pbp_a_hnumber	pbp_a_plan_identifier	segment_id	pbp_a_ben_cov	pbp_a_plan_type	orgtype	bid_id	version	part_d_model_demo	part_d_enhncd_cvrg_demo	mrx_tier_post_label_list	mrx_tier_post_benefit_type	mrx_tier_post_form_model_desc	mrx_tier_post_id	mrx_tier_post_type_id	mrx_tier_post_drug_type	mrx_tier_post_includes	mrx_tier_post_cost_struct	mrx_tier_post_copay_amt	mrx_tier_post_coins_pct
H0028	007	0	1	01	01	H0028_007_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H0028	007	0	1	01	01	H0028_007_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0028	007	0	1	01	01	H0028_007_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0028	007	0	1	01	01	H0028_007_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0028	007	0	1	01	01	H0028_007_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0028	014	0	1	01	01	H0028_014_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H0028	014	0	1	01	01	H0028_014_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0028	014	0	1	01	01	H0028_014_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0028	014	0	1	01	01	H0028_014_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0028	014	0	1	01	01	H0028_014_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0028	015	0	1	02	01	H0028_015_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H0028	015	0	1	02	01	H0028_015_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0028	015	0	1	02	01	H0028_015_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0028	015	0	1	02	01	H0028_015_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0028	015	0	1	02	01	H0028_015_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0028	016	0	1	02	01	H0028_016_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H0028	016	0	1	02	01	H0028_016_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0028	016	0	1	02	01	H0028_016_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0028	016	0	1	02	01	H0028_016_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0028	016	0	1	02	01	H0028_016_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0028	017	0	1	01	01	H0028_017_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H0028	017	0	1	01	01	H0028_017_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0028	017	0	1	01	01	H0028_017_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0028	017	0	1	01	01	H0028_017_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0028	017	0	1	01	01	H0028_017_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0028	019	0	1	01	01	H0028_019_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H0028	019	0	1	01	01	H0028_019_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0028	019	0	1	01	01	H0028_019_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0028	019	0	1	01	01	H0028_019_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0028	019	0	1	01	01	H0028_019_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0028	021	0	1	01	01	H0028_021_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H0028	021	0	1	01	01	H0028_021_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0028	021	0	1	01	01	H0028_021_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0028	021	0	1	01	01	H0028_021_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0028	021	0	1	01	01	H0028_021_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0028	024	0	1	01	01	H0028_024_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H0028	024	0	1	01	01	H0028_024_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0028	024	0	1	01	01	H0028_024_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0028	024	0	1	01	01	H0028_024_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0028	024	0	1	01	01	H0028_024_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0028	028	0	1	01	01	H0028_028_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H0028	028	0	1	01	01	H0028_028_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0028	028	0	1	01	01	H0028_028_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0028	028	0	1	01	01	H0028_028_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0028	028	0	1	01	01	H0028_028_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0028	029	0	1	01	01	H0028_029_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0028	029	0	1	01	01	H0028_029_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0028	029	0	1	01	01	H0028_029_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0028	029	0	1	01	01	H0028_029_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0028	029	0	1	01	01	H0028_029_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0028	030	0	1	01	01	H0028_030_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0028	030	0	1	01	01	H0028_030_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0028	030	0	1	01	01	H0028_030_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0028	030	0	1	01	01	H0028_030_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0028	030	0	1	01	01	H0028_030_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0028	032	0	1	01	01	H0028_032_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0028	032	0	1	01	01	H0028_032_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0028	032	0	1	01	01	H0028_032_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0028	032	0	1	01	01	H0028_032_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0028	032	0	1	01	01	H0028_032_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0028	035	0	1	01	01	H0028_035_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0028	035	0	1	01	01	H0028_035_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0028	035	0	1	01	01	H0028_035_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0028	035	0	1	01	01	H0028_035_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0028	035	0	1	01	01	H0028_035_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0028	036	0	1	01	01	H0028_036_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0028	036	0	1	01	01	H0028_036_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0028	036	0	1	01	01	H0028_036_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0028	036	0	1	01	01	H0028_036_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0028	036	0	1	01	01	H0028_036_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0028	037	0	1	01	01	H0028_037_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0028	037	0	1	01	01	H0028_037_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0028	037	0	1	01	01	H0028_037_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0028	037	0	1	01	01	H0028_037_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0028	037	0	1	01	01	H0028_037_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0028	039	0	1	01	01	H0028_039_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H0028	039	0	1	01	01	H0028_039_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0028	039	0	1	01	01	H0028_039_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0028	039	0	1	01	01	H0028_039_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0028	039	0	1	01	01	H0028_039_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0028	039	0	1	01	01	H0028_039_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0028	041	0	1	01	01	H0028_041_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0028	041	0	1	01	01	H0028_041_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0028	041	0	1	01	01	H0028_041_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0028	041	0	1	01	01	H0028_041_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0028	041	0	1	01	01	H0028_041_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0028	042	0	1	01	01	H0028_042_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0028	042	0	1	01	01	H0028_042_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0028	042	0	1	01	01	H0028_042_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0028	042	0	1	01	01	H0028_042_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0028	042	0	1	01	01	H0028_042_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0028	043	1	1	01	01	H0028_043_1	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0028	043	1	1	01	01	H0028_043_1	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0028	043	1	1	01	01	H0028_043_1	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0028	043	1	1	01	01	H0028_043_1	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0028	043	1	1	01	01	H0028_043_1	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0028	043	2	1	01	01	H0028_043_2	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0028	043	2	1	01	01	H0028_043_2	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0028	043	2	1	01	01	H0028_043_2	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0028	043	2	1	01	01	H0028_043_2	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0028	043	2	1	01	01	H0028_043_2	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0028	046	0	1	01	01	H0028_046_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0028	046	0	1	01	01	H0028_046_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0028	046	0	1	01	01	H0028_046_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0028	046	0	1	01	01	H0028_046_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0028	046	0	1	01	01	H0028_046_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0028	051	0	1	01	01	H0028_051_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H0028	051	0	1	01	01	H0028_051_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0028	051	0	1	01	01	H0028_051_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0028	051	0	1	01	01	H0028_051_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0028	051	0	1	01	01	H0028_051_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0028	051	0	1	01	01	H0028_051_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0028	053	1	1	01	01	H0028_053_1	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H0028	053	1	1	01	01	H0028_053_1	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0028	053	1	1	01	01	H0028_053_1	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0028	053	1	1	01	01	H0028_053_1	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0028	053	1	1	01	01	H0028_053_1	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0028	053	3	1	01	01	H0028_053_3	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H0028	053	3	1	01	01	H0028_053_3	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0028	053	3	1	01	01	H0028_053_3	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0028	053	3	1	01	01	H0028_053_3	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0028	053	3	1	01	01	H0028_053_3	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0028	054	1	1	02	01	H0028_054_1	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H0028	054	1	1	02	01	H0028_054_1	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0028	054	1	1	02	01	H0028_054_1	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0028	054	1	1	02	01	H0028_054_1	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0028	054	1	1	02	01	H0028_054_1	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0028	054	2	1	02	01	H0028_054_2	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H0028	054	2	1	02	01	H0028_054_2	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0028	054	2	1	02	01	H0028_054_2	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0028	054	2	1	02	01	H0028_054_2	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0028	054	2	1	02	01	H0028_054_2	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0028	055	0	1	02	01	H0028_055_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H0028	055	0	1	02	01	H0028_055_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0028	055	0	1	02	01	H0028_055_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0028	055	0	1	02	01	H0028_055_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0028	055	0	1	02	01	H0028_055_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0028	055	0	1	02	01	H0028_055_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0028	056	0	1	02	01	H0028_056_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H0028	056	0	1	02	01	H0028_056_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0028	056	0	1	02	01	H0028_056_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0028	056	0	1	02	01	H0028_056_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0028	056	0	1	02	01	H0028_056_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0028	056	0	1	02	01	H0028_056_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0028	059	0	1	01	01	H0028_059_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0028	059	0	1	01	01	H0028_059_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0028	059	0	1	01	01	H0028_059_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0028	059	0	1	01	01	H0028_059_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0028	059	0	1	01	01	H0028_059_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0028	060	0	1	01	01	H0028_060_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H0028	060	0	1	01	01	H0028_060_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0028	060	0	1	01	01	H0028_060_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0028	060	0	1	01	01	H0028_060_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0028	060	0	1	01	01	H0028_060_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0028	060	0	1	01	01	H0028_060_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0028	062	0	1	01	01	H0028_062_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H0028	062	0	1	01	01	H0028_062_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0028	062	0	1	01	01	H0028_062_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0028	062	0	1	01	01	H0028_062_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0028	062	0	1	01	01	H0028_062_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0028	063	0	1	01	01	H0028_063_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H0028	063	0	1	01	01	H0028_063_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0028	063	0	1	01	01	H0028_063_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0028	063	0	1	01	01	H0028_063_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0028	063	0	1	01	01	H0028_063_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0028	065	0	1	01	01	H0028_065_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H0028	065	0	1	01	01	H0028_065_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0028	065	0	1	01	01	H0028_065_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0028	065	0	1	01	01	H0028_065_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0028	065	0	1	01	01	H0028_065_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0028	066	0	1	02	01	H0028_066_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H0028	066	0	1	02	01	H0028_066_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0028	066	0	1	02	01	H0028_066_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0028	066	0	1	02	01	H0028_066_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0028	066	0	1	02	01	H0028_066_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0028	067	0	1	02	01	H0028_067_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H0028	067	0	1	02	01	H0028_067_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0028	067	0	1	02	01	H0028_067_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0028	067	0	1	02	01	H0028_067_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0028	067	0	1	02	01	H0028_067_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0028	067	0	1	02	01	H0028_067_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0028	070	0	1	01	01	H0028_070_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0028	070	0	1	01	01	H0028_070_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0028	070	0	1	01	01	H0028_070_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0028	070	0	1	01	01	H0028_070_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0028	070	0	1	01	01	H0028_070_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0028	072	0	1	01	01	H0028_072_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0028	072	0	1	01	01	H0028_072_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0028	072	0	1	01	01	H0028_072_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0028	072	0	1	01	01	H0028_072_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0028	072	0	1	01	01	H0028_072_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0028	074	1	1	01	01	H0028_074_1	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H0028	074	1	1	01	01	H0028_074_1	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0028	074	1	1	01	01	H0028_074_1	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0028	074	1	1	01	01	H0028_074_1	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0028	074	1	1	01	01	H0028_074_1	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0028	074	2	1	01	01	H0028_074_2	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H0028	074	2	1	01	01	H0028_074_2	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0028	074	2	1	01	01	H0028_074_2	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0028	074	2	1	01	01	H0028_074_2	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0028	074	2	1	01	01	H0028_074_2	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0028	076	0	1	01	01	H0028_076_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H0028	076	0	1	01	01	H0028_076_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0028	076	0	1	01	01	H0028_076_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0028	076	0	1	01	01	H0028_076_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0028	076	0	1	01	01	H0028_076_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0028	076	0	1	01	01	H0028_076_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0028	077	0	1	01	01	H0028_077_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H0028	077	0	1	01	01	H0028_077_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0028	077	0	1	01	01	H0028_077_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0028	077	0	1	01	01	H0028_077_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0028	077	0	1	01	01	H0028_077_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0028	077	0	1	01	01	H0028_077_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0028	078	0	1	01	01	H0028_078_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H0028	078	0	1	01	01	H0028_078_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0028	078	0	1	01	01	H0028_078_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0028	078	0	1	01	01	H0028_078_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0028	078	0	1	01	01	H0028_078_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0028	079	0	1	01	01	H0028_079_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H0028	079	0	1	01	01	H0028_079_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0028	079	0	1	01	01	H0028_079_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0028	079	0	1	01	01	H0028_079_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0028	079	0	1	01	01	H0028_079_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0028	080	0	1	01	01	H0028_080_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H0028	080	0	1	01	01	H0028_080_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0028	080	0	1	01	01	H0028_080_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0028	080	0	1	01	01	H0028_080_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0028	080	0	1	01	01	H0028_080_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0028	081	1	1	01	01	H0028_081_1	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H0028	081	1	1	01	01	H0028_081_1	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0028	081	1	1	01	01	H0028_081_1	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0028	081	1	1	01	01	H0028_081_1	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0028	081	1	1	01	01	H0028_081_1	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0028	081	2	1	01	01	H0028_081_2	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H0028	081	2	1	01	01	H0028_081_2	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0028	081	2	1	01	01	H0028_081_2	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0028	081	2	1	01	01	H0028_081_2	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0028	081	2	1	01	01	H0028_081_2	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0028	082	0	1	01	01	H0028_082_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H0028	082	0	1	01	01	H0028_082_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0028	082	0	1	01	01	H0028_082_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0028	082	0	1	01	01	H0028_082_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0028	082	0	1	01	01	H0028_082_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0029	007	0	1	02	01	H0029_007_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H0029	007	0	1	02	01	H0029_007_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0029	007	0	1	02	01	H0029_007_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0029	007	0	1	02	01	H0029_007_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0029	007	0	1	02	01	H0029_007_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0029	007	0	1	02	01	H0029_007_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0029	008	0	1	02	01	H0029_008_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H0029	008	0	1	02	01	H0029_008_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0029	008	0	1	02	01	H0029_008_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0029	008	0	1	02	01	H0029_008_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0029	008	0	1	02	01	H0029_008_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0029	008	0	1	02	01	H0029_008_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0029	009	0	1	02	01	H0029_009_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H0029	009	0	1	02	01	H0029_009_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0029	009	0	1	02	01	H0029_009_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0029	009	0	1	02	01	H0029_009_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0029	009	0	1	02	01	H0029_009_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0029	009	0	1	02	01	H0029_009_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0029	010	0	1	02	01	H0029_010_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H0029	010	0	