				2				2			2		1	0.00	0.00	1	1
H0524	063	0	1	01	01	H0524_063_0	8	1																																																																																																													Advanced Care At Home	2	2				2				2			2		1	0.00	0.00	1	1
H0571	001	0	1	01	01	H0571_001_0	11	1																										1	2	2				2				2		2	2			2		2			1																																																																																	
H0571	005	0	1	01	01	H0571_005_0	9	2																										1	2	2				2				2		2	2			2		2			1																																																																																	
H0571	007	0	1	01	01	H0571_007_0	10	1																										1	2	2				2				2		2	2			2		2			2																																																																																	
H0571	010	0	1	01	01	H0571_010_0	10	1																										1	2	2				2				2		2	2			2		2			1																																																																																	
H0571	011	0	1	01	01	H0571_011_0	10	1																										1	2	2				2				2		2	2			2		2			2																																																																																	
H0628	001	0	1	02	01	H0628_001_0	2	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H0628	005	0	1	02	01	H0628_005_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H0628	012	0	1	01	01	H0628_012_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H0628	013	0	1	01	01	H0628_013_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H0628	017	0	1	02	01	H0628_017_0	2	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H0628	801	0	1	01	01	H0628_801_0	1	2	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1																				
H0628	801	0	1	01	01	H0628_801_0	1	1	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1																																																												
H0628	802	0	1	01	01	H0628_802_0	1	1	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1																																																												
H0628	802	0	1	01	01	H0628_802_0	1	2	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1																				
H0630	013	0	1	01	01	H0630_013_0	10	1																																																																																									Advanced Care at Home	2	2				2				2			2		1	0.00	0.00	1	1																				
H0630	014	0	1	01	01	H0630_014_0	10	1																																																																																									Advanced Care at Home	2	2				2				2			2		1	0.00	0.00	1	1																				
H0630	015	0	1	02	01	H0630_015_0	10	1																																																																																									Advanced Care at Home	2	2				2				2			2		1	0.00	0.00	1	1																				
H0630	016	0	1	02	01	H0630_016_0	10	1																																																																																									Advanced Care at Home	2	2				2				2			2		1	0.00	0.00	1	1																				
H0630	025	0	1	02	01	H0630_025_0	9	1																																																																																									Advanced Care at Home	2	2				2				2			2		1	0.00	0.00	1	1																				
H0630	027	0	1	01	01	H0630_027_0	11	1																																																																																									Advanced Care at Home	2	2				2				2			2		1	0.00	0.00	1	1																				
H1019	001	0	1	02	01	H1019_001_0	6	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			1																						Transitional Care	2	2				2				2			2		2			1	2																																								
H1019	006	0	1	01	01	H1019_006_0	5	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			1																						Transitional Care	2	2				2				2			2		2			1	2																																								
H1019	023	0	1	01	01	H1019_023_0	5	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H1019	057	0	1	02	01	H1019_057_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H1019	073	0	1	01	01	H1019_073_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H1019	098	0	1	01	01	H1019_098_0	6	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			1																						Transitional Care	2	2				2				2			2		2			1	2																																								
H1019	103	1	1	01	01	H1019_103_1	6	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			1																						Transitional Care	2	2				2				2			2		2			1	2																																								
H1019	103	2	1	01	01	H1019_103_2	6	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			1																						Transitional Care	2	2				2				2			2		2			1	2																																								
H1019	108	0	1	01	01	H1019_108_0	8	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			1																						Transitional Care	2	2				2				2			2		2			1	2																																								
H1019	109	0	1	01	01	H1019_109_0	3	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H1019	113	0	1	01	01	H1019_113_0	5	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			1																						Transitional Care	2	2				2				2			2		2			1	2																																								
H1019	117	0	1	01	01	H1019_117_0	5	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			1																						Transitional Care	2	2				2				2			2		2			1	2																																								
H1019	118	0	1	01	01	H1019_118_0	3	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H1019	121	0	1	01	01	H1019_121_0	3	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H1019	123	0	1	01	01	H1019_123_0	3	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H1019	124	0	1	01	01	H1019_124_0	5	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			1																						Transitional Care	2	2				2				2			2		2			1	2																																								
H1019	130	0	1	01	01	H1019_130_0	5	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			2																						Transitional Care	2	2				2				2			2		2			1	2																																								
H1019	144	0	1	01	01	H1019_144_0	5	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H1019	146	0	1	01	01	H1019_146_0	5	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H1019	147	2	1	01	01	H1019_147_2	6	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			1																						Transitional Care	2	2				2				2			2		2			1	2																																								
H1019	148	0	1	01	01	H1019_148_0	5	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H1019	151	1	1	01	01	H1019_151_1	3	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H1019	151	2	1	01	01	H1019_151_2	5	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			2																						Transitional Care	2	2				2				2			2		2			1	2																																								
H1035	022	0	1	01	01	H1035_022_0	9	1																										1	2	1	50.00	5	2	2				1	1	1	2			2		2			1	1	2	001	2				2				2			2		2			1	2																																																												
H1035	025	0	1	01	01	H1035_025_0	8	1																										1	2	1	50.00	5	2	2				1	1	1	2			2		2			1	1	2	001	2				2				2			2		2			1	2																																																												
H1035	026	0	1	01	01	H1035_026_0	8	1																										1	2	1	50.00	5	2	2				1	1	1	2			2		2			1	1	2	001	2				2				2			2		2			1	2																																																												
H1035	033	0	1	01	01	H1035_033_0	8	1																										1	2	1	50.00	5	2	2				1	1	1	2			2		2			1	1	2	001	2				2				2			2		2			1	2																																																												
H1035	034	0	1	01	01	H1035_034_0	8	1																										1	2	1	50.00	5	2	2				1	1	1	2			2		2			1	1	2	001	2				2				2			2		2			1	2																																																												
H1035	045	0	1	01	01	H1035_045_0	8	1																										1	2	1	50.00	5	2	2				1	1	1	2			2		2			1	1	2	001	2				2				2			2		2			1	2																																																												
H1035	048	0	1	01	01	H1035_048_0	8	1																										1	2	1	50.00	5	2	2				1	1	1	2			2		2			1	1	2	001	2				2				2			2		2			1	2																																																												
H1036	054	0	1	01	01	H1036_054_0	5	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			1																						Transitional Care	2	2				2				2			2		2			1	2																																								
H1036	062	0	1	01	01	H1036_062_0	6	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			1																						Transitional Care	2	2				2				2			2		2			1	2																																								
H1036	065	0	1	01	01	H1036_065_0	6	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			1																						Transitional Care	2	2				2				2			2		2			1	2																																								
H1036	077	0	1	01	01	H1036_077_0	7	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			1																						Transitional Care	2	2				2				2			2		2			1	2																																								
H1036	077	0	1	01	01	H1036_077_0	7	2																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H1036	102	0	1	01	01	H1036_102_0	7	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			1																						Transitional Care	2	2				2				2			2		2			1	2																																								
H1036	102	0	1	01	01	H1036_102_0	7	2																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H1036	143	0	1	01	01	H1036_143_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H1036	167	0	1	01	01	H1036_167_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H1036	209	0	1	01	01	H1036_209_0	7	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			1																						Transitional Care	2	2				2				2			2		2			1	2																																								
H1036	209	0	1	01	01	H1036_209_0	7	2																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H1036	210	0	1	01	01	H1036_210_0	8	2																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H1036	210	0	1	01	01	H1036_210_0	8	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			1																						Transitional Care	2	2				2				2			2		2			1	2																																								
H1036	213	0	1	01	01	H1036_213_0	7	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			1																						Transitional Care	2	2				2				2			2		2			1	2																																								
H1036	213	0	1	01	01	H1036_213_0	7	2																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H1036	214	0	1	01	01	H1036_214_0	7	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			1																						Transitional Care	2	2				2				2			2		2			1	2																																								
H1036	214	0	1	01	01	H1036_214_0	7	2																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H1036	217	0	1	01	01	H1036_217_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H1036	222	0	1	01	01	H1036_222_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H1036	226	0	1	01	01	H1036_226_0	6	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H1036	229	0	1	01	01	H1036_229_0	3	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H1036	230	0	1	01	01	H1036_230_0	6	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			1																						Transitional Care	2	2				2				2			2		2			1	2																																								
H1036	233	0	1	02	01	H1036_233_0	4	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			1																						Transitional Care	2	2				2				2			2		2			1	2																																								
H1036	235	0	1	01	01	H1036_235_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H1036	280	0	1	01	01	H1036_280_0	6	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H1036	285	0	1	01	01	H1036_285_0	8	2																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H1036	285	0	1	01	01	H1036_285_0	8	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			1																						Transitional Care	2	2				2				2			2		2			1	2																																								
H1036	291	0	1	02	01	H1036_291_0	4	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			1																						Transitional Care	2	2				2				2			2		2			1	2																																								
H1036	295	0	1	01	01	H1036_295_0	5	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H1036	301	0	1	01	01	H1036_301_0	6	1	1	1	2	1				2				2				2			2		2			1	2																																												Transitional Care	2	2				2				2			2		2			1	2																																								
H1036	302	0	1	01	01	H1036_302_0	5	1	1	1	2	1				2				2				2			2		2			1	2																																												Transitional Care	2	2				2				2			2		2			1	2																																								
H1036	304	0	1	01	01	H1036_304_0	7	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			1																						Transitional Care	2	2				2				2			2		2			1	2																																								
H1036	304	0	1	01	01	H1036_304_0	7	2																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H1036	307	0	1	01	01	H1036_307_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H1036	314	0	1	01	01	H1036_314_0	8	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			1																						Transitional Care	2	2				2				2			2		2			1	2																																								
H1036	314	0	1	01	01	H1036_314_0	8	2																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H1036	315	0	1	01	01	H1036_315_0	5	1	1	1	2	1				2				2				2			2		2			1	2																																												Transitional Care	2	2				2				2			2		2			1	2																																								
H1036	316	0	1	01	01	H1036_316_0	5	1	1	1	2	1				2				2				2			2		2			1	2																																												Transitional Care	2	2				2				2			2		2			1	2																																								
H1109	801	0	1	01	01	H1109_801_0	1	2	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1																				
H1109	801	0	1	01	01	H1109_801_0	1	1	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1																																																												
H1109	802	0	1	01	01	H1109_802_0	1	2	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1																				
H1109	802	0	1	01	01	H1109_802_0	1	1	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1																																																												
H1170	002	0	1	01	01	H1170_002_0	12	1																																																																																																													Acute Care at Home	2	2				2				2			2		1	0.00	0.00	1	1
H1170	008	0	1	01	01	H1170_008_0	12	1																																																																																																													Acute Care at Home	2	2				2				2			2		1	0.00	0.00	1	1
H1170	009	0	1	01	01	H1170_009_0	12	1																																																																																																													Acute Care at Home	2	2				2				2			2		1	0.00	0.00	1	1
H1170	011	0	1	01	01	H1170_011_0	11	1																																																																																																													Acute Care at Home	2	2				2				2			2		1	0.00	0.00	1	1
H1170	012	0	1	01	01	H1170_012_0	11	1																																																																																																													Acute Care at Home	2	2				2				2			2		1	0.00	0.00	1	1
H1170	013	0	1	02	01	H1170_013_0	11	1																																																																																																													Acute Care at Home	2	2				2				2			2		1	0.00	0.00	1	1
H1170	014	0	1	01	01	H1170_014_0	11	1																																																																																																													Acute Care at Home	2	2				2				2			2		1	0.00	0.00	1	1
H1170	015	0	1	01	01	H1170_015_0	11	1																																																																																																													Acute Care at Home	2	2				2				2			2		1	0.00	0.00	1	1
H1206	004	0	1	01	01	H1206_004_0	2	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H1206	005	0	1	01	01	H1206_005_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H1206	801	0	1	01	01	H1206_801_0	1	1	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1																																																												
H1206	801	0	1	01	01	H1206_801_0	1	2	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1																				
H1206	802	0	1	01	01	H1206_802_0	1	1	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1																																																												
H1206	802	0	1	01	01	H1206_802_0	1	2	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1																				
H1280	001	0	1	01	01	H1280_001_0	8	1																										1	2	2				2				2		1	2			2		2			1																																																																																	
H1290	019	0	1	01	01	H1290_019_0	10	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H1290	020	0	1	01	01	H1290_020_0	10	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H1290	021	0	1	01	01	H1290_021_0	11	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H1290	022	0	1	01	01	H1290_022_0	8	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H1290	023	0	1	01	01	H1290_023_0	8	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H1290	024	0	1	01	01	H1290_024_0	8	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H1290	033	0	1	01	01	H1290_033_0	10	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H1290	034	0	1	01	01	H1290_034_0	11	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H1290	037	1	1	01	01	H1290_037_1	10	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H1290	037	2	1	01	01	H1290_037_2	10	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H1290	037	3	1	01	01	H1290_037_3	10	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H1290	037	4	1	01	01	H1290_037_4	8	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H1290	037	5	1	01	01	H1290_037_5	8	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H1290	039	0	1	01	01	H1290_039_0	11	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H1290	041	0	1	01	01	H1290_041_0	10	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H1290	042	0	1	01	01	H1290_042_0	10	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H1290	043	0	1	01	01	H1290_043_0	10	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H1290	044	1	1	01	01	H1290_044_1	9	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H1290	044	2	1	01	01	H1290_044_2	9	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H1290	044	3	1	01	01	H1290_044_3	11	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H1290	052	0	1	01	01	H1290_052_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H1290	053	0	1	01	01	H1290_053_0	8	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H1290	054	0	1	01	01	H1290_054_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H1290	055	0	1	01	01	H1290_055_0	8	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H1290	056	0	1	01	01	H1290_056_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H1290	057	0	1	01	01	H1290_057_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H1290	058	0	1	01	01	H1290_058_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H1290	059	0	1	01	01	H1290_059_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H1290	060	0	1	01	01	H1290_060_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H1290	061	0	1	01	01	H1290_061_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H1290	062	0	1	01	01	H1290_062_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H1290	063	0	1	01	01	H1290_063_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H1290	064	0	1	01	01	H1290_064_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H1290	065	0	1	01	01	H1290_065_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H1290	066	0	1	01	01	H1290_066_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H1347	001	0	1	04	01	H1347_001_0	4	1																																																1	2	010	2				2				2			2		2			2	2																																																												
H1347	002	0	1	04	01	H1347_002_0	3	1																																																1	2	010	2				2				2			2		2			2	2																																																												