1	02	01	H0029_010_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0029	010	0	1	02	01	H0029_010_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0029	010	0	1	02	01	H0029_010_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0029	010	0	1	02	01	H0029_010_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0029	010	0	1	02	01	H0029_010_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0029	011	0	1	02	01	H0029_011_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H0029	011	0	1	02	01	H0029_011_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0029	011	0	1	02	01	H0029_011_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0029	011	0	1	02	01	H0029_011_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0029	011	0	1	02	01	H0029_011_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0029	011	0	1	02	01	H0029_011_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0062	011	0	1	01	01	H0062_011_0	7		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H0062	011	0	1	01	01	H0062_011_0	7		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0062	011	0	1	01	01	H0062_011_0	7		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0062	011	0	1	01	01	H0062_011_0	7		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0062	011	0	1	01	01	H0062_011_0	7		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0062	011	0	1	01	01	H0062_011_0	7		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0062	012	0	1	01	01	H0062_012_0	7		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H0062	012	0	1	01	01	H0062_012_0	7		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0062	012	0	1	01	01	H0062_012_0	7		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0062	012	0	1	01	01	H0062_012_0	7		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0062	012	0	1	01	01	H0062_012_0	7		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0062	012	0	1	01	01	H0062_012_0	7		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0074	001	0	1	04	01	H0074_001_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H0074	001	0	1	04	01	H0074_001_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0074	001	0	1	04	01	H0074_001_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0074	001	0	1	04	01	H0074_001_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0074	001	0	1	04	01	H0074_001_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0074	001	0	1	04	01	H0074_001_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0074	004	0	1	04	01	H0074_004_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H0074	004	0	1	04	01	H0074_004_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0074	004	0	1	04	01	H0074_004_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0074	004	0	1	04	01	H0074_004_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0074	004	0	1	04	01	H0074_004_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0074	004	0	1	04	01	H0074_004_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0104	012	0	1	04	01	H0104_012_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0104	012	0	1	04	01	H0104_012_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0104	012	0	1	04	01	H0104_012_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0104	012	0	1	04	01	H0104_012_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0104	012	0	1	04	01	H0104_012_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0104	014	0	1	04	01	H0104_014_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0104	014	0	1	04	01	H0104_014_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0104	014	0	1	04	01	H0104_014_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H0104	014	0	1	04	01	H0104_014_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0104	014	0	1	04	01	H0104_014_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0104	015	0	1	04	01	H0104_015_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0104	015	0	1	04	01	H0104_015_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0104	015	0	1	04	01	H0104_015_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H0104	015	0	1	04	01	H0104_015_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0104	015	0	1	04	01	H0104_015_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0104	016	0	1	04	01	H0104_016_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0104	016	0	1	04	01	H0104_016_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0104	016	0	1	04	01	H0104_016_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0104	016	0	1	04	01	H0104_016_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0104	016	0	1	04	01	H0104_016_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0107	003	0	1	04	01	H0107_003_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0107	003	0	1	04	01	H0107_003_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0107	003	0	1	04	01	H0107_003_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0107	003	0	1	04	01	H0107_003_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0107	003	0	1	04	01	H0107_003_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0107	004	0	1	04	01	H0107_004_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0107	004	0	1	04	01	H0107_004_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0107	004	0	1	04	01	H0107_004_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0107	004	0	1	04	01	H0107_004_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0107	004	0	1	04	01	H0107_004_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0107	005	0	1	04	01	H0107_005_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0107	005	0	1	04	01	H0107_005_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0107	005	0	1	04	01	H0107_005_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0107	005	0	1	04	01	H0107_005_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0107	005	0	1	04	01	H0107_005_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0107	007	0	1	04	01	H0107_007_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0107	007	0	1	04	01	H0107_007_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0107	007	0	1	04	01	H0107_007_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0107	007	0	1	04	01	H0107_007_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0107	007	0	1	04	01	H0107_007_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0107	010	0	1	04	01	H0107_010_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0107	010	0	1	04	01	H0107_010_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0107	010	0	1	04	01	H0107_010_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0107	010	0	1	04	01	H0107_010_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0107	010	0	1	04	01	H0107_010_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0111	001	0	1	04	01	H0111_001_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H0111	001	0	1	04	01	H0111_001_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0111	001	0	1	04	01	H0111_001_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0111	001	0	1	04	01	H0111_001_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0111	001	0	1	04	01	H0111_001_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0111	001	0	1	04	01	H0111_001_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0111	004	0	1	04	01	H0111_004_0	7		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H0111	004	0	1	04	01	H0111_004_0	7		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0111	004	0	1	04	01	H0111_004_0	7		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0111	004	0	1	04	01	H0111_004_0	7		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0111	004	0	1	04	01	H0111_004_0	7		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0111	004	0	1	04	01	H0111_004_0	7		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0154	011	0	1	01	01	H0154_011_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0154	011	0	1	01	01	H0154_011_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0154	011	0	1	01	01	H0154_011_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0154	011	0	1	01	01	H0154_011_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0154	011	0	1	01	01	H0154_011_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0154	015	1	1	01	01	H0154_015_1	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0154	015	1	1	01	01	H0154_015_1	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0154	015	1	1	01	01	H0154_015_1	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0154	015	1	1	01	01	H0154_015_1	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0154	015	1	1	01	01	H0154_015_1	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0154	015	2	1	01	01	H0154_015_2	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0154	015	2	1	01	01	H0154_015_2	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0154	015	2	1	01	01	H0154_015_2	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0154	015	2	1	01	01	H0154_015_2	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0154	015	2	1	01	01	H0154_015_2	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0154	017	0	1	01	01	H0154_017_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0154	017	0	1	01	01	H0154_017_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0154	017	0	1	01	01	H0154_017_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0154	017	0	1	01	01	H0154_017_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0154	017	0	1	01	01	H0154_017_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0154	020	0	1	01	01	H0154_020_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0154	020	0	1	01	01	H0154_020_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0154	020	0	1	01	01	H0154_020_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0154	020	0	1	01	01	H0154_020_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0154	020	0	1	01	01	H0154_020_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0169	001	0	1	02	01	H0169_001_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0169	001	0	1	02	01	H0169_001_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0169	001	0	1	02	01	H0169_001_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0169	001	0	1	02	01	H0169_001_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0169	001	0	1	02	01	H0169_001_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0169	002	0	1	02	01	H0169_002_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0169	002	0	1	02	01	H0169_002_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0169	002	0	1	02	01	H0169_002_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0169	002	0	1	02	01	H0169_002_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0169	002	0	1	02	01	H0169_002_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0169	003	0	1	02	01	H0169_003_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0169	003	0	1	02	01	H0169_003_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0169	003	0	1	02	01	H0169_003_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0169	003	0	1	02	01	H0169_003_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0169	003	0	1	02	01	H0169_003_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0169	004	0	1	02	01	H0169_004_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0169	004	0	1	02	01	H0169_004_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0169	004	0	1	02	01	H0169_004_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0169	004	0	1	02	01	H0169_004_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0169	004	0	1	02	01	H0169_004_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0169	006	0	1	02	01	H0169_006_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0169	006	0	1	02	01	H0169_006_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0169	006	0	1	02	01	H0169_006_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0169	006	0	1	02	01	H0169_006_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0169	006	0	1	02	01	H0169_006_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0169	008	0	1	02	01	H0169_008_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0169	008	0	1	02	01	H0169_008_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0169	008	0	1	02	01	H0169_008_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0169	008	0	1	02	01	H0169_008_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0169	008	0	1	02	01	H0169_008_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0169	009	0	1	02	01	H0169_009_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0169	009	0	1	02	01	H0169_009_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0169	009	0	1	02	01	H0169_009_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0169	009	0	1	02	01	H0169_009_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0169	009	0	1	02	01	H0169_009_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0169	010	0	1	02	01	H0169_010_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0169	010	0	1	02	01	H0169_010_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0169	010	0	1	02	01	H0169_010_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0169	010	0	1	02	01	H0169_010_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0169	010	0	1	02	01	H0169_010_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0174	004	0	1	01	01	H0174_004_0	6		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H0174	004	0	1	01	01	H0174_004_0	6		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0174	004	0	1	01	01	H0174_004_0	6		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0174	004	0	1	01	01	H0174_004_0	6		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0174	004	0	1	01	01	H0174_004_0	6		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0174	004	0	1	01	01	H0174_004_0	6		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0174	006	0	1	01	01	H0174_006_0	7		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H0174	006	0	1	01	01	H0174_006_0	7		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0174	006	0	1	01	01	H0174_006_0	7		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0174	006	0	1	01	01	H0174_006_0	7		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0174	006	0	1	01	01	H0174_006_0	7		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0174	006	0	1	01	01	H0174_006_0	7		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0174	009	0	1	01	01	H0174_009_0	7			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H0174	009	0	1	01	01	H0174_009_0	7			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0174	009	0	1	01	01	H0174_009_0	7			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0174	009	0	1	01	01	H0174_009_0	7			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0174	009	0	1	01	01	H0174_009_0	7			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0174	009	0	1	01	01	H0174_009_0	7			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0174	010	0	1	01	01	H0174_010_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H0174	010	0	1	01	01	H0174_010_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0174	010	0	1	01	01	H0174_010_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0174	010	0	1	01	01	H0174_010_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0174	010	0	1	01	01	H0174_010_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0174	010	0	1	01	01	H0174_010_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0174	014	0	1	01	01	H0174_014_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H0174	014	0	1	01	01	H0174_014_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0174	014	0	1	01	01	H0174_014_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0174	014	0	1	01	01	H0174_014_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0174	014	0	1	01	01	H0174_014_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0174	014	0	1	01	01	H0174_014_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0174	015	0	1	01	01	H0174_015_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H0174	015	0	1	01	01	H0174_015_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0174	015	0	1	01	01	H0174_015_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0174	015	0	1	01	01	H0174_015_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0174	015	0	1	01	01	H0174_015_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0174	015	0	1	01	01	H0174_015_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0174	016	0	1	01	01	H0174_016_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H0174	016	0	1	01	01	H0174_016_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0174	016	0	1	01	01	H0174_016_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0174	016	0	1	01	01	H0174_016_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0174	016	0	1	01	01	H0174_016_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0174	016	0	1	01	01	H0174_016_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0174	017	0	1	01	01	H0174_017_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H0174	017	0	1	01	01	H0174_017_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0174	017	0	1	01	01	H0174_017_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0174	017	0	1	01	01	H0174_017_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0174	017	0	1	01	01	H0174_017_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0174	017	0	1	01	01	H0174_017_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0174	018	0	1	01	01	H0174_018_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H0174	018	0	1	01	01	H0174_018_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0174	018	0	1	01	01	H0174_018_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0174	018	0	1	01	01	H0174_018_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0174	018	0	1	01	01	H0174_018_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0174	018	0	1	01	01	H0174_018_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0174	019	0	1	01	01	H0174_019_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H0174	019	0	1	01	01	H0174_019_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0174	019	0	1	01	01	H0174_019_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0174	019	0	1	01	01	H0174_019_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0174	019	0	1	01	01	H0174_019_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0174	019	0	1	01	01	H0174_019_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0174	020	0	1	01	01	H0174_020_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H0174	020	0	1	01	01	H0174_020_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0174	020	0	1	01	01	H0174_020_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0174	020	0	1	01	01	H0174_020_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0174	020	0	1	01	01	H0174_020_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0174	020	0	1	01	01	H0174_020_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0174	021	0	1	01	01	H0174_021_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H0174	021	0	1	01	01	H0174_021_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0174	021	0	1	01	01	H0174_021_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0174	021	0	1	01	01	H0174_021_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0174	021	0	1	01	01	H0174_021_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0174	021	0	1	01	01	H0174_021_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0174	022	0	1	01	01	H0174_022_0	6		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H0174	022	0	1	01	01	H0174_022_0	6		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0174	022	0	1	01	01	H0174_022_0	6		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0174	022	0	1	01	01	H0174_022_0	6		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0174	022	0	1	01	01	H0174_022_0	6		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0174	022	0	1	01	01	H0174_022_0	6		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0174	023	0	1	01	01	H0174_023_0	7		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H0174	023	0	1	01	01	H0174_023_0	7		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0174	023	0	1	01	01	H0174_023_0	7		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0174	023	0	1	01	01	H0174_023_0	7		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0174	023	0	1	01	01	H0174_023_0	7		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0174	023	0	1	01	01	H0174_023_0	7		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0174	024	0	1	01	01	H0174_024_0	7		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H0174	024	0	1	01	01	H0174_024_0	7		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0174	024	0	1	01	01	H0174_024_0	7		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0174	024	0	1	01	01	H0174_024_0	7		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0174	024	0	1	01	01	H0174_024_0	7		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0174	024	0	1	01	01	H0174_024_0	7		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0174	025	0	1	01	01	H0174_025_0	7		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H0174	025	0	1	01	01	H0174_025_0	7		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0174	025	0	1	01	01	H0174_025_0	7		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0174	025	0	1	01	01	H0174_025_0	7		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0174	025	0	1	01	01	H0174_025_0	7		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0174	025	0	1	01	01	H0174_025_0	7		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0174	026	0	1	01	01	H0174_026_0	6		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H0174	026	0	1	01	01	H0174_026_0	6		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0174	026	0	1	01	01	H0174_026_0	6		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0174	026	0	1	01	01	H0174_026_0	6		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0174	026	0	1	01	01	H0174_026_0	6		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0174	026	0	1	01	01	H0174_026_0	6		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0251	002	0	1	02	01	H0251_002_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0251	002	0	1	02	01	H0251_002_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0251	002	0	1	02	01	H0251_002_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0251	002	0	1	02	01	H0251_002_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0251	002	0	1	02	01	H0251_002_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0251	