H1347	003	0	1	04	01	H1347_003_0	3	1																																																1	2	010	2				2				2			2		2			2	2																																																												
H1365	001	0	1	04	01	H1365_001_0	6	1	1	1	2	1				2				2				2			2		2			2	1																																																																																																							
H1365	004	2	1	04	01	H1365_004_2	9	1	1	1	2	1				2				2				2			2		2			2	1																																																																																																							
H1365	004	3	1	04	01	H1365_004_3	7	1	1	1	2	1				2				2				2			2		2			2	1																																																																																																							
H1587	001	0	1	02	01	H1587_001_0	8	1																										1	2	2				2				2		2	2			2		2			2																																																																																	
H1608	027	0	1	04	01	H1608_027_0	4	1																										1	2	2				2				2		2	2			2		1	0.00	0.00	2	1	2	001	2				2				2			2		1	0.00	0.00	2	2	Reminder Device	2	2				2				2			2		1	0.00	0.00	2	2																																								
H1608	027	0	1	04	01	H1608_027_0	4	2																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H1608	062	0	1	04	01	H1608_062_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H1608	073	0	1	04	01	H1608_073_0	2	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H1608	075	0	1	04	01	H1608_075_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H1608	076	0	1	04	01	H1608_076_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H1608	077	0	1	04	01	H1608_077_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H1608	078	0	1	04	01	H1608_078_0	2	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H1608	080	0	1	04	01	H1608_080_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H1608	083	0	1	04	01	H1608_083_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H1608	801	0	1	04	01	H1608_801_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H1608	801	0	1	04	01	H1608_801_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H1608	802	0	1	04	01	H1608_802_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H1608	802	0	1	04	01	H1608_802_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H1609	017	0	1	01	01	H1609_017_0	8	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H1609	018	0	1	01	01	H1609_018_0	6	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H1609	019	0	1	01	01	H1609_019_0	8	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H1609	020	0	1	01	01	H1609_020_0	6	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H1609	021	0	1	01	01	H1609_021_0	6	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H1609	022	0	1	01	01	H1609_022_0	7	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H1609	025	0	1	01	01	H1609_025_0	6	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H1609	027	0	1	01	01	H1609_027_0	6	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H1609	035	0	1	01	01	H1609_035_0	7	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H1609	041	0	1	01	01	H1609_041_0	7	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H1609	042	0	1	01	01	H1609_042_0	6	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H1609	043	0	1	01	01	H1609_043_0	7	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H1609	044	0	1	01	01	H1609_044_0	7	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H1609	045	0	1	01	01	H1609_045_0	7	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H1609	046	0	1	01	01	H1609_046_0	7	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H1609	047	0	1	01	01	H1609_047_0	7	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H1609	048	0	1	01	01	H1609_048_0	8	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H1609	049	0	1	01	01	H1609_049_0	7	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H1609	055	0	1	01	01	H1609_055_0	7	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H1609	056	0	1	01	01	H1609_056_0	7	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H1609	061	0	1	01	01	H1609_061_0	7	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H1609	062	0	1	01	01	H1609_062_0	7	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H1609	063	0	1	01	01	H1609_063_0	7	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H1609	064	0	1	01	01	H1609_064_0	6	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H1609	065	0	1	01	01	H1609_065_0	6	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H1609	066	0	1	01	01	H1609_066_0	6	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H1609	067	0	1	01	01	H1609_067_0	6	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H1609	068	0	1	02	01	H1609_068_0	4	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H1609	801	0	1	01	01	H1609_801_0	2	2	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1																				
H1609	801	0	1	01	01	H1609_801_0	2	1	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1																																																												
H1609	807	0	1	01	01	H1609_807_0	2	2	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1																				
H1609	807	0	1	01	01	H1609_807_0	2	1	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1																																																												
H1610	001	0	1	01	01	H1610_001_0	4	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H1610	003	0	1	01	01	H1610_003_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H1692	005	0	1	01	01	H1692_005_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H1692	801	0	1	01	01	H1692_801_0	1	2	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1																				
H1692	801	0	1	01	01	H1692_801_0	1	1	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1																																																												
H1692	802	0	1	01	01	H1692_802_0	1	2	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1																				
H1692	802	0	1	01	01	H1692_802_0	1	1	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1																																																												
H1748	010	0	1	01	01	H1748_010_0	7	1																																																																					Reconstructive Medical Procedures	2	1	3500.00	3		2				2			2		2			1	2																																								
H1748	014	0	1	01	01	H1748_014_0	7	1																										1	2	1	500.00	4	2	2				2		2	2			2		2			2																						Reconstructive Medical Procedures	2	1	3500.00	3		2				2			2		2			1	2																																								
H1951	032	0	1	01	01	H1951_032_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H1951	041	0	1	01	01	H1951_041_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H1951	056	0	1	01	01	H1951_056_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H1951	057	0	1	01	01	H1951_057_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H2041	001	0	1	01	01	H2041_001_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H2041	003	0	1	01	01	H2041_003_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H2041	005	0	1	01	01	H2041_005_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H2041	007	0	1	01	01	H2041_007_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H2041	008	0	1	01	01	H2041_008_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H2056	801	0	1	01	01	H2056_801_0	1	1	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1																																																												
H2056	801	0	1	01	01	H2056_801_0	1	2	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1																				
H2056	802	0	1	01	01	H2056_802_0	1	1	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1																																																												
H2056	802	0	1	01	01	H2056_802_0	1	2	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1																				
H2096	001	0	1	04	01	H2096_001_0	6	1																										1	2	1	135.00	7	2	2				1	1	1	2			2		2			1																						Healthy Food	2	1	135.00	7		2				2			2		2			2	2	General Supports for Living (Utilities)	2	1	135.00	7		2				2			2		2			2	2																				
H2096	001	0	1	04	01	H2096_001_0	6	2																										1	2	1	135.00	7	2	2				1	1	1	2			2		2			1																						Healthy Food	2	1	135.00	7		2				2			2		2			2	2	General Supports for Living (Utilities)	2	1	135.00	7		2				2			2		2			2	2																				
H2172	001	0	1	02	01	H2172_001_0	8	1																																																																																																													Acute Care at Home	2	2				2				2			2		1	0.00	0.00	1	1
H2172	002	0	1	02	01	H2172_002_0	7	1																																																																																																													Acute Care at Home	2	2				2				2			2		1	0.00	0.00	1	1
H2172	003	0	1	02	01	H2172_003_0	9	1																																																																																																													Acute Care at Home	2	2				2				2			2		1	0.00	0.00	1	1
H2172	004	0	1	02	01	H2172_004_0	8	1																																																																																																													Acute Care at Home	2	2				2				2			2		1	0.00	0.00	1	1
H2172	005	0	1	01	01	H2172_005_0	7	1																																																																																																													Acute Care at Home	2	2				2				2			2		1	0.00	0.00	1	1
H2172	006	0	1	01	01	H2172_006_0	8	1																																																																																																													Acute Care at Home	2	2				2				2			2		1	0.00	0.00	1	1
H2172	008	0	1	02	01	H2172_008_0	7	1																																																																																																													Acute Care at Home	2	2				2				2			2		1	0.00	0.00	1	1
H2172	009	0	1	02	01	H2172_009_0	7	1																																																																																																													Acute Care at Home	2	2				2				2			2		1	0.00	0.00	1	1
H2172	010	0	1	02	01	H2172_010_0	7	1																																																																																																													Acute Care at Home	2	2				2				2			2		1	0.00	0.00	1	1
H2172	011	0	1	01	01	H2172_011_0	8	1																																																																																																													Acute Care at Home	2	2				2				2			2		1	0.00	0.00	1	1
H2172	012	0	1	02	01	H2172_012_0	8	1																																																																																																													Acute Care at Home	2	2				2				2			2		1	0.00	0.00	1	1
H2172	013	0	1	02	01	H2172_013_0	7	1																																																																																																													Acute Care at Home	2	2				2				2			2		1	0.00	0.00	1	1
H2172	014	0	1	02	01	H2172_014_0	7	1																																																																																																													Acute Care at Home	2	2				2				2			2		1	0.00	0.00	1	1
H2256	001	1	1	01	01	H2256_001_1	5	1																										1	2	2				2				2		2	1	10	10	2		2			2																																																																																	
H2256	001	2	1	01	01	H2256_001_2	5	1																										1	2	2				2				2		2	1	10	10	2		2			2																																																																																	
H2256	001	6	1	01	01	H2256_001_6	5	1																										1	2	2				2				2		2	1	10	10	2		2			2																																																																																	
H2256	015	1	1	01	01	H2256_015_1	5	1																										1	2	2				2				2		2	1	10	10	2		2			2																																																																																	
H2256	015	2	1	01	01	H2256_015_2	5	1																										1	2	2				2				2		2	1	10	10	2		2			2																																																																																	
H2256	015	6	1	01	01	H2256_015_6	5	1																										1	2	2				2				2		2	1	10	10	2		2			2																																																																																	
H2256	016	1	1	01	01	H2256_016_1	3	1																										1	2	2				2				2		2	1	10	10	2		2			2																																																																																	
H2256	016	2	1	01	01	H2256_016_2	3	1																										1	2	2				2				2		2	1	10	10	2		2			2																																																																																	
H2256	018	1	1	01	01	H2256_018_1	5	1																										1	2	2				2				2		2	1	10	10	2		2			2																																																																																	
H2256	018	7	1	01	01	H2256_018_7	5	1																										1	2	2				2				2		2	1	10	10	2		2			2																																																																																	
H2256	018	8	1	01	01	H2256_018_8	5	1																										1	2	2				2				2		2	1	10	10	2		2			2																																																																																	
H2256	019	1	1	01	01	H2256_019_1	3	1																										1	2	2				2				2		2	1	10	10	2		2			2																																																																																	
H2256	019	7	1	01	01	H2256_019_7	3	1																										1	2	2				2				2		2	1	10	10	2		2			2																																																																																	
H2256	026	1	1	01	01	H2256_026_1	5	1																										1	2	2				2				2		2	1	20	20	2		2			2																																																																																	
H2256	026	2	1	01	01	H2256_026_2	5	1																										1	2	2				2				2		2	1	20	20	2		2			2																																																																																	
H2256	026	3	1	01	01	H2256_026_3	5	1																										1	2	2				2				2		2	1	20	20	2		2			2																																																																																	
H2256	028	0	1	01	01	H2256_028_0	5	1																										1	2	2				2				2		2	1	20	20	2		2			2																																																																																	
H2256	033	0	1	01	01	H2256_033_0	5	1																										1	2	2				2				2		2	1	10	10	2		2			2																																																																																	
H2256	034	0	1	01	01	H2256_034_0	5	1																										1	2	2				2				2		2	1	10	10	2		2			2																																																																																	
H2256	036	0	1	01	01	H2256_036_0	4	1																										1	2	2				2				2		2	1	20	20	2		2			2																																																																																	
H2256	039	0	1	01	01	H2256_039_0	3	1																										1	2	2				2				2		2	1	10	10	2		2			2																																																																																	
H2256	040	0	1	01	01	H2256_040_0	3	1																										1	2	2				2				2		2	1	10	10	2		2			2																																																																																	
H2256	041	0	1	01	01	H2256_041_0	3	1																										1	2	2				2				2		2	1	20	20	2		2			2																																																																																	
H2256	042	0	1	01	01	H2256_042_0	3	1																										1	2	2				2				2		2	1	20	20	2		2			2																																																																																	
H2256	046	0	1	01	01	H2256_046_0	6	1																										1	2	2				2				2		2	1	20	20	2		2			2																																																																																	
H2293	001	0	1	04	01	H2293_001_0	4	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H2293	002	0	1	04	01	H2293_002_0	3	2																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H2293	002	0	1	04	01	H2293_002_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H2293	003	0	1	04	01	H2293_003_0	3	2																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H2293	003	0	1	04	01	H2293_003_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H2293	004	0	1	04	01	H2293_004_0	3	2																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H2293	004	0	1	04	01	H2293_004_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H2293	005	0	1	04	01	H2293_005_0	3	2																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H2293	005	0	1	04	01	H2293_005_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H2293	009	0	1	04	01	H2293_009_0	2	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H2293	011	0	1	04	01	H2293_011_0	3	2																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H2293	011	0	1	04	01	H2293_011_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H2293	021	0	1	04	01	H2293_021_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H2293	023	0	1	04	01	H2293_023_0	3	2																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H2293	023	0	1	04	01	H2293_023_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H2293	028	0	1	04	01	H2293_028_0	2	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H2293	029	0	1	04	01	H2293_029_0	2	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H2293	031	0	1	04	01	H2293_031_0	2	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H2293	033	0	1	04	01	H2293_033_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H2425	001	0	1	01	01	H2425_001_0	7	1																										1	2	2				2				2		2	2			2		2			2																																																																																	
H2456	002	0	1	01	01	H2456_002_0	8	3	1	1	2	2	12	3		2				2				2			2		2			2	2																																																																																																							
H2459	021	1	1	02	01	H2459_021_1	12	1																																																1	2	011	2				2				2			2		2			2	2																																																												
H2459	021	2	1	02	01	H2459_021_2	12	1																																																1	2	011	2				2				2			2		2			2	2																																																												
H2459	021	3	1	02	01	H2459_021_3	13	1																																																1	2	011	2				2				2			2		2			2	2																																																												
H2506	001	0	1	48	05	H2506_001_0	4	1																																																																					Flex card	2	1	50.00	7		2				2			2		2			2	2																																								
H2526	003	0	1	04	01	H2526_003_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H2663	052	0	1	01	01	H2663_052_0	4	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H2663	053	0	1	01	01	H2663_053_0	4	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H2663	054	0	1	01	01	H2663_054_0	4	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H2663	055	0	1	01	01	H2663_055_0	4	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H2663	056	0	1	01	01	H2663_056_0	4	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H2663	057	0	1	02	01	H2663_057_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H2663	064	0	1	01	01	H2663_064_0	4	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H2663	067	0	1	01	01	H2663_067_0	2	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H2663	805	0	1	01	01	H2663_805_0	1	2	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1																				
H2663	805	0	1	01	01	H2663_805_0	1	1	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1																																																												
H2663	810	0	1	01	01	H2663_810_0	1	2	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1																				
H2663	810	0	1	01	01	H2663_810_0	1	1	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1																																																												
H2686	004	1	1	04	01	H2686_004_1	6	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H2686	004	3	1	04	01	H2686_004_3	5	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H2686	006	1	1	04	01	H2686_006_1	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H2686	006	2	1	04	01	H2686_006_2	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H2686	008	0	1	04	01	H2686_008_0	8	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H2686	010	0	1	04	01	H2686_010_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H2694	002	0	1	04	01	H2694_002_0	8	1																										1	2	2				2				2		1	2			2		2			1																																																																																	