008	0	1	02	01	H0251_008_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0251	008	0	1	02	01	H0251_008_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0251	008	0	1	02	01	H0251_008_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0251	008	0	1	02	01	H0251_008_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0251	008	0	1	02	01	H0251_008_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0270	001	0	1	04	01	H0270_001_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H0270	001	0	1	04	01	H0270_001_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0270	001	0	1	04	01	H0270_001_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0270	001	0	1	04	01	H0270_001_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0270	001	0	1	04	01	H0270_001_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0270	001	0	1	04	01	H0270_001_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0292	001	0	1	01	01	H0292_001_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0292	001	0	1	01	01	H0292_001_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0292	001	0	1	01	01	H0292_001_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0292	001	0	1	01	01	H0292_001_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0292	001	0	1	01	01	H0292_001_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0292	002	0	1	01	01	H0292_002_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0292	002	0	1	01	01	H0292_002_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0292	002	0	1	01	01	H0292_002_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0292	002	0	1	01	01	H0292_002_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0292	002	0	1	01	01	H0292_002_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0292	003	0	1	01	01	H0292_003_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0292	003	0	1	01	01	H0292_003_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0292	003	0	1	01	01	H0292_003_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0292	003	0	1	01	01	H0292_003_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0292	003	0	1	01	01	H0292_003_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0294	002	0	1	04	01	H0294_002_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0294	002	0	1	04	01	H0294_002_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H0294	002	0	1	04	01	H0294_002_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0294	002	0	1	04	01	H0294_002_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0294	002	0	1	04	01	H0294_002_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0294	004	0	1	04	01	H0294_004_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0294	004	0	1	04	01	H0294_004_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H0294	004	0	1	04	01	H0294_004_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0294	004	0	1	04	01	H0294_004_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0294	004	0	1	04	01	H0294_004_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0294	015	0	1	04	01	H0294_015_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0294	015	0	1	04	01	H0294_015_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H0294	015	0	1	04	01	H0294_015_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0294	015	0	1	04	01	H0294_015_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0294	015	0	1	04	01	H0294_015_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0294	016	0	1	04	01	H0294_016_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0294	016	0	1	04	01	H0294_016_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H0294	016	0	1	04	01	H0294_016_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0294	016	0	1	04	01	H0294_016_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0294	016	0	1	04	01	H0294_016_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0294	017	0	1	04	01	H0294_017_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0294	017	0	1	04	01	H0294_017_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H0294	017	0	1	04	01	H0294_017_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0294	017	0	1	04	01	H0294_017_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0294	017	0	1	04	01	H0294_017_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0294	018	0	1	04	01	H0294_018_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0294	018	0	1	04	01	H0294_018_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H0294	018	0	1	04	01	H0294_018_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0294	018	0	1	04	01	H0294_018_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0294	018	0	1	04	01	H0294_018_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0294	027	0	1	04	01	H0294_027_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0294	027	0	1	04	01	H0294_027_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0294	027	0	1	04	01	H0294_027_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0294	027	0	1	04	01	H0294_027_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0294	027	0	1	04	01	H0294_027_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0294	032	0	1	04	01	H0294_032_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0294	032	0	1	04	01	H0294_032_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H0294	032	0	1	04	01	H0294_032_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0294	032	0	1	04	01	H0294_032_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0294	032	0	1	04	01	H0294_032_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0294	049	0	1	04	01	H0294_049_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0294	049	0	1	04	01	H0294_049_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0294	049	0	1	04	01	H0294_049_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0294	049	0	1	04	01	H0294_049_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0294	049	0	1	04	01	H0294_049_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0294	050	0	1	04	01	H0294_050_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0294	050	0	1	04	01	H0294_050_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0294	050	0	1	04	01	H0294_050_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0294	050	0	1	04	01	H0294_050_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0294	050	0	1	04	01	H0294_050_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0294	051	0	1	04	01	H0294_051_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0294	051	0	1	04	01	H0294_051_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0294	051	0	1	04	01	H0294_051_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0294	051	0	1	04	01	H0294_051_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0294	051	0	1	04	01	H0294_051_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0302	001	0	1	01	01	H0302_001_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H0302	001	0	1	01	01	H0302_001_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H0302	001	0	1	01	01	H0302_001_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0302	001	0	1	01	01	H0302_001_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0302	001	0	1	01	01	H0302_001_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0302	001	0	1	01	01	H0302_001_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H0302	006	0	1	01	01	H0302_006_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H0302	006	0	1	01	01	H0302_006_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H0302	006	0	1	01	01	H0302_006_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0302	006	0	1	01	01	H0302_006_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0302	006	0	1	01	01	H0302_006_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0302	006	0	1	01	01	H0302_006_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H0302	008	0	1	01	01	H0302_008_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H0302	008	0	1	01	01	H0302_008_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H0302	008	0	1	01	01	H0302_008_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0302	008	0	1	01	01	H0302_008_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0302	008	0	1	01	01	H0302_008_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0302	008	0	1	01	01	H0302_008_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H0321	002	0	1	02	01	H0321_002_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0321	002	0	1	02	01	H0321_002_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0321	002	0	1	02	01	H0321_002_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0321	002	0	1	02	01	H0321_002_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0321	002	0	1	02	01	H0321_002_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0332	004	0	1	02	01	H0332_004_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H0332	004	0	1	02	01	H0332_004_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	3	2	15.00	
H0332	004	0	1	02	01	H0332_004_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0332	004	0	1	02	01	H0332_004_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0332	004	0	1	02	01	H0332_004_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0332	004	0	1	02	01	H0332_004_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0332	009	0	1	01	01	H0332_009_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H0332	009	0	1	01	01	H0332_009_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	3	2	12.00	
H0332	009	0	1	01	01	H0332_009_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0332	009	0	1	01	01	H0332_009_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0332	009	0	1	01	01	H0332_009_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0332	009	0	1	01	01	H0332_009_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0342	001	0	1	04	01	H0342_001_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	01	3	2	0.00	
H0342	001	0	1	04	01	H0342_001_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	01	3	2	0.00	
H0342	001	0	1	04	01	H0342_001_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H0342	001	0	1	04	01	H0342_001_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H0342	001	0	1	04	01	H0342_001_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H0342	001	0	1	04	01	H0342_001_0	9			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	11	1	2	0.00	
H0351	038	0	1	01	01	H0351_038_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H0351	038	0	1	01	01	H0351_038_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0351	038	0	1	01	01	H0351_038_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0351	038	0	1	01	01	H0351_038_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0351	038	0	1	01	01	H0351_038_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0351	038	0	1	01	01	H0351_038_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0351	053	0	1	01	01	H0351_053_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H0351	053	0	1	01	01	H0351_053_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0351	053	0	1	01	01	H0351_053_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0351	053	0	1	01	01	H0351_053_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0351	053	0	1	01	01	H0351_053_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0351	053	0	1	01	01	H0351_053_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0351	054	0	1	01	01	H0351_054_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H0351	054	0	1	01	01	H0351_054_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0351	054	0	1	01	01	H0351_054_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0351	054	0	1	01	01	H0351_054_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0351	054	0	1	01	01	H0351_054_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0351	054	0	1	01	01	H0351_054_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0351	057	0	1	01	01	H0351_057_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H0351	057	0	1	01	01	H0351_057_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0351	057	0	1	01	01	H0351_057_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0351	057	0	1	01	01	H0351_057_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0351	057	0	1	01	01	H0351_057_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0351	057	0	1	01	01	H0351_057_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0351	063	0	1	01	01	H0351_063_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H0351	063	0	1	01	01	H0351_063_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0351	063	0	1	01	01	H0351_063_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0351	063	0	1	01	01	H0351_063_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0351	063	0	1	01	01	H0351_063_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0351	063	0	1	01	01	H0351_063_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0351	064	0	1	01	01	H0351_064_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H0351	064	0	1	01	01	H0351_064_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0351	064	0	1	01	01	H0351_064_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0351	064	0	1	01	01	H0351_064_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0351	064	0	1	01	01	H0351_064_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0351	064	0	1	01	01	H0351_064_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0351	065	0	1	01	01	H0351_065_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H0351	065	0	1	01	01	H0351_065_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0351	065	0	1	01	01	H0351_065_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0351	065	0	1	01	01	H0351_065_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0351	065	0	1	01	01	H0351_065_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0351	065	0	1	01	01	H0351_065_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0351	066	0	1	02	01	H0351_066_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H0351	066	0	1	02	01	H0351_066_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0351	066	0	1	02	01	H0351_066_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0351	066	0	1	02	01	H0351_066_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0351	066	0	1	02	01	H0351_066_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0351	066	0	1	02	01	H0351_066_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0351	067	0	1	02	01	H0351_067_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H0351	067	0	1	02	01	H0351_067_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0351	067	0	1	02	01	H0351_067_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0351	067	0	1	02	01	H0351_067_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0351	067	0	1	02	01	H0351_067_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0351	067	0	1	02	01	H0351_067_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0351	068	0	1	02	01	H0351_068_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H0351	068	0	1	02	01	H0351_068_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0351	068	0	1	02	01	H0351_068_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0351	068	0	1	02	01	H0351_068_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0351	068	0	1	02	01	H0351_068_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0351	068	0	1	02	01	H0351_068_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0351	069	0	1	02	01	H0351_069_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H0351	069	0	1	02	01	H0351_069_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0351	069	0	1	02	01	H0351_069_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0351	069	0	1	02	01	H0351_069_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0351	069	0	1	02	01	H0351_069_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0351	069	0	1	02	01	H0351_069_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0351	070	0	1	02	01	H0351_070_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H0351	070	0	1	02	01	H0351_070_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0351	070	0	1	02	01	H0351_070_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0351	070	0	1	02	01	H0351_070_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0351	070	0	1	02	01	H0351_070_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0351	070	0	1	02	01	H0351_070_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0354	001	0	1	01	01	H0354_001_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H0354	001	0	1	01	01	H0354_001_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0354	001	0	1	01	01	H0354_001_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0354	001	0	1	01	01	H0354_001_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0354	001	0	1	01	01	H0354_001_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0354	027	0	1	01	01	H0354_027_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	1	2	01	3	2	10.00	
H0354	027	0	1	01	01	H0354_027_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	2	2	01	1	2	0.00	
H0354	027	0	1	01	01	H0354_027_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	3	2	11	1	2	0.00	
H0354	027	0	1	01	01	H0354_027_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	4	2	11	1	2	0.00	
H0354	027	0	1	01	01	H0354_027_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	5	2	11	1	2	0.00	
H0354	027	0	1	01	01	H0354_027_0	4			Select Diabetic Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	6	2	11	1	2	0.00	
H0354	028	0	1	01	01	H0354_028_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H0354	028	0	1	01	01	H0354_028_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0354	028	0	1	01	01	H0354_028_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0354	028	0	1	01	01	H0354_028_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0354	028	0	1	01	01	H0354_028_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0354	029	0	1	01	01	H0354_029_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	5.00	
H0354	029	0	1	01	01	H0354_029_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0354	029	0	1	01	01	H0354_029_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0354	029	0	1	01	01	H0354_029_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0354	029	0	1	01	01	H0354_029_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0354	030	0	1	01	01	H0354_030_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	5.00	
H0354	030	0	1	01	01	H0354_030_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0354	030	0	1	01	01	H0354_030_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0354	030	0	1	01	01	H0354_030_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0354	030	0	1	01	01	H0354_030_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0413	001	0	1	04	01	H0413_001_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0413	001	0	1	04	01	H0413_001_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H0413	001	0	1	04	01	H0413_001_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0413	001	0	1	04	01	H0413_001_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0413	001	0	1	04	01	H0413_001_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0413	002	0	1	04	01	H0413_002_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0413	002	0	1	04	01	H0413_002_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H0413	002	0	1	04	01	H0413_002_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0413	002	0	1	04	01	H0413_002_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0413	002	0	1	04	01	H0413_002_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0413	003	0	1	04	01	H0413_003_0	7			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H0413	003	0	1	04	01	H0413_003_0	7			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0413	003	0	1	04	01	H0413_003_0	7			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0413	003	0	1	04	01	H0413_003_0	7			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0413	003	0	1	04	01	H0413_003_0	7			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0413	003	0	1	04	01	H0413_003_0	7			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0421	001	0	1	04	01	H0421_001_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0421	001	0	1	04	01	H0421_001_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0421	001	0	1	04	01	H0421_001_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0421	001	0	1	04	01	H0421_001_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0421	001	0	1	04	01	H0421_001_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0423	001	0	1	01	01	H0423_001_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0423	001	0	1	01	01	H0423_001_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0423	001	0	1	01	01	H0423_001_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0423	001	0	1	01	01	H0423_001_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0423	001	0	1	01	01	H0423_001_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0432	003	0	1	02	01	H0432_003_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0432	003	0	1	02	01	H0432_003_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H0432	003	0	1	02	01	H0432_003_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0432	003	0	1	02	01	H0432_003_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0432	003	0	1	02	01	H0432_003_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0432	004	0	1	02	01	H0432_004_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0432	004	0	1	02	01	H0432_004_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H0432	004	0	1	02	01	H0432_004_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0432	004	0	1	02	01	H0432_004_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0432	004	0	1	02	01	H0432_004_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0432	009	0	1	02	01	H0432_009_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0432	009	0	1	02	01	H0432_009_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0432	009	0	1	02	01	H0432_009_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0432	009	0	1	02	01	H0432_009_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0432	009	0	1	02	01	H0432_009_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0432	013	0	1	02	01	H0432_013_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0432	013	0	1	02	01	H0432_013_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0432	013	0	1	02	01	H0432_013_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0432	013	0	1	02	01	H0432_013_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0432	