H2697	007	0	1	01	01	H2697_007_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H2697	010	0	1	01	01	H2697_010_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H2697	011	0	1	01	01	H2697_011_0	8	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H2875	001	0	1	02	01	H2875_001_0	5	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			1																						Transitional Care	2	2				2				2			2		2			1	2																																								
H2875	001	0	1	02	01	H2875_001_0	5	2																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H2875	002	0	1	02	01	H2875_002_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H2875	003	0	1	01	01	H2875_003_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H2875	004	0	1	01	01	H2875_004_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H2923	001	0	1	01	01	H2923_001_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H2923	003	0	1	01	01	H2923_003_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H2923	005	0	1	01	01	H2923_005_0	8	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H2923	006	0	1	01	01	H2923_006_0	8	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H3015	001	0	1	01	01	H3015_001_0	4	2																										1	2	1	205.00	7	2	2				1	1	1	2			2		2			1																						Healthy Food	2	1	205.00	7		2				2			2		2			2	2	General Supports of Living (Utilities)	2	1	205.00	7		2				2			2		2			2	2																				
H3015	001	0	1	01	01	H3015_001_0	4	1																										1	2	1	205.00	7	2	2				1	1	1	2			2		2			1																						Healthy Food	2	1	205.00	7		2				2			2		2			2	2	General Supports of Living (Utilities)	2	1	205.00	7		2				2			2		2			2	2																				
H3041	001	0	1	01	01	H3041_001_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H3041	003	0	1	01	01	H3041_003_0	8	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H3080	001	0	1	01	01	H3080_001_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H3080	003	0	1	01	01	H3080_003_0	8	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H3080	004	0	1	01	01	H3080_004_0	10	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H3080	006	0	1	01	01	H3080_006_0	10	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H3080	007	0	1	01	01	H3080_007_0	10	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H3146	001	0	1	02	01	H3146_001_0	2	1																										1	2	2				2				2		2	2			2		1	0.00	0.00	2																																																																																	
H3146	002	0	1	01	01	H3146_002_0	5	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3146	003	0	1	01	01	H3146_003_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3146	004	0	1	02	01	H3146_004_0	3	1																										1	2	2				2				2		2	2			2		1	0.00	0.00	2																																																																																	
H3146	006	0	1	01	01	H3146_006_0	4	2																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3146	006	0	1	01	01	H3146_006_0	4	1																										1	2	2				2				2		2	2			2		1	0.00	0.00	2																																																																																	
H3146	007	0	1	02	01	H3146_007_0	3	1																										1	2	2				2				2		2	2			2		1	0.00	0.00	2																																																																																	
H3146	008	0	1	01	01	H3146_008_0	4	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3146	011	0	1	01	01	H3146_011_0	3	1																										1	2	2				2				2		2	2			2		1	0.00	0.00	2																																																																																	
H3146	011	0	1	01	01	H3146_011_0	3	2																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3146	012	0	1	01	01	H3146_012_0	4	1																										1	2	2				2				2		2	2			2		1	0.00	0.00	2																																																																																	
H3146	012	0	1	01	01	H3146_012_0	4	2																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3146	014	0	1	02	01	H3146_014_0	3	1																										1	2	2				2				2		2	2			2		1	0.00	0.00	2																																																																																	
H3146	016	0	1	01	01	H3146_016_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3146	017	0	1	01	01	H3146_017_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3146	018	0	1	01	01	H3146_018_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3146	019	0	1	01	01	H3146_019_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3146	021	0	1	01	01	H3146_021_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3146	022	0	1	01	01	H3146_022_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3146	022	0	1	01	01	H3146_022_0	3	2																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3146	023	0	1	01	01	H3146_023_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3146	023	0	1	01	01	H3146_023_0	3	2																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3146	801	0	1	01	01	H3146_801_0	1	1	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1																																																												
H3146	801	0	1	01	01	H3146_801_0	1	2	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1																				
H3146	802	0	1	01	01	H3146_802_0	1	1	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1																																																												
H3146	802	0	1	01	01	H3146_802_0	1	2	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1																				
H3152	801	0	1	01	01	H3152_801_0	1	2	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1																				
H3152	801	0	1	01	01	H3152_801_0	1	1	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1																																																												
H3152	804	0	1	01	01	H3152_804_0	1	1	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1																																																												
H3152	804	0	1	01	01	H3152_804_0	1	2	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1																				
H3192	007	0	1	01	01	H3192_007_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3192	007	0	1	01	01	H3192_007_0	3	2																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3192	021	0	1	02	01	H3192_021_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3192	801	0	1	01	01	H3192_801_0	1	1	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1																																																												
H3192	801	0	1	01	01	H3192_801_0	1	2	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1																				
H3192	802	0	1	01	01	H3192_802_0	1	2	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1																				
H3192	802	0	1	01	01	H3192_802_0	1	1	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1																																																												
H3219	002	0	1	04	01	H3219_002_0	5	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3219	801	0	1	04	01	H3219_801_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H3219	801	0	1	04	01	H3219_801_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H3219	802	0	1	04	01	H3219_802_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H3219	802	0	1	04	01	H3219_802_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H3239	001	0	1	01	01	H3239_001_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3239	002	0	1	01	01	H3239_002_0	4	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3239	003	0	1	01	01	H3239_003_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3239	005	0	1	01	01	H3239_005_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3239	006	0	1	01	01	H3239_006_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3239	007	0	1	01	01	H3239_007_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3239	008	0	1	01	01	H3239_008_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3239	010	0	1	01	01	H3239_010_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3239	012	0	1	01	01	H3239_012_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3239	013	0	1	01	01	H3239_013_0	3	2																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3239	013	0	1	01	01	H3239_013_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3239	015	0	1	01	01	H3239_015_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3239	015	0	1	01	01	H3239_015_0	3	2																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3239	016	0	1	01	01	H3239_016_0	3	2																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3239	016	0	1	01	01	H3239_016_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3239	017	0	1	01	01	H3239_017_0	2	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3239	018	0	1	01	01	H3239_018_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3239	018	0	1	01	01	H3239_018_0	3	2																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3239	019	0	1	01	01	H3239_019_0	3	2																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3239	019	0	1	01	01	H3239_019_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3239	020	0	1	01	01	H3239_020_0	2	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3239	021	0	1	01	01	H3239_021_0	4	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3239	021	0	1	01	01	H3239_021_0	4	2																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3239	022	0	1	01	01	H3239_022_0	2	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3239	023	0	1	01	01	H3239_023_0	3	2																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3239	023	0	1	01	01	H3239_023_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3259	001	0	1	01	01	H3259_001_0	6	1																										1	2	2				2				1	1	2	2			2		2			2																																																																																	
H3259	002	0	1	01	01	H3259_002_0	6	1																										1	2	2				2				1	1	2	2			2		2			2																																																																																	
H3259	003	0	1	01	01	H3259_003_0	6	1																										1	2	2				2				1	1	2	2			2		2			2																																																																																	
H3288	001	0	1	04	01	H3288_001_0	4	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3288	002	0	1	04	01	H3288_002_0	4	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3288	003	0	1	04	01	H3288_003_0	4	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3288	004	0	1	04	01	H3288_004_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3288	017	0	1	04	01	H3288_017_0	4	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3288	018	0	1	04	01	H3288_018_0	4	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3288	019	0	1	04	01	H3288_019_0	4	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3288	034	0	1	04	01	H3288_034_0	2	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3288	047	0	1	04	01	H3288_047_0	2	1																										1	2	2				2				2		2	2			2		1	0.00	0.00	2																																																																																	
H3288	048	0	1	04	01	H3288_048_0	4	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3288	053	0	1	04	01	H3288_053_0	3	2																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3288	053	0	1	04	01	H3288_053_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3288	801	0	1	04	01	H3288_801_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H3288	801	0	1	04	01	H3288_801_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H3288	802	0	1	04	01	H3288_802_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H3288	802	0	1	04	01	H3288_802_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H3305	007	0	1	02	01	H3305_007_0	6	1																										1	2	2				2				2		2	2			2		2			2																																																																																	
H3305	015	0	1	02	01	H3305_015_0	7	1																										1	2	2				2				2		2	2			2		2			2																																																																																	
H3305	020	0	1	02	01	H3305_020_0	6	1																										1	2	2				2				2		2	2			2		2			2																																																																																	
H3305	022	0	1	02	01	H3305_022_0	7	1																										1	2	2				2				2		2	2			2		2			2																																																																																	
H3305	030	0	1	02	01	H3305_030_0	7	1																										1	2	2				2				2		2	2			2		2			2																																																																																	
H3312	069	0	1	01	01	H3312_069_0	4	2																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3312	069	0	1	01	01	H3312_069_0	4	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3312	070	0	1	01	01	H3312_070_0	4	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3312	073	0	1	01	01	H3312_073_0	2	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3312	074	0	1	01	01	H3312_074_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3312	087	0	1	01	01	H3312_087_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3312	088	0	1	01	01	H3312_088_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3312	089	0	1	01	01	H3312_089_0	4	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3312	090	0	1	01	01	H3312_090_0	4	2																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3312	090	0	1	01	01	H3312_090_0	4	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3312	801	0	1	01	01	H3312_801_0	1	1	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1																																																												
H3312	801	0	1	01	01	H3312_801_0	1	2	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1																				
H3312	804	0	1	01	01	H3312_804_0	1	1	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1																																																												
H3312	804	0	1	01	01	H3312_804_0	1	2	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1																				
H3443	001	0	1	01	01	H3443_001_0	9	2																										1	2	1	0.00	7	2	2				1	1	1	2			2		2			2																																																																																	
H3443	002	0	1	01	01	H3443_002_0	9	2																										1	2	1	50.00	7	2	2				1	1	1	2			2		2			2																																																																																	
H3443	006	0	1	01	01	H3443_006_0	6	2																																																1	2	011	2				2				2			2		2			2	2																																																												
H3533	002	0	1	01	01	H3533_002_0	5	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H3533	034	1	1	01	01	H3533_034_1	5	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H3533	034	2	1	01	01	H3533_034_2	5	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H3551	001	0	1	01	01	H3551_001_0	8	1																										1	2	2				2				2		1	2			2		2			1																																																																																	
H3597	011	0	1	02	01	H3597_011_0	4	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3597	012	0	1	02	01	H3597_012_0	4	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3597	801	0	1	01	01	H3597_801_0	1	1	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1																																																												
H3597	801	0	1	01	01	H3597_801_0	1	2	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1																				
H3597	802	0	1	01	01	H3597_802_0	1	1	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1																																																												
H3597	802	0	1	01	01	H3597_802_0	1	2	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1																				
H3660	028	0	1	02	01	H3660_028_0	9	1																																																1	2	001	2				2				2			2		2			2	2																																																												
H3660	029	0	1	02	01	H3660_029_0	10	2																																																1	2	001	2				2				2			2		2			2	2																																																												
H3660	044	0	1	01	01	H3660_044_0	9	2																																																1	2	001	2				2				2			2		2			2	2																																																												
H3660	050	0	1	01	01	H3660_050_0	10	2																																																1	2	001	2				2				2			2		2			2	2																																																												
H3660	052	1	1	01	01	H3660_052_1	7	2																																																1	2	001	2				2				2			2		2			2	2																																																												
H3660	052	2	1	01	01	H3660_052_2	7	2																																																1	2	001	2				2				2			2		2			2	2																																																												
H3660	053	1	1	01	01	H3660_053_1	10	2																																																1	2	001	2				2				2			2		2			2	2																																																												
H3660	053	2	1	01	01	H3660_053_2	10	2																																																1	2	001	2				2				2			2		2			2	2																																																												
H3660	056	1	1	01	01	H3660_056_1	10	1																																																1	2	001	2				2				2			2		2			2	2																																																												
H3660	056	2	1	01	01	H3660_056_2	10	1																																																1	2	001	2				2				2			2		2			2	2																																																												
H3660	801	0	1	01	01	H3660_801_0	3	2																																																1	2	001	2				2				2			2		2			2	2																																																												
H3660	805	0	1	02	01	H3660_805_0	3	2																																																1	2	001	2				2				2			2		2			2	2																																																												
H3706	024	0	1	01	01	H3706_024_0	10	1																										1	2	1	0.00	7	1	2				1	1	2	2			2		2			1																																																																																	
H3706	025	0	1	01	01	H3706_025_0	9	1																										1	2	1	0.00	7	1	2				1	1	2	2			2		2			1																																																																																	
H3706	028	0	1	01	01	H3706_028_0	8	2																																																1	2	100	2				2				2			2		2			1	2																																																												
H3706	029	0	1	01	01	H3706_029_0	7	2																																																1	2	100	2				2				2			2		2			1	2																																																												
H3748	801	0	1	01	01	H3748_801_0	1	1	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1																																																												
H3748	801	0	1	01	01	H3748_801_0	1	2	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1																				
H3748	802	0	1	01	01	H3748_802_0	1	1	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1																																																												
H3748	802	0	1	01	01	H3748_802_0	1	2	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1																				
H3755	006	0	1	01	01	H3755_006_0	6	1																																																1	2	011	2				2				2			2		2			1	1																																																												
H3815	007	0	1	01	01	H3815_007_0	16	2	1	1	2	2	12	3		2				2				2			2		2			2	2	1	2	1	80.00	7	2	2				1	1	1	2			2		2			2	1	2	011	2				2				2			2		2			2	2																																																												
H3815	039	0	1	01	01	H3815_039_0	12	2																																																1	2	011	2				2				2			2		2			1	1																																																												
H3815	041	0	1	01	01	H3815_041_0	12	2																																																1	2	011	2				2				2			2		2			1	1																																																												
H3815	042	0	1	01	01	H3815_042_0	12	2																																																1	2	011	2				2				2			2		2			1	1																																																												
H3815	044	0	1	01	01	H3815_044_0	9	2																																																1	2	011	2				2				2			2		2			1	1																																																												