013	0	1	02	01	H0432_013_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0432	017	0	1	02	01	H0432_017_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0432	017	0	1	02	01	H0432_017_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H0432	017	0	1	02	01	H0432_017_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0432	017	0	1	02	01	H0432_017_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0432	017	0	1	02	01	H0432_017_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0439	002	0	1	01	01	H0439_002_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0439	002	0	1	01	01	H0439_002_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0439	002	0	1	01	01	H0439_002_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0439	002	0	1	01	01	H0439_002_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0439	002	0	1	01	01	H0439_002_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0439	003	1	1	01	01	H0439_003_1	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H0439	003	1	1	01	01	H0439_003_1	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0439	003	1	1	01	01	H0439_003_1	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0439	003	1	1	01	01	H0439_003_1	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0439	003	1	1	01	01	H0439_003_1	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0439	003	2	1	01	01	H0439_003_2	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H0439	003	2	1	01	01	H0439_003_2	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0439	003	2	1	01	01	H0439_003_2	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0439	003	2	1	01	01	H0439_003_2	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0439	003	2	1	01	01	H0439_003_2	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0439	006	0	1	01	01	H0439_006_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H0439	006	0	1	01	01	H0439_006_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0439	006	0	1	01	01	H0439_006_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0439	006	0	1	01	01	H0439_006_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0439	006	0	1	01	01	H0439_006_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0439	008	0	1	01	01	H0439_008_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H0439	008	0	1	01	01	H0439_008_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0439	008	0	1	01	01	H0439_008_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0439	008	0	1	01	01	H0439_008_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0439	008	0	1	01	01	H0439_008_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0439	009	0	1	01	01	H0439_009_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H0439	009	0	1	01	01	H0439_009_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0439	009	0	1	01	01	H0439_009_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0439	009	0	1	01	01	H0439_009_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0439	009	0	1	01	01	H0439_009_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0439	010	0	1	01	01	H0439_010_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H0439	010	0	1	01	01	H0439_010_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0439	010	0	1	01	01	H0439_010_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0439	010	0	1	01	01	H0439_010_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0439	010	0	1	01	01	H0439_010_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0439	011	0	1	01	01	H0439_011_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H0439	011	0	1	01	01	H0439_011_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0439	011	0	1	01	01	H0439_011_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0439	011	0	1	01	01	H0439_011_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0439	011	0	1	01	01	H0439_011_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0439	012	0	1	01	01	H0439_012_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0439	012	0	1	01	01	H0439_012_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0439	012	0	1	01	01	H0439_012_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0439	012	0	1	01	01	H0439_012_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0439	012	0	1	01	01	H0439_012_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0439	013	0	1	01	01	H0439_013_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H0439	013	0	1	01	01	H0439_013_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0439	013	0	1	01	01	H0439_013_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0439	013	0	1	01	01	H0439_013_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0439	013	0	1	01	01	H0439_013_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0439	015	1	1	01	01	H0439_015_1	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H0439	015	1	1	01	01	H0439_015_1	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0439	015	1	1	01	01	H0439_015_1	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0439	015	1	1	01	01	H0439_015_1	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0439	015	1	1	01	01	H0439_015_1	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0439	015	2	1	01	01	H0439_015_2	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H0439	015	2	1	01	01	H0439_015_2	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0439	015	2	1	01	01	H0439_015_2	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0439	015	2	1	01	01	H0439_015_2	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0439	015	2	1	01	01	H0439_015_2	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0439	016	0	1	01	01	H0439_016_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H0439	016	0	1	01	01	H0439_016_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0439	016	0	1	01	01	H0439_016_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0439	016	0	1	01	01	H0439_016_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0439	016	0	1	01	01	H0439_016_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0439	017	0	1	01	01	H0439_017_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H0439	017	0	1	01	01	H0439_017_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0439	017	0	1	01	01	H0439_017_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0439	017	0	1	01	01	H0439_017_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0439	017	0	1	01	01	H0439_017_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0439	018	0	1	01	01	H0439_018_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H0439	018	0	1	01	01	H0439_018_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0439	018	0	1	01	01	H0439_018_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0439	018	0	1	01	01	H0439_018_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0439	018	0	1	01	01	H0439_018_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0439	019	0	1	01	01	H0439_019_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H0439	019	0	1	01	01	H0439_019_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0439	019	0	1	01	01	H0439_019_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0439	019	0	1	01	01	H0439_019_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0439	019	0	1	01	01	H0439_019_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0439	020	0	1	01	01	H0439_020_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H0439	020	0	1	01	01	H0439_020_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0439	020	0	1	01	01	H0439_020_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0439	020	0	1	01	01	H0439_020_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0439	020	0	1	01	01	H0439_020_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0439	021	0	1	01	01	H0439_021_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H0439	021	0	1	01	01	H0439_021_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0439	021	0	1	01	01	H0439_021_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0439	021	0	1	01	01	H0439_021_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0439	021	0	1	01	01	H0439_021_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0439	022	0	1	01	01	H0439_022_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0439	022	0	1	01	01	H0439_022_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0439	022	0	1	01	01	H0439_022_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0439	022	0	1	01	01	H0439_022_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0439	022	0	1	01	01	H0439_022_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0439	023	0	1	01	01	H0439_023_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0439	023	0	1	01	01	H0439_023_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0439	023	0	1	01	01	H0439_023_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0439	023	0	1	01	01	H0439_023_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0439	023	0	1	01	01	H0439_023_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0439	024	0	1	02	01	H0439_024_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H0439	024	0	1	02	01	H0439_024_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0439	024	0	1	02	01	H0439_024_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0439	024	0	1	02	01	H0439_024_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0439	024	0	1	02	01	H0439_024_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0473	003	0	1	04	01	H0473_003_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0473	003	0	1	04	01	H0473_003_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0473	003	0	1	04	01	H0473_003_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0473	003	0	1	04	01	H0473_003_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0473	003	0	1	04	01	H0473_003_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0473	004	0	1	04	01	H0473_004_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0473	004	0	1	04	01	H0473_004_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0473	004	0	1	04	01	H0473_004_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0473	004	0	1	04	01	H0473_004_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0473	004	0	1	04	01	H0473_004_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0473	005	0	1	04	01	H0473_005_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0473	005	0	1	04	01	H0473_005_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0473	005	0	1	04	01	H0473_005_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0473	005	0	1	04	01	H0473_005_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0473	005	0	1	04	01	H0473_005_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0504	015	0	1	01	01	H0504_015_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0504	015	0	1	01	01	H0504_015_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0504	015	0	1	01	01	H0504_015_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0504	015	0	1	01	01	H0504_015_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0504	015	0	1	01	01	H0504_015_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0504	017	0	1	01	01	H0504_017_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0504	017	0	1	01	01	H0504_017_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0504	017	0	1	01	01	H0504_017_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0504	017	0	1	01	01	H0504_017_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0504	017	0	1	01	01	H0504_017_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0504	021	0	1	01	01	H0504_021_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0504	021	0	1	01	01	H0504_021_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0504	021	0	1	01	01	H0504_021_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0504	021	0	1	01	01	H0504_021_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0504	021	0	1	01	01	H0504_021_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0504	026	0	1	01	01	H0504_026_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0504	026	0	1	01	01	H0504_026_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0504	026	0	1	01	01	H0504_026_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0504	026	0	1	01	01	H0504_026_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0504	026	0	1	01	01	H0504_026_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0504	028	0	1	01	01	H0504_028_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0504	028	0	1	01	01	H0504_028_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0504	028	0	1	01	01	H0504_028_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0504	028	0	1	01	01	H0504_028_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0504	028	0	1	01	01	H0504_028_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0504	038	0	1	01	01	H0504_038_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0504	038	0	1	01	01	H0504_038_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0504	038	0	1	01	01	H0504_038_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0504	038	0	1	01	01	H0504_038_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0504	038	0	1	01	01	H0504_038_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0504	039	0	1	01	01	H0504_039_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0504	039	0	1	01	01	H0504_039_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H0504	039	0	1	01	01	H0504_039_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0504	039	0	1	01	01	H0504_039_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0504	039	0	1	01	01	H0504_039_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0504	040	0	1	01	01	H0504_040_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0504	040	0	1	01	01	H0504_040_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H0504	040	0	1	01	01	H0504_040_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0504	040	0	1	01	01	H0504_040_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0504	040	0	1	01	01	H0504_040_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0504	041	0	1	01	01	H0504_041_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0504	041	0	1	01	01	H0504_041_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0504	041	0	1	01	01	H0504_041_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0504	041	0	1	01	01	H0504_041_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0504	041	0	1	01	01	H0504_041_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0504	043	0	1	01	01	H0504_043_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0504	043	0	1	01	01	H0504_043_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H0504	043	0	1	01	01	H0504_043_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0504	043	0	1	01	01	H0504_043_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0504	043	0	1	01	01	H0504_043_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0504	047	0	1	01	01	H0504_047_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0504	047	0	1	01	01	H0504_047_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0504	047	0	1	01	01	H0504_047_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0504	047	0	1	01	01	H0504_047_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0504	047	0	1	01	01	H0504_047_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0504	050	0	1	01	01	H0504_050_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0504	050	0	1	01	01	H0504_050_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0504	050	0	1	01	01	H0504_050_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0504	050	0	1	01	01	H0504_050_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0504	050	0	1	01	01	H0504_050_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0523	022	0	1	01	01	H0523_022_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0523	022	0	1	01	01	H0523_022_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0523	022	0	1	01	01	H0523_022_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0523	022	0	1	01	01	H0523_022_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0523	022	0	1	01	01	H0523_022_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0523	065	0	1	01	01	H0523_065_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0523	065	0	1	01	01	H0523_065_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0523	065	0	1	01	01	H0523_065_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0523	065	0	1	01	01	H0523_065_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0523	065	0	1	01	01	H0523_065_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0523	070	0	1	02	01	H0523_070_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0523	070	0	1	02	01	H0523_070_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0523	070	0	1	02	01	H0523_070_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0523	070	0	1	02	01	H0523_070_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0523	070	0	1	02	01	H0523_070_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0523	073	0	1	02	01	H0523_073_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0523	073	0	1	02	01	H0523_073_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0523	073	0	1	02	01	H0523_073_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0523	073	0	1	02	01	H0523_073_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0523	073	0	1	02	01	H0523_073_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0523	074	0	1	02	01	H0523_074_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0523	074	0	1	02	01	H0523_074_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0523	074	0	1	02	01	H0523_074_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0523	074	0	1	02	01	H0523_074_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0523	074	0	1	02	01	H0523_074_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0523	075	0	1	02	01	H0523_075_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0523	075	0	1	02	01	H0523_075_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0523	075	0	1	02	01	H0523_075_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0523	075	0	1	02	01	H0523_075_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0523	075	0	1	02	01	H0523_075_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0523	083	0	1	02	01	H0523_083_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0523	083	0	1	02	01	H0523_083_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0523	083	0	1	02	01	H0523_083_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0523	083	0	1	02	01	H0523_083_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0523	083	0	1	02	01	H0523_083_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0523	085	0	1	02	01	H0523_085_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0523	085	0	1	02	01	H0523_085_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0523	085	0	1	02	01	H0523_085_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0523	085	0	1	02	01	H0523_085_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0523	085	0	1	02	01	H0523_085_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0523	086	0	1	01	01	H0523_086_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0523	086	0	1	01	01	H0523_086_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0523	086	0	1	01	01	H0523_086_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0523	086	0	1	01	01	H0523_086_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0523	086	0	1	01	01	H0523_086_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0523	088	0	1	02	01	H0523_088_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0523	088	0	1	02	01	H0523_088_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0523	088	0	1	02	01	H0523_088_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0523	088	0	1	02	01	H0523_088_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0523	088	0	1	02	01	H0523_088_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0523	089	0	1	01	01	H0523_089_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0523	089	0	1	01	01	H0523_089_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0523	089	0	1	01	01	H0523_089_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0523	089	0	1	01	01	H0523_089_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0523	089	0	1	01	01	H0523_089_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0523	091	0	1	01	01	H0523_091_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0523	091	0	1	01	01	H0523_091_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0523	091	0	1	01	01	H0523_091_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0523	091	0	1	01	01	H0523_091_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0523	091	0	1	01	01	H0523_091_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0523	092	0	1	01	01	H0523_092_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0523	092	0	1	01	01	H0523_092_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0523	092	0	1	01	01	H0523_092_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0523	092	0	1	01	01	H0523_092_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0523	092	0	1	01	01	H0523_092_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0524	003	0	1	01	01	H0524_003_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H0524	003	0	1	01	01	H0524_003_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H0524	003	0	1	01	01	H0524_003_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H0524	003	0	1	01	01	H0524_003_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H0524	003	0	1	01	01	H0524_003_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H0524	003	0	1	01	01	H0524_003_0	4			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H0524	008	0	1	01	01	H0524_008_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H0524	008	0	1	01	01	H0524_008_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H0524	008	0	1	01	01	H0524_008_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H0524	008	0	1	01	01	H0524_008_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H0524	008	0	1	01	01	H0524_008_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H0524	008	0	1	01	01	H0524_008_0	5			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H0524	013	0	1	01	01	H0524_013_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H0524	013	0	1	01	01	H0524_013_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H0524	013	0	1	01	01	H0524_013_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H0524	013	0	1	01	01	H0524_013_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H0524	013	0	1	01	01	H0524_013_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H0524	013	0	1	01	01	H0524_013_0	5			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H0524	015	0	1	01	01	H0524_015_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H0524	015	0	1	01	01	H0524_015_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H0524	015	0	1	01	01	H0524_015_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H0524	015	0	1	01	01	H0524_015_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H0524	015	0	1	01	01	H0524_015_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H0524	015	0	1	01	01	H0524_015_0	5			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H0524	031	0	1	01	01	H0524_031_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H0524	031	0	1	01	01	H0524_031_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H0524	031	0	1	01	01	H0524_031_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H0524	031	0	1	01	01	H0524_031_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H0524	031	0	1	01	01	H0524_031_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H0524	031	0	1	01	01	H0524_031_0	5			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H0524	032	0	1	01	01	H0524_032_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H0524	032	0	1	01	01	H0524_032_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H0524	032	0	1	01	01	H0524_032_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H0524	032	0	1	01	01	H0524_032_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H0524	032	0	1	01	01	H0524_032_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H0524	032	0	1	01	01	H0524_032_0	5			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H0524	033	0	1	01	01	H0524_033_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H0524	033	0	1	01	01	H0524_033_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H0524	033	0	1	01	01	H0524_033_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H0524	033	0	1	01	01	H0524_033_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H0524	033	0	1	01	01	H0524_033_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H0524	033	0	1	01	01	H0524_033_0	5			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H0524	034	0	1	01	01	H0524_034_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H0524	034	0	1	01	01	H0524_034_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H0524	034	0	1	01	01	H0524_034_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H0524	034	0	1	01	01	H0524_034_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H0524	034	0	1	01	01	H0524_034_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H0524	034	0	1	01	01	H0524_034_0	5			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H0524	035	0	1	01	01	H0524_035_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H0524	035	0	1	01	01	H0524_035_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H0524	035	0	1	01	01	H0524_035_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H0524	035	0	1	01	01	H0524_035_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H0524	035	0	1	01	01	H0524_035_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H0524	035	0	1	01	01	H0524_035_0	5			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H0524	036	0	1	01	01	H0524_036_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H0524	036	0	1	01	01	H0524_036_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H0524	036	0	1	01	01	H0524_036_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H0524	036	0	1	01	01	H0524_036_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H0524	036	0	1	01	01	H0524_036_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H0524	036	0	1	01	01	H0524_036_0	5			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H0524	037	0	1	01	01	H0524_037_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H0524	037	0	1	01	01	H0524_037_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H0524	037	0	1	01	01	H0524_037_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H0524	037	0	1	01	01	H0524_037_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H0524	037	0	1	01	01	H0524_037_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H0524	037	0	1	01	01	H0524_037_0	5			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H0524	038	0	1	01	01	H0524_038_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H0524	038	0	1	01	01	H0524_038_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H0524	038	0	1	01	01	H0524_038_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H0524	038	0	1	01	01	H0524_038_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H0524	038	0	1	01	01	H0524_038_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H0524	038	0	1	01	01	H0524_038_0	5			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H0524	039	0	1	01	01	H0524_039_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H0524	039	0	1	01	01	H0524_039_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H0524	039	0	1	01	01	H0524_039_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H0524	039	0	1	01	01	H0524_039_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H0524	039	0	1	01	01	H0524_039_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H0524	039	0	1	01	01	H0524_039_0	5			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H0524	040	0	1	01	01	H0524_040_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H0524	040	0	1	01	01	H0524_040_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H0524	040	0	1	01	01	H0524_040_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H0524	040	0	1	01	01	H0524_040_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H0524	040	0	1	01	01	H0524_040_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H0524	040	0	1	01	01	H0524_040_0	5			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H0524	041	0	1	01	01	H0524_041_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H0524	041	0	1	01	01	H0524_041_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H0524	041	0	1	01	01	H0524_041_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H0524	041	0	1	01	01	H0524_041_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H0524	041	0	1	01	01	H0524_041_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H0524	041	0	1	01	01	H0524_041_0	5			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H0524	042	0	1	01	01	H0524_042_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H0524	042	0	1	01	01	H0524_042_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H0524	042	0	1	01	01	H0524_042_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H0524	042	0	1	01	01	H0524_042_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H0524	042	0	1	01	01	H0524_042_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H0524	042	0	1	01	01	H0524_042_0	5			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H0524	043	0	1	01	01	H0524_043_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H0524	043	0	1	01	01	H0524_043_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H0524	043	0	1	01	01	H0524_043_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H0524	043	0	1	01	01	H0524_043_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H0524	043	0	1	01	01	H0524_043_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H0524	043	0	1	01	01	H0524_043_0	5			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H0524	046	0	1	01	01	H0524_046_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H0524	046	0	1	01	01	H0524_046_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H0524	046	0	1	01	01	H0524_046_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H0524	046	0	1	01	01	H0524_046_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H0524	046	0	1	01	01	H0524_046_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H0524	046	0	1	01	01	H0524_046_0	5			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H0524	051	0	1	01	01	H0524_051_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H0524	051	0	1	01	01	H0524_051_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H0524	051	0	1	01	01	H0524_051_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H0524	051	0	1	01	01	H0524_051_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H0524	051	0	1	01	01	H0524_051_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H0524	051	0	1	01	01	H0524_051_0	5			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H0524	054	0	1	01	01	H0524_054_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H0524	054	0	1	01	01	H0524_054_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H0524	054	0	1	01	01	H0524_054_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H0524	054	0	1	01	01	H0524_054_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H0524	054	0	1	01	01	H0524_054_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H0524	054	0	1	01	01	H0524_054_0	5			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H0524	059	0	1	01	01	H0524_059_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H0524	059	0	1	01	01	H0524_059_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H0524	059	0	1	01	01	H0524_059_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H0524	059	0	1	01	01	H0524_059_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H0524	059	0	1	01	01	H0524_059_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H0524	059	0	1	01	01	H0524_059_0	5			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H0524	060	0	1	01	01	H0524_060_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H0524	060	0	1	01	01	H0524_060_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H0524	060	0	1	01	01	H0524_060_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H0524	060	0	1	01	01	H0524_060_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H0524	060	0	1	01	01	H0524_060_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H0524	060	0	1	01	01	H0524_060_0	5			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H0524	061	0	1	01	01	H0524_061_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H0524	061	0	1	01	01	H0524_061_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H0524	061	0	1	01	01	H0524_061_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H0524	061	0	1	01	01	H0524_061_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H0524	061	0	1	01	01	H0524_061_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H0524	061	0	1	01	01	H0524_061_0	5			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H0524	062	0	1	01	01	H0524_062_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H0524	062	0	1	01	01	H0524_062_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H0524	062	0	1	01	01	H0524_062_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H0524	062	0	1	01	01	H0524_062_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H0524	062	0	1	01	01	H0524_062_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H0524	062	0	1	01	01	H0524_062_0	5			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H0524	063	0	1	01	01	H0524_063_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H0524	063	0	1	01	01	H0524_063_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H0524	063	0	1	01	01	H0524_063_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H0524	063	0	1	01	01	H0524_063_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H0524	063	0	1	01	01	H0524_063_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H0524	063	0	1	01	01	H0524_063_0	5			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H0524	064	0	1	01	01	H0524_064_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H0524	064	0	1	01	01	H0524_064_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H0524	064	0	1	01	01	H0524_064_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H0524	064	0	1	01	01	H0524_064_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H0524	064	0	1	01	01	H0524_064_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H0524	064	0	1	01	01	H0524_064_0	5			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H0524	065	0	1	01	01	H0524_065_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H0524	065	0	1	01	01	H0524_065_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H0524	065	0	1	01	01	H0524_065_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H0524	065	0	1	01	01	H0524_065_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H0524	065	0	1	01	01	H0524_065_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H0524	065	0	1	01	01	H0524_065_0	5			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H0524	078	0	1	01	01	H0524_078_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H0524	078	0	1	01	01	H0524_078_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H0524	078	0	1	01	01	H0524_078_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H0524	078	0	1	01	01	H0524_078_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H0524	078	0	1	01	01	H0524_078_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H0524	078	0	1	01	01	H0524_078_0	5			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H0524	081	0	1	01	01	H0524_081_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H0524	081	0	1	01	01	H0524_081_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H0524	081	0	1	01	01	H0524_081_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H0524	081	0	1	01	01	H0524_081_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H0524	081	0	1	01	01	H0524_081_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H0524	081	0	1	01	01	H0524_081_0	5			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H0524	082	0	1	01	01	H0524_082_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H0524	082	0	1	01	01	H0524_082_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H0524	082	0	1	01	01	H0524_082_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H0524	082	0	1	01	01	H0524_082_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H0524	082	0	1	01	01	H0524_082_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H0524	082	0	1	01	01	H0524_082_0	5			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H0524	083	0	1	01	01	H0524_083_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H0524	083	0	1	01	01	H0524_083_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H0524	083	0	1	01	01	H0524_083_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H0524	083	0	1	01	01	H0524_083_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H0524	083	0	1	01	01	H0524_083_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H0524	083	0	1	01	01	H0524_083_0	5			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H0543	013	0	1	02	01	H0543_013_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0543	013	0	1	02	01	H0543_013_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H0543	013	0	1	02	01	H0543_013_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0543	013	0	1	02	01	H0543_013_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0543	013	0	1	02	01	H0543_013_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0543	019	0	1	02	01	H0543_019_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0543	019	0	1	02	01	H0543_019_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H0543	019	0	1	02	01	H0543_019_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0543	019	0	1	02	01	H0543_019_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0543	019	0	1	02	01	H0543_019_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0543	035	0	1	02	01	H0543_035_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0543	035	0	1	02	01	H0543_035_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H0543	035	0	1	02	01	H0543_035_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0543	035	0	1	02	01	H0543_035_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0543	035	0	1	02	01	H0543_035_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0543	060	0	1	02	01	H0543_060_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0543	060	0	1	02	01	H0543_060_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H0543	060	0	1	02	01	H0543_060_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0543	060	0	1	02	01	H0543_060_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0543	060	0	1	02	01	H0543_060_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0543	086	0	1	02	01	H0543_086_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0543	086	0	1	02	01	H0543_086_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H0543	086	0	1	02	01	H0543_086_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0543	086	0	1	02	01	H0543_086_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0543	086	0	1	02	01	H0543_086_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0543	140	0	1	02	01	H0543_140_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0543	140	0	1	02	01	H0543_140_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H0543	140	0	1	02	01	H0543_140_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0543	140	0	1	02	01	H0543_140_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0543	140	0	1	02	01	H0543_140_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0543	145	0	1	02	01	H0543_145_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0543	145	0	1	02	01	H0543_145_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H0543	145	0	1	02	01	H0543_145_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0543	145	0	1	02	01	H0543_145_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0543	145	0	1	02	01	H0543_145_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0543	151	0	1	02	01	H0543_151_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0543	151	0	1	02	01	H0543_151_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H0543	151	0	1	02	01	H0543_151_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0543	151	0	1	02	01	H0543_151_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0543	151	0	1	02	01	H0543_151_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0543	152	0	1	02	01	H0543_152_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0543	152	0	1	02	01	H0543_152_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	5.00	
H0543	152	0	1	02	01	H0543_152_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0543	152	0	1	02	01	H0543_152_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0543	152	0	1	02	01	H0543_152_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0543	166	0	1	02	01	H0543_166_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0543	166	0	1	02	01	H0543_166_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H0543	166	0	1	02	01	H0543_166_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0543	166	0	1	02	01	H0543_166_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0543	166	0	1	02	01	H0543_166_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0543	168	0	1	02	01	H0543_168_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0543	168	0	1	02	01	H0543_168_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H0543	168	0	1	02	01	H0543_168_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0543	168	0	1	02	01	H0543_168_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0543	168	0	1	02	01	H0543_168_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0543	169	0	1	02	01	H0543_169_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0543	169	0	1	02	01	H0543_169_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H0543	169	0	1	02	01	H0543_169_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0543	169	0	1	02	01	H0543_169_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0543	169	0	1	02	01	H0543_169_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0543	170	0	1	02	01	H0543_170_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0543	170	0	1	02	01	H0543_170_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H0543	170	0	1	02	01	H0543_170_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0543	170	0	1	02	01	H0543_170_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0543	170	0	1	02	01	H0543_170_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0543	188	0	1	02	01	H0543_188_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0543	188	0	1	02	01	H0543_188_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H0543	188	0	1	02	01	H0543_188_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0543	188	0	1	02	01	H0543_188_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0543	188	0	1	02	01	H0543_188_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0543	189	0	1	02	01	H0543_189_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0543	189	0	1	02	01	H0543_189_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H0543	189	0	1	02	01	H0543_189_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0543	189	0	1	02	01	H0543_189_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0543	189	0	1	02	01	H0543_189_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0543	191	0	1	02	01	H0543_191_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0543	191	0	1	02	01	H0543_191_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H0543	191	0	1	02	01	H0543_191_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0543	191	0	1	02	01	H0543_191_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0543	191	0	1	02	01	H0543_191_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0543	193	0	1	02	01	H0543_193_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0543	193	0	1	02	01	H0543_193_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H0543	193	0	1	02	01	H0543_193_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0543	193	0	1	02	01	H0543_193_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0543	193	0	1	02	01	H0543_193_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0543	204	0	1	02	01	H0543_204_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0543	204	0	1	02	01	H0543_204_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	20.00	