H3815	045	0	1	01	01	H3815_045_0	9	2																																																1	2	011	2				2				2			2		2			1	1																																																												
H3907	002	0	1	01	01	H3907_002_0	9	1																																																1	2	011	2				2				2			2		2			2	2																																																												
H3907	006	0	1	01	01	H3907_006_0	10	1																																																1	2	011	2				2				2			2		2			2	2																																																												
H3907	037	0	1	01	01	H3907_037_0	11	1																																																1	2	011	2				2				2			2		2			2	2																																																												
H3907	057	1	1	01	01	H3907_057_1	11	1																																																1	2	011	2				2				2			2		2			2	2																																																												
H3907	057	2	1	01	01	H3907_057_2	11	1																																																1	2	011	2				2				2			2		2			2	2																																																												
H3907	057	3	1	01	01	H3907_057_3	11	1																																																1	2	011	2				2				2			2		2			2	2																																																												
H3907	057	4	1	01	01	H3907_057_4	11	1																																																1	2	011	2				2				2			2		2			2	2																																																												
H3907	057	5	1	01	01	H3907_057_5	11	1																																																1	2	011	2				2				2			2		2			2	2																																																												
H3907	058	1	1	01	01	H3907_058_1	10	1																																																1	2	011	2				2				2			2		2			2	2																																																												
H3907	058	2	1	01	01	H3907_058_2	10	1																																																1	2	011	2				2				2			2		2			2	2																																																												
H3907	059	1	1	01	01	H3907_059_1	10	1																																																1	2	011	2				2				2			2		2			2	2																																																												
H3907	059	2	1	01	01	H3907_059_2	10	1																																																1	2	011	2				2				2			2		2			2	2																																																												
H3907	059	3	1	01	01	H3907_059_3	11	1																																																1	2	011	2				2				2			2		2			2	2																																																												
H3928	001	0	1	01	01	H3928_001_0	4	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3928	801	0	1	01	01	H3928_801_0	1	2	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1																				
H3928	801	0	1	01	01	H3928_801_0	1	1	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1																																																												
H3928	803	0	1	01	01	H3928_803_0	1	1	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1																																																												
H3928	803	0	1	01	01	H3928_803_0	1	2	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1																				
H3931	004	0	1	02	01	H3931_004_0	4	2																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3931	004	0	1	02	01	H3931_004_0	4	1																										1	2	2				2				2		2	2			2		1	0.00	0.00	2	1	2	001	2				2				2			2		1	0.00	0.00	2	2	Reminder Device	2	2				2				2			2		1	0.00	0.00	2	2																																								
H3931	095	0	1	02	01	H3931_095_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3931	099	0	1	02	01	H3931_099_0	4	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3931	100	0	1	02	01	H3931_100_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3931	157	0	1	02	01	H3931_157_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3931	159	0	1	01	01	H3931_159_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3931	160	0	1	02	01	H3931_160_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3931	166	0	1	02	01	H3931_166_0	3	2																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3931	166	0	1	02	01	H3931_166_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3931	169	0	1	02	01	H3931_169_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3931	175	0	1	01	01	H3931_175_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3931	176	0	1	02	01	H3931_176_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3931	176	0	1	02	01	H3931_176_0	3	2																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3931	177	0	1	02	01	H3931_177_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3931	177	0	1	02	01	H3931_177_0	3	2																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3931	178	0	1	02	01	H3931_178_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3931	801	0	1	01	01	H3931_801_0	1	1	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1																																																												
H3931	801	0	1	01	01	H3931_801_0	1	2	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1																				
H3931	804	0	1	01	01	H3931_804_0	1	2	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1	Non-Medicare (Other	2	2				2				2			2		2			2	1	Non-Medicare (Other	2	2				2				2			2		2			2	1																				
H3931	804	0	1	01	01	H3931_804_0	1	1	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1																																																												
H3952	053	0	1	02	01	H3952_053_0	7	3																										1	2	1	10.00	5	2	2				2		1	2			2		2			2																																																																																	
H3952	054	0	1	02	01	H3952_054_0	7	3																										1	2	1	10.00	5	2	2				2		1	2			2		2			2																																																																																	
H3959	001	0	1	02	01	H3959_001_0	3	2																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3959	001	0	1	02	01	H3959_001_0	3	1																										1	2	2				2				2		2	2			2		1	0.00	0.00	2	1	2	001	2				2				2			2		1	0.00	0.00	2	2	Reminder Device	2	2				2				2			2		1	0.00	0.00	2	2																																								
H3959	002	0	1	02	01	H3959_002_0	4	2																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3959	002	0	1	02	01	H3959_002_0	4	1																										1	2	2				2				2		2	2			2		1	0.00	0.00	2	1	2	001	2				2				2			2		1	0.00	0.00	2	2	Reminder Device	2	2				2				2			2		1	0.00	0.00	2	2																																								
H3959	010	0	1	02	01	H3959_010_0	2	1																										1	2	2				2				2		2	2			2		1	0.00	0.00	2																																																																																	
H3959	032	0	1	02	01	H3959_032_0	3	1																										1	2	2				2				2		2	2			2		1	0.00	0.00	2																																																																																	
H3959	033	0	1	02	01	H3959_033_0	3	2																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3959	033	0	1	02	01	H3959_033_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3959	035	0	1	01	01	H3959_035_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3959	035	0	1	01	01	H3959_035_0	3	2																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3959	036	0	1	01	01	H3959_036_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3959	036	0	1	01	01	H3959_036_0	3	2																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3959	039	0	1	02	01	H3959_039_0	3	1																										1	2	2				2				2		2	2			2		1	0.00	0.00	2	1	2	001	2				2				2			2		1	0.00	0.00	2	2	Reminder Device	2	2				2				2			2		1	0.00	0.00	2	2																																								
H3959	039	0	1	02	01	H3959_039_0	3	2																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3959	052	0	1	02	01	H3959_052_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3959	063	0	1	01	01	H3959_063_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3959	069	0	1	01	01	H3959_069_0	3	2																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3959	069	0	1	01	01	H3959_069_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3959	070	0	1	01	01	H3959_070_0	3	2																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3959	070	0	1	01	01	H3959_070_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3959	071	0	1	01	01	H3959_071_0	3	2																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3959	071	0	1	01	01	H3959_071_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3959	072	0	1	01	01	H3959_072_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3959	073	0	1	01	01	H3959_073_0	3	2																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3959	073	0	1	01	01	H3959_073_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3959	074	0	1	01	01	H3959_074_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3959	075	0	1	01	01	H3959_075_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3959	076	0	1	01	01	H3959_076_0	2	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3959	077	0	1	01	01	H3959_077_0	2	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H3959	803	0	1	01	01	H3959_803_0	1	2	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1																				
H3959	803	0	1	01	01	H3959_803_0	1	1	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1																																																												
H3959	804	0	1	01	01	H3959_804_0	1	1	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1																																																												
H3959	804	0	1	01	01	H3959_804_0	1	2	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1	Non-Medicare (Other	2	2				2				2			2		2			2	1	Non-Medicare (Other	2	2				2				2			2		2			2	1																				
H4003	009	0	1	01	01	H4003_009_0	9	2																										1	2	2				2				1	1	2	2			2		2			2																																																																																	
H4003	017	0	1	01	01	H4003_017_0	8	1																										1	2	2				2				1	1	2	2			2		2			2																																																																																	
H4003	019	0	1	02	01	H4003_019_0	9	1																										1	2	2				2				1	1	2	2			2		2			2																																																																																	
H4003	034	0	1	02	01	H4003_034_0	8	2																										1	2	2				2				1	1	2	2			2		2			2																																																																																	
H4003	058	0	1	01	01	H4003_058_0	8	1																										1	2	2				2				1	1	2	2			2		2			2																																																																																	
H4004	048	0	1	01	01	H4004_048_0	8	1																										1	2	2				2				1	1	2	2			2		2			2																																																																																	
H4004	056	0	1	02	01	H4004_056_0	8	1																										1	2	2				2				1	1	2	2			2		2			2																																																																																	
H4004	062	0	1	01	01	H4004_062_0	8	1																										1	2	2				2				1	1	2	2			2		2			2																																																																																	
H4004	063	0	1	02	01	H4004_063_0	8	1																										1	2	2				2				1	1	2	2			2		2			2																																																																																	
H4004	065	0	1	02	01	H4004_065_0	9	1																										1	2	2				2				1	1	2	2			2		2			2																																																																																	
H4004	066	0	1	02	01	H4004_066_0	8	2																										1	2	2				2				1	1	2	2			2		2			2																																																																																	
H4004	068	0	1	01	01	H4004_068_0	7	1																										1	2	2				2				1	1	2	2			2		2			2																																																																																	
H4004	069	0	1	01	01	H4004_069_0	7	1																										1	2	1	130.00	7	1	2				1	1	2	2			2		2			2																																																																																	
H4004	070	0	1	02	01	H4004_070_0	7	1																										1	2	2				2				1	1	2	2			2		2			2																																																																																	
H4004	071	0	1	02	01	H4004_071_0	6	1																										1	2	2				2				1	1	2	2			2		2			2																																																																																	
H4007	012	0	1	01	01	H4007_012_0	5	1																										1	2	1	125.00	7	2	2				2		2	2			2		2			2																																																																																	
H4007	012	0	1	01	01	H4007_012_0	5	2																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H4007	016	0	1	01	01	H4007_016_0	5	1																										1	2	1	125.00	7	2	2				2		2	2			2		2			2																																																																																	
H4007	021	0	1	01	01	H4007_021_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H4007	024	0	1	01	01	H4007_024_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H4007	027	0	1	01	01	H4007_027_0	5	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H4007	030	0	1	01	01	H4007_030_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H4007	031	0	1	01	01	H4007_031_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H4140	004	0	1	01	01	H4140_004_0	6	1																										1	2	2				2				1	1	2	2			2		2			1																																																																																	
H4140	009	0	1	01	01	H4140_009_0	6	1																										1	2	2				2				1	1	2	2			2		2			1																																																																																	
H4140	010	0	1	01	01	H4140_010_0	6	1																										1	2	2				2				1	1	2	2			2		2			1																																																																																	
H4140	012	0	1	01	01	H4140_012_0	5	1																										1	2	2				2				1	1	2	2			2		2			1																																																																																	
H4140	013	0	1	01	01	H4140_013_0	5	1																										1	2	2				2				1	1	2	2			2		2			1																																																																																	
H4141	003	0	1	01	01	H4141_003_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H4141	015	0	1	01	01	H4141_015_0	4	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			1																						Transitional Care	2	2				2				2			2		2			1	2																																								
H4141	017	5	1	01	01	H4141_017_5	4	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			1																						Transitional Care	2	2				2				2			2		2			1	2																																								
H4141	023	0	1	01	01	H4141_023_0	4	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			1																						Transitional Care	2	2				2				2			2		2			1	2																																								
H4152	022	0	1	02	01	H4152_022_0	7	1																										1	2	2				2				1	1	2	2			2		2			2																																																																																	
H4286	002	0	1	01	01	H4286_002_0	10	1																										1	2	2				2				1	1	2	2			2		2			2																																																																																	
H4286	005	0	1	01	01	H4286_005_0	9	1																										1	2	2				2				1	1	2	2			2		2			2																																																																																	
H4461	004	0	1	01	01	H4461_004_0	3	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H4461	022	0	1	01	01	H4461_022_0	6	2																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H4461	022	0	1	01	01	H4461_022_0	6	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			1																						Transitional Care	2	2				2				2			2		2			1	2																																								
H4461	038	0	1	01	01	H4461_038_0	5	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			1																						Transitional Care	2	2				2				2			2		2			1	2																																								
H4461	038	0	1	01	01	H4461_038_0	5	2																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H4523	020	0	1	01	01	H4523_020_0	2	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H4523	021	0	1	01	01	H4523_021_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H4523	024	0	1	01	01	H4523_024_0	2	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H4523	027	0	1	01	01	H4523_027_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H4523	028	0	1	01	01	H4523_028_0	3	2																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H4523	028	0	1	01	01	H4523_028_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H4523	029	0	1	01	01	H4523_029_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H4523	029	0	1	01	01	H4523_029_0	3	2																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H4523	030	0	1	01	01	H4523_030_0	3	2																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H4523	030	0	1	01	01	H4523_030_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H4523	801	0	1	01	01	H4523_801_0	1	2	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1																				
H4523	801	0	1	01	01	H4523_801_0	1	1	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1																																																												
H4523	802	0	1	01	01	H4523_802_0	1	2	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1	Non-Medicare (Other	2	2				2				2			2		2			2	1	Non-Medicare (Other	2	2				2				2			2		2			2	1																				
H4523	802	0	1	01	01	H4523_802_0	1	1	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1																																																												
H4711	011	0	1	01	01	H4711_011_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H4711	012	0	1	01	01	H4711_012_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H4711	013	0	1	01	01	H4711_013_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H4711	801	0	1	01	01	H4711_801_0	1	1	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1																																																												
H4711	801	0	1	01	01	H4711_801_0	1	2	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1																				
H4711	802	0	1	01	01	H4711_802_0	1	2	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1																				
H4711	802	0	1	01	01	H4711_802_0	1	1	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1																																																												
H4733	001	0	1	01	01	H4733_001_0	5	1																										1	2	2				2				2		2	2			2		2			2																																																																																	
H4808	001	0	1	04	01	H4808_001_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H4808	002	0	1	04	01	H4808_002_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H4835	801	0	1	01	01	H4835_801_0	1	1	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1																																																												
H4835	801	0	1	01	01	H4835_801_0	1	2	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1																				
H4835	802	0	1	01	01	H4835_802_0	1	1	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1																																																												
H4835	802	0	1	01	01	H4835_802_0	1	2	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1																				
H4982	801	0	1	01	01	H4982_801_0	1	2	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1																				
H4982	801	0	1	01	01	H4982_801_0	1	1	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1																																																												
H4982	802	0	1	01	01	H4982_802_0	1	2	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1																				
H4982	802	0	1	01	01	H4982_802_0	1	1	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1																																																												
H5050	004	0	1	01	01	H5050_004_0	4	1																																																																					Advanced Care At Home	2	2				2				2			2		1	0.00	0.00	1	1																																								
H5050	009	0	1	01	01	H5050_009_0	4	1																																																																					Advanced Care At Home	2	2				2				2			2		1	0.00	0.00	1	1																																								
H5050	013	0	1	01	01	H5050_013_0	4	1																																																																					Advanced Care At Home	2	2				2				2			2		1	0.00	0.00	1	1																																								
H5050	022	0	1	01	01	H5050_022_0	5	1																																																																					Advanced Care At Home	2	2				2				2			2		1	0.00	0.00	1	1																																								
H5178	002	0	1	01	01	H5178_002_0	5	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			1																						Transitional Care	2	2				2				2			2		2			1	2																																								
H5211	001	0	1	02	01	H5211_001_0	9	2																																																																																									Hospital at Home	2	2				2				1	0	20	2		1	0.00	150.00	1	2																				
H5211	001	0	1	02	01	H5211_001_0	9	1																																																1	2	010	2				2				2			2		2			2	2																																																												
H5211	002	0	1	02	01	H5211_002_0	6	1																																																1	2	010	2				2				2			2		2			2	2																																																												
H5211	002	0	1	02	01	H5211_002_0	6	2																																																																																									Hospital At Home	2	2				2				1	0	20	2		1	0.00	200.00	1	2																				
H5211	003	0	1	02	01	H5211_003_0	5	1																																																1	2	010	2				2				2			2		2			2	2																																																												
H5211	003	0	1	02	01	H5211_003_0	5	2																																																																																									Hospital At Home	2	2				2				1	0	20	2		1	0.00	200.00	1	2																				
H5211	004	0	1	02	01	H5211_004_0	6	2																																																																																									Hospital At Home	2	2				2				1	0	20	2		1	0.00	150.00	1	2																				
H5211	004	0	1	02	01	H5211_004_0	6	1																																																1	2	010	2				2				2			2		2			2	2																																																												
H5211	010	0	1	01	01	H5211_010_0	5	1																																																1	2	010	2				2				2			2		2			2	2																																																												
H5211	012	0	1	02	01	H5211_012_0	11	1																																																1	2	010	2				2				2			2		2			2	2																																																												
H5211	012	0	1	02	01	H5211_012_0	11	2																																																																																									Hospital At Home	2	2				2				1	0	20	2		1	0.00	250.00	1	2																				
H5215	002	0	1	04	01	H5215_002_0	23	1	1	1	2	2	12	3		2				2				2			2		2			1	2																																																																																																							
H5215	005	0	1	04	01	H5215_005_0	9	1	1	1	2	2	12	3		2				2				2			2		2			1	2																																																																																																							
H5215	007	0	1	04	01	H5215_007_0	9	1	1	1	2	2	12	3		2				2				2			2		2			1	2																																																																																																							
H5215	008	0	1	04	01	H5215_008_0	8	1	1	1	2	2	12	3		2				2				2			2		2			1	2																																																																																																							
H5215	009	0	1	04	01	H5215_009_0	10	1	1	1	2	2	12	3		2				2				2			2		2			1	2																																																																																																							
H5215	010	0	1	04	01	H5215_010_0	11	1	1	1	2	2	12	3		2				2				2			2		2			1	2																																																																																																							
H5215	011	0	1	04	01	H5215_011_0	11	1	1	1	2	2	12	3		2				2				2			2		2			1	2																																																																																																							
H5215	012	0	1	04	01	H5215_012_0	9	1	1	1	2	2	12	3		2				2				2			2		2			1	2																																																																																																							
H5215	013	0	1	04	01	H5215_013_0	7	1	1	1	2	2	12	3		2				2				2			2		2			1	2																																																																																																							
H5215	014	0	1	04	01	H5215_014_0	8	1	1	1	2	2	12	3		2				2				2			2		2			1	2																																																																																																							
H5216	142	2	1	04	01	H5216_142_2	4	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			1																						Transitional Care	2	2				2				2			2		2			1	2																																								
H5216	160	0	1	04	01	H5216_160_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H5216	161	0	1	04	01	H5216_161_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H5216	164	0	1	04	01	H5216_164_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H5216	179	0	1	04	01	H5216_179_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H5216	180	0	1	04	01	H5216_180_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H5216	200	0	1	04	01	H5216_200_0	3	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H5216	201	0	1	04	01	H5216_201_0	3	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H5216	205	0	1	04	01	H5216_205_0	3	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H5216	219	0	1	04	01	H5216_219_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H5216	220	0	1	04	01	H5216_220_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H5216	227	0	1	04	01	H5216_227_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H5216	228	0	1	04	01	H5216_228_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H5216	236	0	1	04	01	H5216_236_0	3	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H5216	242	0	1	04	01	H5216_242_0	7	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			1																						Transitional Care	2	2				2				2			2		2			1	2																																								
H5216	243	0	1	04	01	H5216_243_0	9	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			1																						Transitional Care	2	2				2				2			2		2			1	2																																								
H5216	257	0	1	04	01	H5216_257_0	4	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			1																						Transitional Care	2	2				2				2			2		2			1	2																																								
H5216	267	0	1	04	01	H5216_267_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H5216	268	0	1	04	01	H5216_268_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H5216	277	0	1	04	01	H5216_277_0	4	2																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H5216	277	0	1	04	01	H5216_277_0	4	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			1																						Transitional Care	2	2				2				2			2		2			1	2																																								
H5216	280	2	1	04	01	H5216_280_2	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H5216	292	0	1	04	01	H5216_292_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H5216	296	0	1	04	01	H5216_296_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H5216	298	0	1	04	01	H5216_298_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H5216	302	0	1	04	01	H5216_302_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H5216	317	0	1	04	01	H5216_317_0	3	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			1																						Transitional Care	2	2				2				2			2		2			1	2																																								
H5216	330	0	1	04	01	H5216_330_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H5216	331	0	1	04	01	H5216_331_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H5216	332	0	1	04	01	H5216_332_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H5216	347	0	1	04	01	H5216_347_0	4	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			1																						Transitional Care	2	2				2				2			2		2			1	2																																								
H5216	361	0	1	04	01	H5216_361_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H5216	362	0	1	04	01	H5216_362_0	6	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			1																						Transitional Care	2	2				2				2			2		2			1	2																																								
H5216	363	0	1	04	01	H5216_363_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H5216	367	0	1	04	01	H5216_367_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H5216	369	0	1	04	01	H5216_369_0	6	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			1																						Transitional Care	2	2				2				2			2		2			1	2																																								
H5216	370	0	1	04	01	H5216_370_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H5216	377	0	1	04	01	H5216_377_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H5216	385	0	1	04	01	H5216_385_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H5216	388	0	1	04	01	H5216_388_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H5216	391	0	1	04	01	H5216_391_0	4	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			1																						Transitional Care	2	2				2				2			2		2			1	2																																								
H5216	394	0	1	04	01	H5216_394_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H5216	400	0	1	04	01	H5216_400_0	6	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			1																						Transitional Care	2	2				2				2			2		2			1	2																																								
H5216	401	0	1	04	01	H5216_401_0	6	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			1																						Transitional Care	2	2				2				2			2		2			1	2																																								
H5216	402	0	1	04	01	H5216_402_0	6	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			1																						Transitional Care	2	2				2				2			2		2			1	2																																								
H5216	413	0	1	04	01	H5216_413_0	6	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			1																						Transitional Care	2	2				2				2			2		2			1	2																																								
H5216	416	0	1	04	01	H5216_416_0	6	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			1																						Transitional Care	2	2				2				2			2		2			1	2																																								
H5216	418	0	1	04	01	H5216_418_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H5216	419	0	1	04	01	H5216_419_0	6	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			1																						Transitional Care	2	2				2				2			2		2			1	2																																								
H5216	420	0	1	04	01	H5216_420_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H5216	444	0	1	04	01	H5216_444_0	5	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			1																						Transitional Care	2	2				2				2			2		2			1	2																																								
H5216	446	0	1	04	01	H5216_446_0	6	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			1																						Transitional Care	2	2				2				2			2		2			1	2																																								
H5216	447	0	1	04	01	H5216_447_0	6	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			1																						Transitional Care	2	2				2				2			2		2			1	2																																								
H5262	001	0	1	01	01	H5262_001_0	7	2																																																																					Hospital at Home	2	2				2				2			2		1	0.00	35.00	2	2																																								
H5262	001	0	1	01	01	H5262_001_0	7	1																										1	2	2				2				2		2	2			2		2			2																																																																																	
H5262	003	0	1	01	01	H5262_003_0	7	1																										1	2	2				2				2		2	2			2		2			2																																																																																	
H5262	003	0	1	01	01	H5262_003_0	7	2																																																																					Hospital at Home	2	2				2				2			2		1	0.00	45.00	2	2																																								
H5262	004	0	1	01	01	H5262_004_0	4	2																																																																					Hospital at Home	2	2				2				2			2		1	0.00	45.00	2	2																																								
H5262	004	0	1	01	01	H5262_004_0	4	1																										1	2	2				2				2		2	2			2		2			2																																																																																	
H5262	005	0	1	01	01	H5262_005_0	4	2																																																																					Hospital at Home	2	2				2				2			2		1	0.00	35.00	2	2																																								
H5262	005	0	1	01	01	H5262_005_0	4	1																										1	2	2				2				2		2	2			2		2			2																																																																																	
H5262	007	0	1	01	01	H5262_007_0	6	1																										1	2	2				2				2		2	2			2		2			2																																																																																	
H5262	008	0	1	01	01	H5262_008_0	6	1																										1	2	2				2				2		2	2			2		2			2																																																																																	
H5262	009	0	1	01	01	H5262_009_0	4	1																										1	2	2				2				2		2	2			2		2			2																																																																																	
H5262	010	0	1	01	01	H5262_010_0	4	1																										1	2	2				2				2		2	2			2		2			2																																																																																	
H5262	011	0	1	01	01	H5262_011_0	6	1																										1	2	2				2				2		1	2			2		2			2																																																																																	
H5262	012	0	1	01	01	H5262_012_0	6	1																										1	2	2				2				2		1	2			2		2			2																																																																																	
H5262	013	0	1	01	01	H5262_013_0	5	1																										1	2	2				2				2		2	2			2		2			2																																																																																	
H5262	018	0	1	01	01	H5262_018_0	6	1																										1	2	2				2				2		2	2			2		2			2																																																																																	
H5262	019	0	1	01	01	H5262_019_0	6	1																										1	2	2				2				2		2	2			2		2			2																																																																																	
H5262	020	0	1	01	01	H5262_020_0	4	1																										1	2	2				2				2		2	2			2		2			2																																																																																	
H5262	021	0	1	01	01	H5262_021_0	6	1																										1	2	2				2				2		2	2			2		2			2																																																																																	
H5262	021	0	1	01	01	H5262_021_0	6	2																																																																					Hospital at Home	2	2				2				2			2		1	0.00	55.00	2	2																																								
H5262	023	0	1	01	01	H5262_023_0	6	1																										1	2	2				2				2		2	2			2		2			2																																																																																	
H5262	024	0	1	01	01	H5262_024_0	6	1																										1	2	2				2				2		1	2			2		2			2																																																																																	
H5262	025	0	1	01	01	H5262_025_0	4	1																										1	2	2				2				2		1	2			2		2			2																																																																																	
H5262	026	0	1	01	01	H5262_026_0	6	1																										1	2	2				2				2		2	2			2		2			2																																																																																	
H5262	027	0	1	01	01	H5262_027_0	4	1																										1	2	2				2				2		2	2			2		2			2																																																																																	
H5262	029	0	1	01	01	H5262_029_0	5	1																										1	2	2				2				2		2	2			2		2			2																																																																																	
H5262	030	0	1	01	01	H5262_030_0	5	1																										1	2	2				2				2		2	2			2		2			2																																																																																	
H5262	031	0	1	01	01	H5262_031_0	5	1																										1	2	2				2				2		2	2			2		2			2																																																																																	
H5299	001	0	1	01	01	H5299_001_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H5299	006	0	1	01	01	H5299_006_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H5299	009	0	1	01	01	H5299_009_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H5302	012	0	1	01	01	H5302_012_0	3	2																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5302	012	0	1	01	01	H5302_012_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5302	013	0	1	01	01	H5302_013_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5302	014	0	1	01	01	H5302_014_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5302	020	0	1	01	01	H5302_020_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5302	022	0	1	01	01	H5302_022_0	2	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5302	809	0	1	01	01	H5302_809_0	1	1	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1																																																												
H5302	809	0	1	01	01	H5302_809_0	1	2	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1																				
H5302	810	0	1	01	01	H5302_810_0	1	2	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1																				
H5302	810	0	1	01	01	H5302_810_0	1	1	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1																																																												
H5325	001	0	1	01	01	H5325_001_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5325	002	0	1	01	01	H5325_002_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5325	003	0	1	01	01	H5325_003_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5325	004	0	1	01	01	H5325_004_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5325	005	0	1	01	01	H5325_005_0	4	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5325	006	0	1	01	01	H5325_006_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5325	007	0	1	01	01	H5325_007_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5325	009	0	1	01	01	H5325_009_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5325	010	0	1	01	01	H5325_010_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5325	010	0	1	01	01	H5325_010_0	3	2																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5325	011	0	1	01	01	H5325_011_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5325	011	0	1	01	01	H5325_011_0	3	2																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5453	001	0	1	04	01	H5453_001_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H5453	004	0	1	04	01	H5453_004_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H5453	010	0	1	04	01	H5453_010_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H5472	004	0	1	02	01	H5472_004_0	7	2																																																1	2	011	2				2				2			2		2			2	2																																																												