H0543	204	0	1	02	01	H0543_204_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0543	204	0	1	02	01	H0543_204_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0543	204	0	1	02	01	H0543_204_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0543	214	0	1	02	01	H0543_214_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0543	214	0	1	02	01	H0543_214_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H0543	214	0	1	02	01	H0543_214_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0543	214	0	1	02	01	H0543_214_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0543	214	0	1	02	01	H0543_214_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0543	217	0	1	02	01	H0543_217_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0543	217	0	1	02	01	H0543_217_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H0543	217	0	1	02	01	H0543_217_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0543	217	0	1	02	01	H0543_217_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0543	217	0	1	02	01	H0543_217_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0543	218	0	1	02	01	H0543_218_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0543	218	0	1	02	01	H0543_218_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H0543	218	0	1	02	01	H0543_218_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0543	218	0	1	02	01	H0543_218_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0543	218	0	1	02	01	H0543_218_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0543	219	0	1	02	01	H0543_219_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0543	219	0	1	02	01	H0543_219_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H0543	219	0	1	02	01	H0543_219_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0543	219	0	1	02	01	H0543_219_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0543	219	0	1	02	01	H0543_219_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0543	220	0	1	02	01	H0543_220_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0543	220	0	1	02	01	H0543_220_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H0543	220	0	1	02	01	H0543_220_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0543	220	0	1	02	01	H0543_220_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0543	220	0	1	02	01	H0543_220_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0543	221	0	1	02	01	H0543_221_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0543	221	0	1	02	01	H0543_221_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H0543	221	0	1	02	01	H0543_221_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0543	221	0	1	02	01	H0543_221_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0543	221	0	1	02	01	H0543_221_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0543	222	0	1	02	01	H0543_222_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0543	222	0	1	02	01	H0543_222_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H0543	222	0	1	02	01	H0543_222_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0543	222	0	1	02	01	H0543_222_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0543	222	0	1	02	01	H0543_222_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0543	225	0	1	02	01	H0543_225_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0543	225	0	1	02	01	H0543_225_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H0543	225	0	1	02	01	H0543_225_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0543	225	0	1	02	01	H0543_225_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0543	225	0	1	02	01	H0543_225_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0543	226	0	1	02	01	H0543_226_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0543	226	0	1	02	01	H0543_226_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H0543	226	0	1	02	01	H0543_226_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0543	226	0	1	02	01	H0543_226_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0543	226	0	1	02	01	H0543_226_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0543	232	0	1	02	01	H0543_232_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0543	232	0	1	02	01	H0543_232_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H0543	232	0	1	02	01	H0543_232_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0543	232	0	1	02	01	H0543_232_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0543	232	0	1	02	01	H0543_232_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0543	236	0	1	02	01	H0543_236_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0543	236	0	1	02	01	H0543_236_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H0543	236	0	1	02	01	H0543_236_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0543	236	0	1	02	01	H0543_236_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0543	236	0	1	02	01	H0543_236_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0543	237	0	1	02	01	H0543_237_0	10			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0543	237	0	1	02	01	H0543_237_0	10			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H0543	237	0	1	02	01	H0543_237_0	10			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0543	237	0	1	02	01	H0543_237_0	10			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0543	237	0	1	02	01	H0543_237_0	10			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0543	238	0	1	02	01	H0543_238_0	10			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0543	238	0	1	02	01	H0543_238_0	10			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H0543	238	0	1	02	01	H0543_238_0	10			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0543	238	0	1	02	01	H0543_238_0	10			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0543	238	0	1	02	01	H0543_238_0	10			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0543	251	0	1	02	01	H0543_251_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0543	251	0	1	02	01	H0543_251_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H0543	251	0	1	02	01	H0543_251_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0543	251	0	1	02	01	H0543_251_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0543	251	0	1	02	01	H0543_251_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0543	254	0	1	02	01	H0543_254_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0543	254	0	1	02	01	H0543_254_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H0543	254	0	1	02	01	H0543_254_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0543	254	0	1	02	01	H0543_254_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0543	254	0	1	02	01	H0543_254_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0543	255	0	1	02	01	H0543_255_0	13			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0543	255	0	1	02	01	H0543_255_0	13			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H0543	255	0	1	02	01	H0543_255_0	13			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0543	255	0	1	02	01	H0543_255_0	13			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0543	255	0	1	02	01	H0543_255_0	13			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0544	002	0	1	02	01	H0544_002_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H0544	002	0	1	02	01	H0544_002_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0544	002	0	1	02	01	H0544_002_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0544	002	0	1	02	01	H0544_002_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0544	002	0	1	02	01	H0544_002_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0544	002	0	1	02	01	H0544_002_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0544	004	0	1	02	01	H0544_004_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H0544	004	0	1	02	01	H0544_004_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0544	004	0	1	02	01	H0544_004_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0544	004	0	1	02	01	H0544_004_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0544	004	0	1	02	01	H0544_004_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0544	004	0	1	02	01	H0544_004_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0544	005	0	1	01	01	H0544_005_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H0544	005	0	1	01	01	H0544_005_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0544	005	0	1	01	01	H0544_005_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0544	005	0	1	01	01	H0544_005_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0544	005	0	1	01	01	H0544_005_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0544	005	0	1	01	01	H0544_005_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0544	010	0	1	02	01	H0544_010_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H0544	010	0	1	02	01	H0544_010_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0544	010	0	1	02	01	H0544_010_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0544	010	0	1	02	01	H0544_010_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0544	010	0	1	02	01	H0544_010_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0544	010	0	1	02	01	H0544_010_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0544	014	0	1	02	01	H0544_014_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H0544	014	0	1	02	01	H0544_014_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0544	014	0	1	02	01	H0544_014_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0544	014	0	1	02	01	H0544_014_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0544	014	0	1	02	01	H0544_014_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0544	014	0	1	02	01	H0544_014_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0544	015	0	1	02	01	H0544_015_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H0544	015	0	1	02	01	H0544_015_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0544	015	0	1	02	01	H0544_015_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0544	015	0	1	02	01	H0544_015_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0544	015	0	1	02	01	H0544_015_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0544	015	0	1	02	01	H0544_015_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0544	019	0	1	02	01	H0544_019_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H0544	019	0	1	02	01	H0544_019_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0544	019	0	1	02	01	H0544_019_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0544	019	0	1	02	01	H0544_019_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0544	019	0	1	02	01	H0544_019_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0544	019	0	1	02	01	H0544_019_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0544	020	0	1	02	01	H0544_020_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H0544	020	0	1	02	01	H0544_020_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0544	020	0	1	02	01	H0544_020_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0544	020	0	1	02	01	H0544_020_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0544	020	0	1	02	01	H0544_020_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0544	020	0	1	02	01	H0544_020_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0544	056	0	1	02	01	H0544_056_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H0544	056	0	1	02	01	H0544_056_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0544	056	0	1	02	01	H0544_056_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0544	056	0	1	02	01	H0544_056_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0544	056	0	1	02	01	H0544_056_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0544	056	0	1	02	01	H0544_056_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0544	058	0	1	02	01	H0544_058_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H0544	058	0	1	02	01	H0544_058_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0544	058	0	1	02	01	H0544_058_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0544	058	0	1	02	01	H0544_058_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0544	058	0	1	02	01	H0544_058_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0544	061	0	1	02	01	H0544_061_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0544	061	0	1	02	01	H0544_061_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0544	061	0	1	02	01	H0544_061_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0544	061	0	1	02	01	H0544_061_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0544	061	0	1	02	01	H0544_061_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0544	062	0	1	02	01	H0544_062_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0544	062	0	1	02	01	H0544_062_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0544	062	0	1	02	01	H0544_062_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0544	062	0	1	02	01	H0544_062_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0544	062	0	1	02	01	H0544_062_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0544	063	0	1	02	01	H0544_063_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0544	063	0	1	02	01	H0544_063_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0544	063	0	1	02	01	H0544_063_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0544	063	0	1	02	01	H0544_063_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0544	063	0	1	02	01	H0544_063_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0544	064	0	1	02	01	H0544_064_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H0544	064	0	1	02	01	H0544_064_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0544	064	0	1	02	01	H0544_064_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0544	064	0	1	02	01	H0544_064_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0544	064	0	1	02	01	H0544_064_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0544	064	0	1	02	01	H0544_064_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0544	065	0	1	02	01	H0544_065_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H0544	065	0	1	02	01	H0544_065_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0544	065	0	1	02	01	H0544_065_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0544	065	0	1	02	01	H0544_065_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0544	065	0	1	02	01	H0544_065_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0544	065	0	1	02	01	H0544_065_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0544	066	0	1	02	01	H0544_066_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H0544	066	0	1	02	01	H0544_066_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0544	066	0	1	02	01	H0544_066_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0544	066	0	1	02	01	H0544_066_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0544	066	0	1	02	01	H0544_066_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0544	069	0	1	02	01	H0544_069_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H0544	069	0	1	02	01	H0544_069_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0544	069	0	1	02	01	H0544_069_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0544	069	0	1	02	01	H0544_069_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0544	069	0	1	02	01	H0544_069_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0544	091	0	1	02	01	H0544_091_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0544	091	0	1	02	01	H0544_091_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0544	091	0	1	02	01	H0544_091_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0544	091	0	1	02	01	H0544_091_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0544	091	0	1	02	01	H0544_091_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0544	095	0	1	02	01	H0544_095_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H0544	095	0	1	02	01	H0544_095_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0544	095	0	1	02	01	H0544_095_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0544	095	0	1	02	01	H0544_095_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0544	095	0	1	02	01	H0544_095_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0544	095	0	1	02	01	H0544_095_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0544	096	0	1	02	01	H0544_096_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0544	096	0	1	02	01	H0544_096_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0544	096	0	1	02	01	H0544_096_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0544	096	0	1	02	01	H0544_096_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0544	096	0	1	02	01	H0544_096_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0544	098	0	1	02	01	H0544_098_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0544	098	0	1	02	01	H0544_098_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0544	098	0	1	02	01	H0544_098_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0544	098	0	1	02	01	H0544_098_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0544	098	0	1	02	01	H0544_098_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0544	108	0	1	02	01	H0544_108_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H0544	108	0	1	02	01	H0544_108_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0544	108	0	1	02	01	H0544_108_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0544	108	0	1	02	01	H0544_108_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0544	108	0	1	02	01	H0544_108_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0562	012	0	1	01	01	H0562_012_0	11			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H0562	012	0	1	01	01	H0562_012_0	11			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0562	012	0	1	01	01	H0562_012_0	11			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0562	012	0	1	01	01	H0562_012_0	11			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0562	012	0	1	01	01	H0562_012_0	11			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0562	012	0	1	01	01	H0562_012_0	11			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0562	092	0	1	01	01	H0562_092_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H0562	092	0	1	01	01	H0562_092_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0562	092	0	1	01	01	H0562_092_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0562	092	0	1	01	01	H0562_092_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0562	092	0	1	01	01	H0562_092_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0562	092	0	1	01	01	H0562_092_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0562	097	0	1	01	01	H0562_097_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H0562	097	0	1	01	01	H0562_097_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0562	097	0	1	01	01	H0562_097_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0562	097	0	1	01	01	H0562_097_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0562	097	0	1	01	01	H0562_097_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0562	097	0	1	01	01	H0562_097_0	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0562	125	0	1	01	01	H0562_125_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H0562	125	0	1	01	01	H0562_125_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0562	125	0	1	01	01	H0562_125_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0562	125	0	1	01	01	H0562_125_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0562	125	0	1	01	01	H0562_125_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0562	125	0	1	01	01	H0562_125_0	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0562	126	0	1	01	01	H0562_126_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H0562	126	0	1	01	01	H0562_126_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0562	126	0	1	01	01	H0562_126_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0562	126	0	1	01	01	H0562_126_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0562	126	0	1	01	01	H0562_126_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0562	126	0	1	01	01	H0562_126_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0562	133	0	1	01	01	H0562_133_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H0562	133	0	1	01	01	H0562_133_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0562	133	0	1	01	01	H0562_133_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0562	133	0	1	01	01	H0562_133_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0562	133	0	1	01	01	H0562_133_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0562	133	0	1	01	01	H0562_133_0	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0562	136	0	1	01	01	H0562_136_0	10			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H0562	136	0	1	01	01	H0562_136_0	10			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0562	136	0	1	01	01	H0562_136_0	10			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0562	136	0	1	01	01	H0562_136_0	10			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0562	136	0	1	01	01	H0562_136_0	10			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0562	136	0	1	01	01	H0562_136_0	10			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0562	137	0	1	01	01	H0562_137_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H0562	137	0	1	01	01	H0562_137_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0562	137	0	1	01	01	H0562_137_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0562	137	0	1	01	01	H0562_137_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0562	137	0	1	01	01	H0562_137_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0562	137	0	1	01	01	H0562_137_0	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0562	138	0	1	01	01	H0562_138_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H0562	138	0	1	01	01	H0562_138_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0562	138	0	1	01	01	H0562_138_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0562	138	0	1	01	01	H0562_138_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0562	138	0	1	01	01	H0562_138_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0562	138	0	1	01	01	H0562_138_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0571	001	0	1	01	01	H0571_001_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0571	001	0	1	01	01	H0571_001_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0571	001	0	1	01	01	H0571_001_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0571	001	0	1	01	01	H0571_001_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0571	001	0	1	01	01	H0571_001_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0571	005	0	1	01	01	H0571_005_0	9		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0571	005	0	1	01	01	H0571_005_0	9		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0571	005	0	1	01	01	H0571_005_0	9		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0571	005	0	1	01	01	H0571_005_0	9		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0571	005	0	1	01	01	H0571_005_0	9		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0571	007	0	1	01	01	H0571_007_0	10			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0571	007	0	1	01	01	H0571_007_0	10			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0571	007	0	1	01	01	H0571_007_0	10			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0571	007	0	1	01	01	H0571_007_0	10			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0571	007	0	1	01	01	H0571_007_0	10			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0571	010	0	1	01	01	H0571_010_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0571	010	0	1	01	01	H0571_010_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0571	010	0	1	01	01	H0571_010_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0571	010	0	1	01	01	H0571_010_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0571	010	0	1	01	01	H0571_010_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0571	011	0	1	01	01	H0571_011_0	10			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0571	011	0	1	01	01	H0571_011_0	10			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0571	011	0	1	01	01	H0571_011_0	10			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0571	011	0	1	01	01	H0571_011_0	10			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0571	011	0	1	01	01	H0571_011_0	10			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0609	007	0	1	02	01	H0609_007_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0609	007	0	1	02	01	H0609_007_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H0609	007	0	1	02	01	H0609_007_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0609	007	0	1	02	01	H0609_007_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0609	007	0	1	02	01	H0609_007_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0609	012	0	1	02	01	H0609_012_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0609	012	0	1	02	01	H0609_012_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H0609	012	0	1	02	01	H0609_012_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0609	012	0	1	02	01	H0609_012_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0609	012	0	1	02	01	H0609_012_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0609	025	0	1	02	01	H0609_025_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0609	025	0	1	02	01	H0609_025_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H0609	025	0	1	02	01	H0609_025_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0609	025	0	1	02	01	H0609_025_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0609	025	0	1	02	01	H0609_025_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0609	026	0	1	02	01	H0609_026_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0609	026	0	1	02	01	H0609_026_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H0609	026	0	1	02	01	H0609_026_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0609	026	0	1	02	01	H0609_026_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0609	026	0	1	02	01	H0609_026_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0609	027	0	1	02	01	H0609_027_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0609	027	0	1	02	01	H0609_027_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H0609	027	0	1	02	01	H0609_027_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0609	027	0	1	02	01	H0609_027_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0609	027	0	1	02	01	H0609_027_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0609	028	0	1	02	01	H0609_028_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0609	028	0	1	02	01	H0609_028_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H0609	028	0	1	02	01	H0609_028_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0609	028	0	1	02	01	H0609_028_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0609	028	0	1	02	01	H0609_028_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0609	031	0	1	02	01	H0609_031_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0609	031	0	1	02	01	H0609_031_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H0609	031	0	1	02	01	H0609_031_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0609	031	0	1	02	01	H0609_031_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0609	031	0	1	02	01	H0609_031_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0609	032	0	1	02	01	H0609_032_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0609	032	0	1	02	01	H0609_032_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H0609	032	0	1	02	01	H0609_032_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0609	032	0	1	02	01	H0609_032_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0609	032	0	1	02	01	H0609_032_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0609	033	0	1	02	01	H0609_033_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0609	033	0	1	02	01	H0609_033_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H0609	033	0	1	02	01	H0609_033_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0609	033	0	1	02	01	H0609_033_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0609	033	0	1	02	01	H0609_033_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0609	034	1	1	02	01	H0609_034_1	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0609	034	1	1	02	01	H0609_034_1	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H0609	034	1	1	02	01	H0609_034_1	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0609	034	1	1	02	01	H0609_034_1	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0609	034	1	1	02	01	H0609_034_1	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0609	034	2	1	02	01	H0609_034_2	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0609	034	2	1	02	01	H0609_034_2	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H0609	034	2	1	02	01	H0609_034_2	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0609	034	2	1	02	01	H0609_034_2	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0609	034	2	1	02	01	H0609_034_2	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0609	036	1	1	02	01	H0609_036_1	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0609	036	1	1	02	01	H0609_036_1	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H0609	036	1	1	02	01	H0609_036_1	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0609	036	1	1	02	01	H0609_036_1	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0609	036	1	1	02	01	H0609_036_1	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0609	036	2	1	02	01	H0609_036_2	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0609	036	2	1	02	01	H0609_036_2	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H0609	036	2	1	02	01	H0609_036_2	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0609	036	2	1	02	01	H0609_036_2	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0609	036	2	1	02	01	H0609_036_2	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0609	037	0	1	02	01	H0609_037_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0609	037	0	1	02	01	H0609_037_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H0609	037	0	1	02	01	H0609_037_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0609	037	0	1	02	01	H0609_037_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0609	037	0	1	02	01	H0609_037_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0609	038	0	1	02	01	H0609_038_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0609	038	0	1	02	01	H0609_038_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	15.00	
H0609	038	0	1	02	01	H0609_038_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0609	038	0	1	02	01	H0609_038_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0609	038	0	1	02	01	H0609_038_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0609	040	0	1	02	01	H0609_040_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0609	040	0	1	02	01	H0609_040_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H0609	040	0	1	02	01	H0609_040_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0609	040	0	1	02	01	H0609_040_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0609	040	0	1	02	01	H0609_040_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0609	042	0	1	02	01	H0609_042_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0609	042	0	1	02	01	H0609_042_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H0609	042	0	1	02	01	H0609_042_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0609	042	0	1	02	01	H0609_042_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0609	042	0	1	02	01	H0609_042_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0609	043	0	1	02	01	H0609_043_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0609	043	0	1	02	01	H0609_043_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	5.00	
H0609	043	0	1	02	01	H0609_043_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0609	043	0	1	02	01	H0609_043_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0609	043	0	1	02	01	H0609_043_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0609	044	0	1	02	01	H0609_044_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0609	044	0	1	02	01	H0609_044_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H0609	044	0	1	02	01	H0609_044_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0609	044	0	1	02	01	H0609_044_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0609	044	0	1	02	01	H0609_044_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0609	045	0	1	02	01	H0609_045_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0609	045	0	1	02	01	H0609_045_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H0609	045	0	1	02	01	H0609_045_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0609	045	0	1	02	01	H0609_045_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0609	045	0	1	02	01	H0609_045_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0609	046	0	1	02	01	H0609_046_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0609	046	0	1	02	01	H0609_046_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H0609	046	0	1	02	01	H0609_046_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0609	046	0	1	02	01	H0609_046_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0609	046	0	1	02	01	H0609_046_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0609	047	0	1	02	01	H0609_047_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0609	047	0	1	02	01	H0609_047_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	5.00	
H0609	047	0	1	02	01	H0609_047_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0609	047	0	1	02	01	H0609_047_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0609	047	0	1	02	01	H0609_047_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0609	048	0	1	02	01	H0609_048_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0609	048	0	1	02	01	H0609_048_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H0609	048	0	1	02	01	H0609_048_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0609	048	0	1	02	01	H0609_048_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0609	048	0	1	02	01	H0609_048_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0609	049	0	1	02	01	H0609_049_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0609	049	0	1	02	01	H0609_049_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	5.00	
H0609	049	0	1	02	01	H0609_049_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0609	049	0	1	02	01	H0609_049_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0609	049	0	1	02	01	H0609_049_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0609	050	0	1	02	01	H0609_050_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0609	050	0	1	02	01	H0609_050_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H0609	050	0	1	02	01	H0609_050_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0609	050	0	1	02	01	H0609_050_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0609	050	0	1	02	01	H0609_050_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0609	051	0	1	02	01	H0609_051_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0609	051	0	1	02	01	H0609_051_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	7.00	
H0609	051	0	1	02	01	H0609_051_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0609	051	0	1	02	01	H0609_051_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0609	051	0	1	02	01	H0609_051_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0609	052	0	1	02	01	H0609_052_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0609	052	0	1	02	01	H0609_052_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0609	052	0	1	02	01	H0609_052_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0609	052	0	1	02	01	H0609_052_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0609	052	0	1	02	01	H0609_052_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0609	054	0	1	02	01	H0609_054_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0609	054	0	1	02	01	H0609_054_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H0609	054	0	1	02	01	H0609_054_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0609	054	0	1	02	01	H0609_054_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0609	054	0	1	02	01	H0609_054_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0609	058	0	1	02	01	H0609_058_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0609	058	0	1	02	01	H0609_058_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H0609	058	0	1	02	01	H0609_058_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0609	058	0	1	02	01	H0609_058_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0609	058	0	1	02	01	H0609_058_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0609	059	0	1	02	01	H0609_059_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0609	059	0	1	02	01	H0609_059_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H0609	059	0	1	02	01	H0609_059_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0609	059	0	1	02	01	H0609_059_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0609	059	0	1	02	01	H0609_059_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0609	060	0	1	02	01	H0609_060_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0609	060	0	1	02	01	H0609_060_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H0609	060	0	1	02	01	H0609_060_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0609	060	0	1	02	01	H0609_060_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0609	060	0	1	02	01	H0609_060_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0609	061	0	1	02	01	H0609_061_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0609	061	0	1	02	01	H0609_061_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H0609	061	0	1	02	01	H0609_061_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0609	061	0	1	02	01	H0609_061_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0609	061	0	1	02	01	H0609_061_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0609	062	0	1	02	01	H0609_062_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0609	062	0	1	02	01	H0609_062_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H0609	062	0	1	02	01	H0609_062_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0609	062	0	1	02	01	H0609_062_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0609	062	0	1	02	01	H0609_062_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0609	063	0	1	02	01	H0609_063_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0609	063	0	1	02	01	H0609_063_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H0609	063	0	1	02	01	H0609_063_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0609	063	0	1	02	01	H0609_063_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0609	063	0	1	02	01	H0609_063_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0609	065	0	1	02	01	H0609_065_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0609	065	0	1	02	01	H0609_065_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0609	065	0	1	02	01	H0609_065_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0609	065	0	1	02	01	H0609_065_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0609	065	0	1	02	01	H0609_065_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0609	066	0	1	02	01	H0609_066_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0609	066	0	1	02	01	H0609_066_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H0609	066	0	1	02	01	H0609_066_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0609	066	0	1	02	01	H0609_066_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0609	066	0	1	02	01	H0609_066_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0609	067	0	1	02	01	H0609_067_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0609	067	0	1	02	01	H0609_067_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H0609	067	0	1	02	01	H0609_067_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0609	067	0	1	02	01	H0609_067_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0609	067	0	1	02	01	H0609_067_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0609	068	0	1	02	01	H0609_068_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0609	068	0	1	02	01	H0609_068_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H0609	068	0	1	02	01	H0609_068_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0609	068	0	1	02	01	H0609_068_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0609	068	0	1	02	01	H0609_068_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0609	070	0	1	02	01	H0609_070_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0609	070	0	1	02	01	H0609_070_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H0609	070	0	1	02	01	H0609_070_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0609	070	0	1	02	01	H0609_070_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0609	070	0	1	02	01	H0609_070_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0609	071	0	1	02	01	H0609_071_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0609	071	0	1	02	01	H0609_071_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H0609	071	0	1	02	01	H0609_071_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0609	071	0	1	02	01	H0609_071_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0609	071	0	1	02	01	H0609_071_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0609	072	0	1	02	01	H0609_072_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0609	072	0	1	02	01	H0609_072_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	5.00	
H0609	072	0	1	02	01	H0609_072_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0609	072	0	1	02	01	H0609_072_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0609	072	0	1	02	01	H0609_072_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0609	073	0	1	02	01	H0609_073_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0609	073	0	1	02	01	H0609_073_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H0609	073	0	1	02	01	H0609_073_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0609	073	0	1	02	01	H0609_073_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0609	073	0	1	02	01	H0609_073_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0609	075	0	1	02	01	H0609_075_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0609	075	0	1	02	01	H0609_075_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	15.00	
H0609	075	0	1	02	01	H0609_075_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0609	075	0	1	02	01	H0609_075_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0609	075	0	1	02	01	H0609_075_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0609	076	0	1	02	01	H0609_076_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0609	076	0	1	02	01	H0609_076_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0609	076	0	1	02	01	H0609_076_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0609	076	0	1	02	01	H0609_076_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0609	076	0	1	02	01	H0609_076_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0609	077	0	1	02	01	H0609_077_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0609	077	0	1	02	01	H0609_077_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H0609	077	0	1	02	01	H0609_077_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0609	077	0	1	02	01	H0609_077_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0609	077	0	1	02	01	H0609_077_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0609	078	0	1	02	01	H0609_078_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0609	078	0	1	02	01	H0609_078_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H0609	078	0	1	02	01	H0609_078_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0609	078	0	1	02	01	H0609_078_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0609	078	0	1	02	01	H0609_078_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0609	079	0	1	02	01	H0609_079_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0609	079	0	1	02	01	H0609_079_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H0609	079	0	1	02	01	H0609_079_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0609	079	0	1	02	01	H0609_079_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0609	079	0	1	02	01	H0609_079_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0609	080	0	1	02	01	H0609_080_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0609	080	0	1	02	01	H0609_080_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H0609	080	0	1	02	01	H0609_080_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0609	080	0	1	02	01	H0609_080_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0609	080	0	1	02	01	H0609_080_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0624	001	0	1	02	01	H0624_001_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0624	001	0	1	02	01	H0624_001_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0624	001	0	1	02	01	H0624_001_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0624	001	0	1	02	01	H0624_001_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0624	001	0	1	02	01	H0624_001_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0624	006	0	1	02	01	H0624_006_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0624	006	0	1	02	01	H0624_006_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0624	006	0	1	02	01	H0624_006_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0624	006	0	1	02	01	H0624_006_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0624	006	0	1	02	01	H0624_006_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0628	001	0	1	02	01	H0628_001_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0628	001	0	1	02	01	H0628_001_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0628	001	0	1	02	01	H0628_001_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0628	001	0	1	02	01	H0628_001_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0628	001	0	1	02	01	