H5521	084	0	1	04	01	H5521_084_0	4	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	116	0	1	04	01	H5521_116_0	2	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	171	0	1	04	01	H5521_171_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	178	0	1	04	01	H5521_178_0	2	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	216	0	1	04	01	H5521_216_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	218	0	1	04	01	H5521_218_0	2	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	220	0	1	04	01	H5521_220_0	2	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	222	0	1	04	01	H5521_222_0	4	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	224	0	1	04	01	H5521_224_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	227	0	1	04	01	H5521_227_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	229	0	1	04	01	H5521_229_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	230	0	1	04	01	H5521_230_0	2	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	232	0	1	04	01	H5521_232_0	2	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	233	0	1	04	01	H5521_233_0	2	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	235	0	1	04	01	H5521_235_0	2	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	251	0	1	04	01	H5521_251_0	4	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	302	0	1	04	01	H5521_302_0	4	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	302	0	1	04	01	H5521_302_0	4	2																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	324	0	1	04	01	H5521_324_0	2	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	326	0	1	04	01	H5521_326_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	364	0	1	04	01	H5521_364_0	4	2																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	364	0	1	04	01	H5521_364_0	4	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	365	0	1	04	01	H5521_365_0	2	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	376	0	1	04	01	H5521_376_0	4	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	398	0	1	04	01	H5521_398_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	399	0	1	04	01	H5521_399_0	3	2																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	399	0	1	04	01	H5521_399_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	400	0	1	04	01	H5521_400_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	414	0	1	04	01	H5521_414_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	424	0	1	04	01	H5521_424_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	443	0	1	04	01	H5521_443_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	449	0	1	04	01	H5521_449_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	462	0	1	04	01	H5521_462_0	4	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	463	0	1	04	01	H5521_463_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	464	0	1	04	01	H5521_464_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	465	0	1	04	01	H5521_465_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	467	0	1	04	01	H5521_467_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	469	0	1	04	01	H5521_469_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	470	0	1	04	01	H5521_470_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	471	0	1	04	01	H5521_471_0	2	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	472	0	1	04	01	H5521_472_0	3	2																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	472	0	1	04	01	H5521_472_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	474	0	1	04	01	H5521_474_0	3	2																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	474	0	1	04	01	H5521_474_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	482	0	1	04	01	H5521_482_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	490	0	1	04	01	H5521_490_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	496	0	1	04	01	H5521_496_0	4	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	496	0	1	04	01	H5521_496_0	4	2																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	500	0	1	04	01	H5521_500_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	501	0	1	04	01	H5521_501_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	502	0	1	04	01	H5521_502_0	2	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	505	0	1	04	01	H5521_505_0	4	2																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	505	0	1	04	01	H5521_505_0	4	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	538	0	1	04	01	H5521_538_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	539	0	1	04	01	H5521_539_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	550	0	1	04	01	H5521_550_0	2	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	551	0	1	04	01	H5521_551_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	553	0	1	04	01	H5521_553_0	2	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	598	0	1	04	01	H5521_598_0	2	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	644	0	1	04	01	H5521_644_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	645	0	1	04	01	H5521_645_0	2	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	646	0	1	04	01	H5521_646_0	4	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5521	801	0	1	04	01	H5521_801_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5521	801	0	1	04	01	H5521_801_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor's discretion	2	2				2				2			2		2			2	2																				
H5521	802	0	1	04	01	H5521_802_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5521	802	0	1	04	01	H5521_802_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H5521	805	0	2	04	01	H5521_805_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H5521	805	0	2	04	01	H5521_805_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5521	806	0	2	04	01	H5521_806_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H5521	806	0	2	04	01	H5521_806_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5521	809	0	1	04	01	H5521_809_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5521	809	0	1	04	01	H5521_809_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H5521	810	0	1	04	01	H5521_810_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H5521	810	0	1	04	01	H5521_810_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5521	812	0	1	04	01	H5521_812_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	2	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5521	812	0	1	04	01	H5521_812_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H5521	814	0	2	04	01	H5521_814_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H5521	814	0	2	04	01	H5521_814_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5521	815	0	2	04	01	H5521_815_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H5521	815	0	2	04	01	H5521_815_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5521	816	0	2	04	01	H5521_816_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H5521	816	0	2	04	01	H5521_816_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5521	817	0	1	04	01	H5521_817_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H5521	817	0	1	04	01	H5521_817_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5521	818	0	2	04	01	H5521_818_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5521	818	0	2	04	01	H5521_818_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	at plan sponsor's discretion	2	2				2				2			2		2			2	2																				
H5521	819	0	1	04	01	H5521_819_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5521	819	0	1	04	01	H5521_819_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H5521	820	0	1	04	01	H5521_820_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5521	820	0	1	04	01	H5521_820_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H5521	821	0	1	04	01	H5521_821_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5521	821	0	1	04	01	H5521_821_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H5521	822	0	1	04	01	H5521_822_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5521	822	0	1	04	01	H5521_822_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H5521	823	0	2	04	01	H5521_823_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5521	823	0	2	04	01	H5521_823_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H5521	824	0	2	04	01	H5521_824_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H5521	824	0	2	04	01	H5521_824_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5521	825	0	1	04	01	H5521_825_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5521	825	0	1	04	01	H5521_825_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	at plan sponsor's discretion	2	2				2				2			2		2			2	2																				
H5521	826	0	2	04	01	H5521_826_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	at plan sponsor's discretion	2	2				2				2			2		2			2	2																				
H5521	826	0	2	04	01	H5521_826_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5521	827	0	2	04	01	H5521_827_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5521	827	0	2	04	01	H5521_827_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H5521	828	0	2	04	01	H5521_828_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5521	828	0	2	04	01	H5521_828_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H5521	829	0	1	04	01	H5521_829_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5521	829	0	1	04	01	H5521_829_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	at plan sponsor's discretion	2	2				2				2			2		2			2	2																				
H5521	830	0	2	04	01	H5521_830_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	at plan sponsor's discretion	2	2				2				2			2		2			2	2																				
H5521	830	0	2	04	01	H5521_830_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5521	831	0	1	04	01	H5521_831_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5521	831	0	1	04	01	H5521_831_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H5521	832	0	1	04	01	H5521_832_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H5521	832	0	1	04	01	H5521_832_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5521	833	0	1	04	01	H5521_833_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H5521	833	0	1	04	01	H5521_833_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5521	834	0	1	04	01	H5521_834_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H5521	834	0	1	04	01	H5521_834_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5521	835	0	2	04	01	H5521_835_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H5521	835	0	2	04	01	H5521_835_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5521	836	0	1	04	01	H5521_836_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H5521	836	0	1	04	01	H5521_836_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5521	837	0	1	04	01	H5521_837_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H5521	837	0	1	04	01	H5521_837_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5522	001	0	1	04	01	H5522_001_0	3	1																										1	2	2				2				2		2	2			2		1	0.00	0.00	2	1	2	001	2				2				2			2		1	0.00	0.00	2	2	Reminder Device	2	2				2				2			2		1	0.00	0.00	2	2																																								
H5522	001	0	1	04	01	H5522_001_0	3	3																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5522	001	0	1	04	01	H5522_001_0	3	2																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5522	002	0	1	04	01	H5522_002_0	3	3																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5522	002	0	1	04	01	H5522_002_0	3	2																										1	2	2				2				2		2	2			2		1	0.00	0.00	2	1	2	001	2				2				2			2		1	0.00	0.00	2	2	Reminder Device	2	2				2				2			2		1	0.00	0.00	2	2																																								
H5522	002	0	1	04	01	H5522_002_0	3	1																										1	2	2				2				2		2	2			2		1	0.00	0.00	2																																																																																	
H5522	005	0	1	04	01	H5522_005_0	3	1																										1	2	2				2				2		2	2			2		1	0.00	0.00	2	1	2	001	2				2				2			2		1	0.00	0.00	2	2	Reminder Device	2	2				2				2			2		1	0.00	0.00	2	2																																								
H5522	005	0	1	04	01	H5522_005_0	3	2																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5522	005	0	1	04	01	H5522_005_0	3	3																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5522	013	0	1	04	01	H5522_013_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5522	013	0	1	04	01	H5522_013_0	3	2																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5522	024	0	1	04	01	H5522_024_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5522	024	0	1	04	01	H5522_024_0	3	2																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5522	802	0	1	04	01	H5522_802_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5522	802	0	1	04	01	H5522_802_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H5522	803	0	1	04	01	H5522_803_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5522	803	0	1	04	01	H5522_803_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H5522	808	0	2	04	01	H5522_808_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5522	808	0	2	04	01	H5522_808_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H5522	809	0	2	04	01	H5522_809_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5522	809	0	2	04	01	H5522_809_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	at plan sponsor's discretion	2	2				2				2			2		2			2	2																				
H5522	810	0	1	04	01	H5522_810_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5522	810	0	1	04	01	H5522_810_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	at plan sponsor's discretion	2	2				2				2			2		2			2	2																				
H5522	811	0	1	04	01	H5522_811_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H5522	811	0	1	04	01	H5522_811_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5522	813	0	2	04	01	H5522_813_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	at plan sponsor's discretion	2	2				2				2			2		2			2	2																				
H5522	813	0	2	04	01	H5522_813_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5522	814	0	2	04	01	H5522_814_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5522	814	0	2	04	01	H5522_814_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H5522	815	0	1	04	01	H5522_815_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H5522	815	0	1	04	01	H5522_815_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5522	816	0	1	04	01	H5522_816_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H5522	816	0	1	04	01	H5522_816_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5522	817	0	2	04	01	H5522_817_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H5522	817	0	2	04	01	H5522_817_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5522	818	0	2	04	01	H5522_818_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5522	818	0	2	04	01	H5522_818_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H5522	819	0	1	04	01	H5522_819_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H5522	819	0	1	04	01	H5522_819_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5522	820	0	1	04	01	H5522_820_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5522	820	0	1	04	01	H5522_820_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H5522	821	0	1	04	01	H5522_821_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H5522	821	0	1	04	01	H5522_821_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5522	822	0	2	04	01	H5522_822_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5522	822	0	2	04	01	H5522_822_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H5522	823	0	1	04	01	H5522_823_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5522	823	0	1	04	01	H5522_823_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H5522	824	0	2	04	01	H5522_824_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5522	824	0	2	04	01	H5522_824_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H5522	825	0	2	04	01	H5522_825_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5522	825	0	2	04	01	H5522_825_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H5522	826	0	2	04	01	H5522_826_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H5522	826	0	2	04	01	H5522_826_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5522	827	0	2	04	01	H5522_827_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5522	827	0	2	04	01	H5522_827_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H5522	828	0	1	04	01	H5522_828_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5522	828	0	1	04	01	H5522_828_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	at plan sponsor's discretion	2	2				2				2			2		2			2	2																				
H5522	829	0	2	04	01	H5522_829_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5522	829	0	2	04	01	H5522_829_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H5522	830	0	1	04	01	H5522_830_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H5522	830	0	1	04	01	H5522_830_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5522	831	0	1	04	01	H5522_831_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5522	831	0	1	04	01	H5522_831_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H5522	832	0	1	04	01	H5522_832_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5522	832	0	1	04	01	H5522_832_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H5522	833	0	1	04	01	H5522_833_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5522	833	0	1	04	01	H5522_833_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H5522	834	0	2	04	01	H5522_834_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5522	834	0	2	04	01	H5522_834_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H5522	835	0	1	04	01	H5522_835_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5522	835	0	1	04	01	H5522_835_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H5522	836	0	1	04	01	H5522_836_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H5522	836	0	1	04	01	H5522_836_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H5525	036	0	1	04	01	H5525_036_0	4	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			1																						Transitional Care	2	2				2				2			2		2			1	2																																								
H5525	036	0	1	04	01	H5525_036_0	4	2																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H5525	046	0	1	04	01	H5525_046_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H5525	050	0	1	04	01	H5525_050_0	4	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			1																						Transitional Care	2	2				2				2			2		2			1	2																																								
H5525	070	0	1	04	01	H5525_070_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H5525	072	0	1	04	01	H5525_072_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H5525	083	0	1	04	01	H5525_083_0	4	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			1																						Transitional Care	2	2				2				2			2		2			1	2																																								
H5533	003	0	1	04	01	H5533_003_0	9	1																																																1	2	011	2				2				2			2		2			2	2																																																												
H5533	005	0	1	04	01	H5533_005_0	9	1																																																1	2	011	2				2				2			2		2			2	2																																																												
H5533	008	0	1	04	01	H5533_008_0	9	1																																																1	2	011	2				2				2			2		2			2	2																																																												
H5533	011	0	1	04	01	H5533_011_0	10	1																																																1	2	011	2				2				2			2		2			2	2																																																												
H5533	013	0	1	04	01	H5533_013_0	12	1																																																1	2	011	2				2				2			2		2			2	2																																																												
H5533	015	1	1	04	01	H5533_015_1	11	1																																																1	2	011	2				2				2			2		2			2	2																																																												
H5533	015	2	1	04	01	H5533_015_2	12	1																																																1	2	011	2				2				2			2		2			2	2																																																												
H5533	015	3	1	04	01	H5533_015_3	12	1																																																1	2	011	2				2				2			2		2			2	2																																																												
H5533	015	4	1	04	01	H5533_015_4	12	1																																																1	2	011	2				2				2			2		2			2	2																																																												
H5533	015	5	1	04	01	H5533_015_5	12	1																																																1	2	011	2				2				2			2		2			2	2																																																												
H5533	016	1	1	04	01	H5533_016_1	10	1																																																1	2	011	2				2				2			2		2			2	2																																																												
H5533	016	2	1	04	01	H5533_016_2	10	1																																																1	2	011	2				2				2			2		2			2	2																																																												
H5533	017	1	1	04	01	H5533_017_1	10	1																																																1	2	011	2				2				2			2		2			2	2																																																												
H5533	017	2	1	04	01	H5533_017_2	10	1																																																1	2	011	2				2				2			2		2			2	2																																																												
H5591	003	0	1	01	01	H5591_003_0	5	1	1	1	2	1				2				2				2			2		2			2	1																																																																																																							
H5591	005	0	1	02	01	H5591_005_0	6	1	1	1	2	1				2				2				2			2		2			2	1																																																																																																							
H5591	006	1	1	02	01	H5591_006_1	6	1	1	1	2	1				2				2				2			2		2			2	1																																																																																																							
H5591	006	2	1	02	01	H5591_006_2	6	1	1	1	2	1				2				2				2			2		2			2	1																																																																																																							
H5591	009	0	1	02	01	H5591_009_0	6	1	1	1	2	1				2				2				2			2		2			2	1																																																																																																							
H5591	015	1	1	02	01	H5591_015_1	6	1	1	1	2	1				2				2				2			2		2			2	1																																																																																																							
H5591	015	2	1	02	01	H5591_015_2	6	1	1	1	2	1				2				2				2			2		2			2	1																																																																																																							
H5593	001	0	1	01	01	H5593_001_0	4	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5593	801	0	1	01	01	H5593_801_0	1	2	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1																				
H5593	801	0	1	01	01	H5593_801_0	1	1	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1																																																												
H5593	802	0	1	01	01	H5593_802_0	1	2	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1																				
H5593	802	0	1	01	01	H5593_802_0	1	1	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1																																																												
H5608	001	0	1	01	01	H5608_001_0	5	1																										1	2	1	135.00	1		2				2		2	2			2		2			2																																																																																	
H5608	002	0	1	01	01	H5608_002_0	4	1																										1	2	1	135.00	1		2				2		2	2			2		2			2																																																																																	
H5619	003	0	1	01	01	H5619_003_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H5619	038	0	1	01	01	H5619_038_0	5	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H5619	054	0	1	02	01	H5619_054_0	7	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			1																						Transitional Care	2	2				2				2			2		2			1	2																																								
H5619	054	0	1	02	01	H5619_054_0	7	2																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H5619	075	0	1	01	01	H5619_075_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H5619	082	0	1	01	01	H5619_082_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H5619	093	0	1	01	01	H5619_093_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H5619	123	0	1	02	01	H5619_123_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H5619	126	0	1	02	01	H5619_126_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H5619	135	0	1	01	01	H5619_135_0	4	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			1																						Transitional Care	2	2				2				2			2		2			1	2																																								
H5619	155	0	1	01	01	H5619_155_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H5619	156	0	1	02	01	H5619_156_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H5619	157	0	1	01	01	H5619_157_0	4	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			1																						Transitional Care	2	2				2				2			2		2			1	2																																								
H5619	158	0	1	02	01	H5619_158_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H5619	162	0	1	02	01	H5619_162_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H5619	163	0	1	01	01	H5619_163_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H5619	165	0	1	01	01	H5619_165_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H5619	166	0	1	01	01	H5619_166_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H5619	167	0	1	01	01	H5619_167_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H5619	168	0	1	01	01	H5619_168_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H5619	173	0	1	01	01	H5619_173_0	3	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			1																						Transitional Care	2	2				2				2			2		2			1	2																																								
H5628	008	0	1	01	01	H5628_008_0	11	2																																																1	2	001	2				2				2			2		2			1	2																																																												
H5649	001	0	1	01	01	H5649_001_0	8	1																										1	2	2				2				2		1	2			2		1	0.00	0.00	2																																																																																	
H5649	002	0	1	01	01	H5649_002_0	9	1																										1	2	2				2				2		2	2			2		1	0.00	0.00	2																																																																																	
H5649	006	0	1	01	01	H5649_006_0	7	1																										1	2	2				2				2		1	2			2		1	0.00	0.00	2																																																																																	
H5649	008	0	1	01	01	H5649_008_0	8	1																										1	2	2				2				2		1	2			2		1	0.00	0.00	2																																																																																	
H5649	009	0	1	01	01	H5649_009_0	8	1																										1	2	2				2				2		2	2			2		1	0.00	0.00	2																																																																																	
H5649	018	0	1	01	01	H5649_018_0	8	1																										1	2	2				2				2		2	2			2		1	0.00	0.00	2																																																																																	
H5649	022	0	1	01	01	H5649_022_0	7	1																										1	2	2				2				2		2	2			2		1	0.00	0.00	2																																																																																	
H5649	024	0	1	01	01	H5649_024_0	8	1																										1	2	2				2				2		2	2			2		1	0.00	0.00	2																																																																																	
H5649	025	1	1	01	01	H5649_025_1	8	1																										1	2	2				2				2		2	2			2		1	0.00	0.00	2																																																																																	
H5649	025	2	1	01	01	H5649_025_2	8	1																										1	2	2				2				2		2	2			2		1	0.00	0.00	2																																																																																	
H5649	026	1	1	01	01	H5649_026_1	9	1																										1	2	2				2				2		2	2			2		1	0.00	0.00	2																																																																																	
H5649	026	2	1	01	01	H5649_026_2	8	1																										1	2	2				2				2		2	2			2		1	0.00	0.00	2																																																																																	
H5718	001	0	1	04	01	H5718_001_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H5718	003	0	1	04	01	H5718_003_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H5774	035	0	1	01	01	H5774_035_0	7	1																										1	2	1	70.00	7	1	2				1	1	1	2			2		2			2																																																																																	
H5774	041	1	1	01	01	H5774_041_1	7	2																										1	2	1	235.00	7	1	2				1	1	1	2			2		2			2																																																																																	
H5774	041	2	1	01	01	H5774_041_2	7	2																										1	2	1	215.00	7	1	2				1	1	1	2			2		2			2																																																																																	
H5774	041	3	1	01	01	H5774_041_3	7	2																										1	2	1	155.00	7	1	2				1	1	1	2			2		2			2																																																																																	
H5774	041	4	1	01	01	H5774_041_4	7	2																										1	2	1	55.00	7	1	2				1	1	1	2			2		2			2																																																																																	
H5774	041	5	1	01	01	H5774_041_5	7	2																										1	2	1	135.00	7	1	2				1	1	1	2			2		2			2																																																																																	
H5774	042	1	1	01	01	H5774_042_1	5	1																										1	2	1	140.00	7	1	2				1	1	1	2			2		2			2																																																																																	
H5774	042	2	1	01	01	H5774_042_2	6	1																										1	2	1	135.00	7	1	2				1	1	1	2			2		2			2																																																																																	
H5774	042	3	1	01	01	H5774_042_3	6	1																										1	2	1	100.00	7	1	2				1	1	1	2			2		2			2																																																																																	
H5774	042	4	1	01	01	H5774_042_4	6	1																										1	2	1	20.00	7	1	2				1	1	1	2			2		2			2																																																																																	
H5774	042	5	1	01	01	H5774_042_5	6	1																										1	2	1	70.00	7	1	2				1	1	1	2			2		2			2																																																																																	
H5774	043	1	1	01	01	H5774_043_1	6	1																										1	2	1	30.00	7	1	2				2		1	2			2		2			2																																																																																	
H5774	043	2	1	01	01	H5774_043_2	6	1																										1	2	1	30.00	7	1	2				2		1	2			2		2			2																																																																																	
H5774	043	3	1	01	01	H5774_043_3	6	1																										1	2	1	30.00	7	1	2				2		1	2			2		2			2																																																																																	
H5774	043	4	1	01	01	H5774_043_4	7	1																										1	2	1	30.00	7	1	2				2		1	2			2		2			2																																																																																	
H5774	043	5	1	01	01	H5774_043_5	7	1																										1	2	1	30.00	7	1	2				2		1	2			2		2			2																																																																																	
H5793	017	0	1	02	01	H5793_017_0	5	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5793	019	0	1	02	01	H5793_019_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5793	020	0	1	02	01	H5793_020_0	5	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H5793	801	0	1	01	01	H5793_801_0	2	2	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1																				
H5793	801	0	1	01	01	H5793_801_0	2	1	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1																																																												
H5793	802	0	1	01	01	H5793_802_0	2	2	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1																				
H5793	802	0	1	01	01	H5793_802_0	2	1	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1																																																												
H5826	006	0	1	01	01	H5826_006_0	3	3																										1	2	2				2				2		2	2			2		2			2																																																																																	
H5826	009	0	1	01	01	H5826_009_0	4	3																										1	2	2				2				2		2	2			2		2			2																																																																																	
H5826	010	0	1	01	01	H5826_010_0	4	1																										1	2	2				2				2		2	2			2		2			2																																																																																	
H5826	014	0	1	01	01	H5826_014_0	4	4																										1	2	2				2				2		2	2			2		2			2																																																																																	
H5826	017	0	1	01	01	H5826_017_0	4	3																										1	2	2				2				2		2	2			2		2			2																																																																																	
H5852	001	0	1	01	01	H5852_001_0	6	1																																																1	2	001	2				2				2			2		2			1	1																																																												
H5859	001	0	1	02	01	H5859_001_0	9	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H5937	001	0	1	01	01	H5937_001_0	5	2	1	1	2	2	12	3		2				2				2			2		2			2	2																																																																																																							
H5969	002	0	1	01	01	H5969_002_0	4	2																										1	2	1	70.00	7	1	2				2		2	2			2		2			1																																																																																	
H5969	002	0	1	01	01	H5969_002_0	4	1																										1	2	1	70.00	7	1	2				2		2	2			2		2			1																																																																																	
H5969	003	0	1	01	01	H5969_003_0	4	2																										1	2	1	70.00	7	1	2				2		2	2			2		2			1																																																																																	
H5969	003	0	1	01	01	H5969_003_0	4	1																										1	2	1	70.00	7	1	2				2		2	2			2		2			1																																																																																	
H5970	020	0	1	04	01	H5970_020_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H6018	001	0	1	04	01	H6018_001_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H6018	002	0	1	04	01	H6018_002_0	8	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H6018	007	0	1	04	01	H6018_007_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H6018	010	0	1	04	01	H6018_010_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H6170	001	0	1	02	01	H6170_001_0	14	1																																																																																									Venipuncture for Home Dialysis Treatments	2	2				2				2			2		2			1	2																				
H6170	002	0	1	02	01	H6170_002_0	13	1																																																																																									Venipuncture for Home Dialysis Treatments	2	2				2				2			2		2			2	2																				
H6170	003	0	1	02	01	H6170_003_0	13	1																																																																																									Venipuncture for Home Dialysis Treatments	2	2				2				2			2		2			2	2																				
H6399	001	0	1	01	01	H6399_001_0	2	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H6474	001	0	1	02	01	H6474_001_0	14	1																																																																																									Venipuncture for Home Dialysis Treatments	2	2				2				2			2		2			2	2																				
H6474	002	0	1	02	01	H6474_002_0	13	1																																																																																									Venipuncture for Home Dialysis Treatments	2	2				2				2			2		2			2	2																				
H6474	003	0	1	02	01	H6474_003_0	13	1																																																																																									Venipuncture for Home Dialysis Treatments	2	2				2				2			2		2			2	2																				
H6586	002	0	1	04	01	H6586_002_0	6	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H6586	003	0	1	04	01	H6586_003_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H6622	008	0	1	01	01	H6622_008_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H6622	015	0	1	01	01	H6622_015_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H6622	018	0	1	01	01	H6622_018_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H6622	027	0	1	02	01	H6622_027_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H6622	048	0	1	01	01	H6622_048_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H6622	061	0	1	02	01	H6622_061_0	4	1	1	1	2	1				2				2				2			2		2			1	2	1	2	2				2				1	1	1	2			2		2			1																						Transitional Care	2	2				2				2			2		2			1	2																																								
H6622	078	1	1	01	01	H6622_078_1	5	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H6622	078	2	1	01	01	H6622_078_2	5	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H6622	079	0	1	01	01	H6622_079_0	5	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H6622	086	0	1	01	01	H6622_086_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H6622	087	0	1	01	01	H6622_087_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H6852	001	0	1	01	01	H6852_001_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H6852	005	0	1	01	01	H6852_005_0	8	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H6852	007	0	1	01	01	H6852_007_0	8	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H6874	001	0	1	04	01	H6874_001_0	9	1																																																1	2	011	2				2				2			2		2			2	2																																																												
H6874	003	0	1	04	01	H6874_003_0	5	1																																																1	2	011	2				2				2			2		2			2	2																																																												
H6988	001	0	1	01	01	H6988_001_0	6	1																										1	2	2				2				2		1	2			2		2			2																																																																																	
H6988	002	0	1	01	01	H6988_002_0	6	1																										1	2	2				2				2		1	2			2		2			2																																																																																	
H6988	004	0	1	01	01	H6988_004_0	6	1																										1	2	2				2				2		1	2			2		2			2																																																																																	
H7028	001	0	1	04	01	H7028_001_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H7147	001	0	1	01	01	H7147_001_0	5	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H7147	003	0	1	01	01	H7147_003_0	9	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H7147	004	0	1	01	01	H7147_004_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H7147	007	0	1	01	01	H7147_007_0	8	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H7149	006	0	1	01	01	H7149_006_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H7149	008	0	1	02	01	H7149_008_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H7149	801	0	1	01	01	H7149_801_0	1	1	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1																																																												
H7149	801	0	1	01	01	H7149_801_0	1	2	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1																				
H7149	802	0	1	01	01	H7149_802_0	1	2	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1																				
H7149	802	0	1	01	01	H7149_802_0	1	1	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1																																																												
H7151	001	0	1	01	01	H7151_001_0	8	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H7172	001	0	1	48	05	H7172_001_0	5	1																																																																					Flex Card	2	1	50.00	7		2				2			2		2			1	2																																								
H7199	002	0	1	04	01	H7199_002_0	8	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H7220	002	0	1	01	01	H7220_002_0	4	1																																																																					Hospital at Home	2	2				2				2			2		2			1	2																																								
H7220	004	0	1	02	01	H7220_004_0	5	1																																																																					Hospital at Home	2	2				2				2			2		2			1	2																																								
H7220	009	1	1	01	01	H7220_009_1	5	1																																																																					Hospital at Home	2	2				2				2			2		2			1	2																																								
H7220	009	2	1	01	01	H7220_009_2	5	1																																																																					Hospital at Home	2	2				2				2			2		2			1	2																																								
H7220	009	3	1	01	01	H7220_009_3	5	1																																																																					Hospital at Home	2	2				2				2			2		2			1	2																																								
H7220	010	0	1	01	01	H7220_010_0	5	1																																																																					Hospital at Home	2	2				2				2			2		2			1	2																																								
H7220	011	0	1	02	01	H7220_011_0	5	1																																																																					Hospital at Home	2	2				2				2			2		2			1	2																																								
H7220	012	0	1	01	01	H7220_012_0	5	1																																																1	2	001	2				2				2			2		2			1	2																																																												
H7220	012	0	1	01	01	H7220_012_0	5	2																																																																					Hospital at Home	2	2				2				2			2		2			1	2																																								
H7284	010	0	1	04	01	H7284_010_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H7301	002	0	1	04	01	H7301_002_0	2	1																										1	2	2				2				2		2	2			2		1	0.00	0.00	2																																																																																	
H7301	006	0	1	04	01	H7301_006_0	3	1																										1	2	2				2				2		2	2			2		1	0.00	0.00	2																																																																																	
H7301	009	0	1	04	01	H7301_009_0	4	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H7301	022	0	1	04	01	H7301_022_0	3	2																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H7301	022	0	1	04	01	H7301_022_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H7301	801	0	1	04	01	H7301_801_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H7301	801	0	1	04	01	H7301_801_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H7301	803	0	1	04	01	H7301_803_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H7301	803	0	1	04	01	H7301_803_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H7355	001	0	1	04	01	H7355_001_0	8	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H7355	003	0	1	04	01	H7355_003_0	9	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H7355	004	0	1	04	01	H7355_004_0	8	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H7397	001	0	1	04	01	H7397_001_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H7397	003	0	1	04	01	H7397_003_0	8	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H7397	004	0	1	04	01	H7397_004_0	8	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H7471	001	0	1	04	01	H7471_001_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H7471	004	0	1	04	01	H7471_004_0	9	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H7471	005	0	1	04	01	H7471_005_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H7471	007	0	1	04	01	H7471_007_0	9	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H7471	008	0	1	04	01	H7471_008_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H7605	001	0	1	01	01	H7605_001_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H7605	004	0	1	01	01	H7605_004_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H7605	006	0	1	01	01	H7605_006_0	10	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H7605	007	0	1	01	01	H7605_007_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H7605	009	0	1	01	01	H7605_009_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H7605	010	0	1	01	01	H7605_010_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H7607	002	1	1	01	01	H7607_002_1	11	1																																																1	2	001	2				2				2			2		2			1	1																																																												
H7607	002	2	1	01	01	H7607_002_2	11	1																																																1	2	001	2				2				2			2		2			1	1																																																												
H7607	002	3	1	01	01	H7607_002_3	11	1																																																1	2	001	2				2				2			2		2			1	1																																																												
H7607	002	4	1	01	01	H7607_002_4	11	1																																																1	2	001	2				2				2			2		2			1	1																																																												
H7607	002	5	1	01	01	H7607_002_5	11	1																																																1	2	001	2				2				2			2		2			1	1																																																												
H7607	011	1	1	01	01	H7607_011_1	10	1																																																1	2	001	2				2				2			2		2			1	1																																																												
H7607	011	2	1	01	01	H7607_011_2	10	1																																																1	2	001	2				2				2			2		2			1	1																																																												
H7607	011	3	1	01	01	H7607_011_3	10	1																																																1	2	001	2				2				2			2		2			1	1																																																												
H7607	011	4	1	01	01	H7607_011_4	10	1																																																1	2	001	2				2				2			2		2			1	1																																																												
H7607	011	5	1	01	01	H7607_011_5	10	1																																																1	2	001	2				2				2			2		2			1	1																																																												
H7993	003	0	1	01	01	H7993_003_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H7993	004	0	1	01	01	H7993_004_0	9	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H7993	005	0	1	01	01	H7993_005_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H7993	007	0	1	01	01	H7993_007_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H7993	010	0	1	01	01	H7993_010_0	8	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H7993	012	0	1	01	01	H7993_012_0	8	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H7993	014	0	1	01	01	H7993_014_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H7993	015	0	1	01	01	H7993_015_0	8	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H7993	017	0	1	01	01	H7993_017_0	8	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H7993	019	0	1	01	01	H7993_019_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H8026	001	0	1	48	05	H8026_001_0	7	1																																																																					Flex card	2	1	50.00	7		2				2			2		2			1	2																																								
H8145	069	0	1	09	04	H8145_069_0	3	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			1																						Transitional Care	2	2				2				2			2		2																																												
H8173	001	0	1	01	01	H8173_001_0	9	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H8173	014	0	1	01	01	H8173_014_0	10	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H8173	016	0	1	01	01	H8173_016_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H8173	020	0	1	01	01	H8173_020_0	8	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H8173	021	0	1	01	01	H8173_021_0	8	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H8298	001	0	1	01	01	H8298_001_0	7	1																										1	2	2				2				2		2	2			2		2			2																																																																																	
H8320	001	0	1	04	01	H8320_001_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H8320	003	0	1	04	01	H8320_003_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H8320	005	0	1	04	01	H8320_005_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H8330	001	0	1	01	01	H8330_001_0	5	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H8330	002	0	1	01	01	H8330_002_0	5	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H8332	004	0	1	01	01	H8332_004_0	3	1																										1	2	2				2				2		2	2			2		1	0.00	0.00	2																																																																																	
H8332	801	0	1	01	01	H8332_801_0	1	2	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1																				
H8332	801	0	1	01	01	H8332_801_0	1	1	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1																																																												
H8332	802	0	1	01	01	H8332_802_0	1	2	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1																				
H8332	802	0	1	01	01	H8332_802_0	1	1	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1																																																												
H8578	001	0	1	01	01	H8578_001_0	7	1																																																																					Nutrition Focused Grocery Store Tour	2	2				2				2			2		2			2	2																																								
H8578	003	0	1	01	01	H8578_003_0	7	1																																																																					Nutrition Focused Grocery Store Tour	2	2				2				2			2		2			2	2																																								
H8578	004	0	1	01	01	H8578_004_0	7	1																																																																					Nutrition Focused Grocery Store Tour	2	2				2				2			2		2			2	2																																								
H8578	009	0	1	01	01	H8578_009_0	7	1																																																																					Nutrition Focused Grocery Store Tour	2	2				2				2			2		2			2	2																																								
H8578	012	0	1	01	01	H8578_012_0	11	1																																																																					Nutrition Focused Grocery Store Tour	2	2				2				2			2		2			2	2																																								
H8597	001	0	1	01	01	H8597_001_0	5	2																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H8597	001	0	1	01	01	H8597_001_0	5	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H8597	002	0	1	01	01	H8597_002_0	4	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H8597	002	0	1	01	01	H8597_002_0	4	2																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H8597	003	0	1	01	01	H8597_003_0	4	2																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H8597	003	0	1	01	01	H8597_003_0	4	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H8649	010	0	1	01	01	H8649_010_0	3	1																										1	2	2				2				1	1	1	2			2		1	0.00	0.00	1																																																																																	
H8649	801	0	1	01	01	H8649_801_0	1	1	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1																																																												
H8649	801	0	1	01	01	H8649_801_0	1	2	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1																				
H8649	803	0	1	01	01	H8649_803_0	1	1	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1																																																												
H8649	803	0	1	01	01	H8649_803_0	1	2	1	1	2	1				2				2				2			2		2			2	1	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1	Non-Medicare (Other)	2	2				2				2			2		2			2	1																				
H8783	001	0	1	04	01	H8783_001_0	10	1																																																1	2	011	2				2				2			2		2			2	2																																																												
H8783	002	0	1	04	01	H8783_002_0	12	1																																																1	2	011	2				2				2			2		2			2	2																																																												
H8783	003	0	1	04	01	H8783_003_0	10	1																																																1	2	011	2				2				2			2		2			2	2																																																												
H8832	003	0	1	04	01	H8832_003_0	10	2																																																1	2	011	2				2				2			2		2			1	2																																																												
H8889	001	0	1	04	01	H8889_001_0	5	1																																																1	2	111	2				2				2			2		2			2	2	Osteoporosis Services	2	2				2				2			2		2			2	2																																								
H8889	002	0	1	04	01	H8889_002_0	5	1																																																1	2	111	2				2				2			2		2			2	2																																																												
H8889	003	0	1	04	01	H8889_003_0	6	1																																																1	2	111	2				2				2			2		2			2	2	Osteoporosis Services	2	2				2				2			2		2			2	2																																								
H8889	004	0	1	04	01	H8889_004_0	5	1																																																1	2	111	2				2				2			2		2			2	2																																																												
H8889	005	0	1	04	01	H8889_005_0	5	1																																																1	2	111	2				2				2			2		2			2	2																																																												
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H8889	013	0	1	04	01	H8889_013_0	6	1																																																1	2	111	2				2				2			2		2			2	2																																																												
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H8894	001	0	1	01	01	H8894_001_0	10	1																																																1	2	001	2				2				2			2		2			2	2																																																												
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H8908	007	0	1	01	01	H8908_007_0	4	1																										1	2	2				2				1	1	1	2			2		2			2																																																																																	
H8917	001	0	1	04	01	H8917_001_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H9003	001	0	1	02	01	H9003_001_0	9	1																																																																																																													Acute Care at Home	2	2				2				2			2		1	0.00	0.00	1	1
H9003	006	0	1	02	01	H9003_006_0	9	1																																																																																																													Acute Care at Home	2	2				2				2			2		1	0.00	0.00	1	1
H9003	009	0	1	02	01	H9003_009_0	10	1																																																																																																													Acute Care at Home	2	2				2				2			2		1	0.00	0.00	1	1
H9231	001	0	1	04	01	H9231_001_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H9231	006	0	1	04	01	H9231_006_0	9	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H9231	007	0	1	04	01	H9231_007_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H9231	010	0	1	04	01	H9231_010_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H9231	011	0	1	04	01	H9231_011_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H9431	801	0	1	04	01	H9431_801_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H9431	801	0	1	04	01	H9431_801_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H9431	802	0	1	04	01	H9431_802_0	1	2	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2	Other CMS defined chronic conditions	2	2				2				2			2		2			2	2	At plan sponsor discretion	2	2				2				2			2		2			2	2																				
H9431	802	0	1	04	01	H9431_802_0	1	1	1	1	2	1				2				2				2			2		2			2	2	1	2	2				2				1	1	1	2			2		2			2	1	2	111	2				2				2			2		2			2	2																																																												
H9615	007	0	1	04	01	H9615_007_0	7	1																										1	2	2				2				2		2	2			2		2			2																																																																																	
H9615	008	0	1	04	01	H9615_008_0	7	1																										1	2	2				2				2		2	2			2		2			2																																																																																	
H9615	010	0	1	04	01	H9615_010_0	7	1																										1	2	2				2				2		2	2			2		2			2																																																																																	
H9615	012	0	1	04	01	H9615_012_0	7	1																										1	2	2				2				2		2	2			2		2			2																																																																																	
H9615	015	0	1	04	01	H9615_015_0	7	1																										1	2	2				2				2		2	2			2		2			2																																																																																	
H9615	015	0	1	04	01	H9615_015_0	7	4																										1	2	2				2				2		2	2			2		2			2																																																																																	
H9615	015	0	1	04	01	H9615_015_0	7	3																										1	2	2				2				2		2	2			2		2			2																																																																																	
H9615	018	0	1	04	01	H9615_018_0	7	1																										1	2	2				2				2		2	2			2		2			2																																																																																	
H9700	001	0	1	04	01	H9700_001_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H9700	003	0	1	04	01	H9700_003_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H9700	005	0	1	04	01	H9700_005_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H9834	001	0	1	01	01	H9834_001_0	6	1																										1	2	2				2				2		2	2			2		2			2																																																																																	
H9834	001	0	1	01	01	H9834_001_0	6	2																																																																					Hospital at Home	2	2				2				2			2		1	0.00	35.00	2	2																																								
H9834	003	0	1	01	01	H9834_003_0	6	2																																																																					Hospital at Home	2	2				2				2			2		1	0.00	45.00	2	2																																								
H9834	003	0	1	01	01	H9834_003_0	6	1																										1	2	2				2				2		2	2			2		2			2																																																																																	
H9834	004	0	1	01	01	H9834_004_0	4	2																																																																					Hospital at Home	2	2				2				2			2		1	0.00	45.00	2	2																																								
H9834	004	0	1	01	01	H9834_004_0	4	1																										1	2	2				2				2		2	2			2		2			2																																																																																	
H9834	005	0	1	01	01	H9834_005_0	4	1																										1	2	2				2				2		2	2			2		2			2																																																																																	
H9834	005	0	1	01	01	H9834_005_0	4	2																																																																					Hospital at Home	2	2				2				2			2		1	0.00	35.00	2	2																																								
H9834	006	0	1	01	01	H9834_006_0	6	1																										1	2	2				2				2		2	2			2		2			2																																																																																	
H9834	006	0	1	01	01	H9834_006_0	6	2																																																																					Hospital at Home	2	2				2				2			2		1	0.00	55.00	2	2																																								
H9884	011	0	1	04	01	H9884_011_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H9888	001	0	1	04	01	H9888_001_0	7	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H9888	002	0	1	04	01	H9888_002_0	8	1																										1	2	2				2				1	1	1	2			2		2			1																																																																																	
H9907	001	0	1	04	01	H9907_001_0	8	1																										1	2	2				2				2		2	1	20	20	2		2			2																																																																																	
H9946	001	0	1	04	01	H9946_001_0	4	2																										1	2	1	203.00	7	2	2				1	1	1	2			2		2			1																						Healthy Food	2	1	203.00	7		2				2			2		2			2	2	General Supports for Living (Utilities)	2	1	203.00	7		2				2			2		2			2	2																				
H9946	001	0	1	04	01	H9946_001_0	4	1																										1	2	1	203.00	7	2	2				1	1	1	2			2		2			1																						Healthy Food	2	1	203.00	7		2				2			2		2			2	2	General Supports for Living (Utilities)	2	1	203.00	7		2				2			2		2			2	2																				
H9986	002	0	1	02	01	H9986_002_0	7	2																																																1	2	001	2				2				2			2		2			1	2																																																												
H9986	002	0	1	02	01	H9986_002_0	7	1																																																																					Advanced Care At Home	2	2				2				1	20	20	2		2			1	2																																								
H9986	004	1	1	02	01	H9986_004_1	7	2																																																1	2	001	2				2				2			2		2			1	2																																																												
H9986	004	1	1	02	01	H9986_004_1	7	1																																																																					Advanced Care At Home	2	2				2				1	20	20	2		2			1	2																																								
H9986	004	2	1	02	01	H9986_004_2	7	2																																																1	2	001	2				2				2			2		2			1	2																																																												
H9986	004	2	1	02	01	H9986_004_2	7	1																																																																					Advanced Care At Home	2	2				2				1	20	20	2		2			1	2																																								
H9986	004	3	1	02	01	H9986_004_3	7	2																																																1	2	001	2				2				2			2		2			1	2																																																												
H9986	004	3	1	02	01	H9986_004_3	7	1																																																																					Advanced Care At Home	2	2				2				1	20	20	2		2			1	2																																								