H0628_001_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0628	003	0	1	02	01	H0628_003_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0628	003	0	1	02	01	H0628_003_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0628	003	0	1	02	01	H0628_003_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0628	003	0	1	02	01	H0628_003_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0628	003	0	1	02	01	H0628_003_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0628	005	0	1	02	01	H0628_005_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0628	005	0	1	02	01	H0628_005_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0628	005	0	1	02	01	H0628_005_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0628	005	0	1	02	01	H0628_005_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0628	005	0	1	02	01	H0628_005_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0628	007	0	1	02	01	H0628_007_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0628	007	0	1	02	01	H0628_007_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0628	007	0	1	02	01	H0628_007_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0628	007	0	1	02	01	H0628_007_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0628	007	0	1	02	01	H0628_007_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0628	008	0	1	02	01	H0628_008_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0628	008	0	1	02	01	H0628_008_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0628	008	0	1	02	01	H0628_008_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0628	008	0	1	02	01	H0628_008_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0628	008	0	1	02	01	H0628_008_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0628	010	0	1	02	01	H0628_010_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0628	010	0	1	02	01	H0628_010_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0628	010	0	1	02	01	H0628_010_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0628	010	0	1	02	01	H0628_010_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0628	010	0	1	02	01	H0628_010_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0628	012	0	1	01	01	H0628_012_0	2		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0628	012	0	1	01	01	H0628_012_0	2		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0628	012	0	1	01	01	H0628_012_0	2		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0628	012	0	1	01	01	H0628_012_0	2		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0628	012	0	1	01	01	H0628_012_0	2		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0628	013	0	1	01	01	H0628_013_0	2		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0628	013	0	1	01	01	H0628_013_0	2		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0628	013	0	1	01	01	H0628_013_0	2		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0628	013	0	1	01	01	H0628_013_0	2		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0628	013	0	1	01	01	H0628_013_0	2		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0628	017	0	1	02	01	H0628_017_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0628	017	0	1	02	01	H0628_017_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0628	017	0	1	02	01	H0628_017_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0628	017	0	1	02	01	H0628_017_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0628	017	0	1	02	01	H0628_017_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0628	019	0	1	02	01	H0628_019_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0628	019	0	1	02	01	H0628_019_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0628	019	0	1	02	01	H0628_019_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0628	019	0	1	02	01	H0628_019_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0628	019	0	1	02	01	H0628_019_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0628	021	0	1	02	01	H0628_021_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0628	021	0	1	02	01	H0628_021_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0628	021	0	1	02	01	H0628_021_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0628	021	0	1	02	01	H0628_021_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0628	021	0	1	02	01	H0628_021_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0628	024	0	1	02	01	H0628_024_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0628	024	0	1	02	01	H0628_024_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0628	024	0	1	02	01	H0628_024_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0628	024	0	1	02	01	H0628_024_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0628	024	0	1	02	01	H0628_024_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0628	027	0	1	02	01	H0628_027_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0628	027	0	1	02	01	H0628_027_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0628	027	0	1	02	01	H0628_027_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0628	027	0	1	02	01	H0628_027_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0628	027	0	1	02	01	H0628_027_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0628	031	0	1	01	01	H0628_031_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0628	031	0	1	01	01	H0628_031_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0628	031	0	1	01	01	H0628_031_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0628	031	0	1	01	01	H0628_031_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0628	031	0	1	01	01	H0628_031_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0628	032	0	1	01	01	H0628_032_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0628	032	0	1	01	01	H0628_032_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0628	032	0	1	01	01	H0628_032_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0628	032	0	1	01	01	H0628_032_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0628	032	0	1	01	01	H0628_032_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0628	033	0	1	01	01	H0628_033_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0628	033	0	1	01	01	H0628_033_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0628	033	0	1	01	01	H0628_033_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0628	033	0	1	01	01	H0628_033_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0628	033	0	1	01	01	H0628_033_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0628	034	0	1	01	01	H0628_034_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0628	034	0	1	01	01	H0628_034_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0628	034	0	1	01	01	H0628_034_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0628	034	0	1	01	01	H0628_034_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0628	034	0	1	01	01	H0628_034_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0628	035	0	1	01	01	H0628_035_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0628	035	0	1	01	01	H0628_035_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0628	035	0	1	01	01	H0628_035_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0628	035	0	1	01	01	H0628_035_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0628	035	0	1	01	01	H0628_035_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0628	036	0	1	01	01	H0628_036_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0628	036	0	1	01	01	H0628_036_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0628	036	0	1	01	01	H0628_036_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0628	036	0	1	01	01	H0628_036_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0628	036	0	1	01	01	H0628_036_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0628	037	0	1	01	01	H0628_037_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0628	037	0	1	01	01	H0628_037_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0628	037	0	1	01	01	H0628_037_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0628	037	0	1	01	01	H0628_037_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0628	037	0	1	01	01	H0628_037_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0628	038	0	1	01	01	H0628_038_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0628	038	0	1	01	01	H0628_038_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0628	038	0	1	01	01	H0628_038_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0628	038	0	1	01	01	H0628_038_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0628	038	0	1	01	01	H0628_038_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0628	039	0	1	01	01	H0628_039_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0628	039	0	1	01	01	H0628_039_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0628	039	0	1	01	01	H0628_039_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0628	039	0	1	01	01	H0628_039_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0628	039	0	1	01	01	H0628_039_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0628	040	0	1	01	01	H0628_040_0	2		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0628	040	0	1	01	01	H0628_040_0	2		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0628	040	0	1	01	01	H0628_040_0	2		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0628	040	0	1	01	01	H0628_040_0	2		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0628	040	0	1	01	01	H0628_040_0	2		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0628	041	0	1	01	01	H0628_041_0	2		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0628	041	0	1	01	01	H0628_041_0	2		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0628	041	0	1	01	01	H0628_041_0	2		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0628	041	0	1	01	01	H0628_041_0	2		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0628	041	0	1	01	01	H0628_041_0	2		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0629	001	0	1	01	01	H0629_001_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H0629	001	0	1	01	01	H0629_001_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0629	001	0	1	01	01	H0629_001_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0629	001	0	1	01	01	H0629_001_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0629	001	0	1	01	01	H0629_001_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0629	001	0	1	01	01	H0629_001_0	5		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0629	002	0	1	01	01	H0629_002_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H0629	002	0	1	01	01	H0629_002_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0629	002	0	1	01	01	H0629_002_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0629	002	0	1	01	01	H0629_002_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0629	002	0	1	01	01	H0629_002_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0629	002	0	1	01	01	H0629_002_0	5		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0629	003	0	1	01	01	H0629_003_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H0629	003	0	1	01	01	H0629_003_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0629	003	0	1	01	01	H0629_003_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0629	003	0	1	01	01	H0629_003_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0629	003	0	1	01	01	H0629_003_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0629	003	0	1	01	01	H0629_003_0	5		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0629	004	0	1	01	01	H0629_004_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H0629	004	0	1	01	01	H0629_004_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0629	004	0	1	01	01	H0629_004_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0629	004	0	1	01	01	H0629_004_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0629	004	0	1	01	01	H0629_004_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0629	004	0	1	01	01	H0629_004_0	5		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0630	013	0	1	01	01	H0630_013_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H0630	013	0	1	01	01	H0630_013_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H0630	013	0	1	01	01	H0630_013_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H0630	013	0	1	01	01	H0630_013_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H0630	013	0	1	01	01	H0630_013_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H0630	013	0	1	01	01	H0630_013_0	5			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H0630	014	0	1	01	01	H0630_014_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H0630	014	0	1	01	01	H0630_014_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H0630	014	0	1	01	01	H0630_014_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H0630	014	0	1	01	01	H0630_014_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H0630	014	0	1	01	01	H0630_014_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H0630	014	0	1	01	01	H0630_014_0	5		N	Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H0630	015	0	1	02	01	H0630_015_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H0630	015	0	1	02	01	H0630_015_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H0630	015	0	1	02	01	H0630_015_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H0630	015	0	1	02	01	H0630_015_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H0630	015	0	1	02	01	H0630_015_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H0630	015	0	1	02	01	H0630_015_0	5			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H0630	016	0	1	02	01	H0630_016_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H0630	016	0	1	02	01	H0630_016_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H0630	016	0	1	02	01	H0630_016_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H0630	016	0	1	02	01	H0630_016_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H0630	016	0	1	02	01	H0630_016_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H0630	016	0	1	02	01	H0630_016_0	6			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H0630	017	0	1	01	01	H0630_017_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H0630	017	0	1	01	01	H0630_017_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H0630	017	0	1	01	01	H0630_017_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H0630	017	0	1	01	01	H0630_017_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H0630	017	0	1	01	01	H0630_017_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H0630	017	0	1	01	01	H0630_017_0	5			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H0630	020	0	1	01	01	H0630_020_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H0630	020	0	1	01	01	H0630_020_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H0630	020	0	1	01	01	H0630_020_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H0630	020	0	1	01	01	H0630_020_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H0630	020	0	1	01	01	H0630_020_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H0630	020	0	1	01	01	H0630_020_0	5			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H0630	021	0	1	02	01	H0630_021_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H0630	021	0	1	02	01	H0630_021_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H0630	021	0	1	02	01	H0630_021_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H0630	021	0	1	02	01	H0630_021_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H0630	021	0	1	02	01	H0630_021_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H0630	021	0	1	02	01	H0630_021_0	5			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H0630	023	0	1	02	01	H0630_023_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H0630	023	0	1	02	01	H0630_023_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H0630	023	0	1	02	01	H0630_023_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H0630	023	0	1	02	01	H0630_023_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H0630	023	0	1	02	01	H0630_023_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H0630	023	0	1	02	01	H0630_023_0	5			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H0630	024	0	1	01	01	H0630_024_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H0630	024	0	1	01	01	H0630_024_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H0630	024	0	1	01	01	H0630_024_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H0630	024	0	1	01	01	H0630_024_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H0630	024	0	1	01	01	H0630_024_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H0630	024	0	1	01	01	H0630_024_0	5		N	Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H0630	025	0	1	02	01	H0630_025_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H0630	025	0	1	02	01	H0630_025_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H0630	025	0	1	02	01	H0630_025_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H0630	025	0	1	02	01	H0630_025_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H0630	025	0	1	02	01	H0630_025_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H0630	025	0	1	02	01	H0630_025_0	5			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H0630	027	0	1	01	01	H0630_027_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H0630	027	0	1	01	01	H0630_027_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H0630	027	0	1	01	01	H0630_027_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H0630	027	0	1	01	01	H0630_027_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H0630	027	0	1	01	01	H0630_027_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H0630	027	0	1	01	01	H0630_027_0	5		N	Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H0672	005	0	1	01	01	H0672_005_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H0672	005	0	1	01	01	H0672_005_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0672	005	0	1	01	01	H0672_005_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0672	005	0	1	01	01	H0672_005_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0672	005	0	1	01	01	H0672_005_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0672	006	0	1	01	01	H0672_006_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	5.00	
H0672	006	0	1	01	01	H0672_006_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0672	006	0	1	01	01	H0672_006_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0672	006	0	1	01	01	H0672_006_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0672	006	0	1	01	01	H0672_006_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0672	009	0	1	01	01	H0672_009_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0672	009	0	1	01	01	H0672_009_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0672	009	0	1	01	01	H0672_009_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0672	009	0	1	01	01	H0672_009_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0672	009	0	1	01	01	H0672_009_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0672	010	0	1	01	01	H0672_010_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0672	010	0	1	01	01	H0672_010_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0672	010	0	1	01	01	H0672_010_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0672	010	0	1	01	01	H0672_010_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0672	010	0	1	01	01	H0672_010_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0672	013	0	1	01	01	H0672_013_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	5.00	
H0672	013	0	1	01	01	H0672_013_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0672	013	0	1	01	01	H0672_013_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0672	013	0	1	01	01	H0672_013_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0672	013	0	1	01	01	H0672_013_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0672	015	0	1	01	01	H0672_015_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0672	015	0	1	01	01	H0672_015_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0672	015	0	1	01	01	H0672_015_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0672	015	0	1	01	01	H0672_015_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0672	015	0	1	01	01	H0672_015_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0672	016	0	1	01	01	H0672_016_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	5.00	
H0672	016	0	1	01	01	H0672_016_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0672	016	0	1	01	01	H0672_016_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0672	016	0	1	01	01	H0672_016_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0672	016	0	1	01	01	H0672_016_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0672	017	0	1	01	01	H0672_017_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	5.00	
H0672	017	0	1	01	01	H0672_017_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0672	017	0	1	01	01	H0672_017_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0672	017	0	1	01	01	H0672_017_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0672	017	0	1	01	01	H0672_017_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0672	018	0	1	01	01	H0672_018_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0672	018	0	1	01	01	H0672_018_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0672	018	0	1	01	01	H0672_018_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0672	018	0	1	01	01	H0672_018_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0672	018	0	1	01	01	H0672_018_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0672	024	0	1	01	01	H0672_024_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	9.00	
H0672	024	0	1	01	01	H0672_024_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0672	024	0	1	01	01	H0672_024_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0672	024	0	1	01	01	H0672_024_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0672	024	0	1	01	01	H0672_024_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0710	030	0	1	04	01	H0710_030_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0710	030	0	1	04	01	H0710_030_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H0710	030	0	1	04	01	H0710_030_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0710	030	0	1	04	01	H0710_030_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0710	030	0	1	04	01	H0710_030_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0710	037	0	1	04	01	H0710_037_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0710	037	0	1	04	01	H0710_037_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H0710	037	0	1	04	01	H0710_037_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0710	037	0	1	04	01	H0710_037_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0710	037	0	1	04	01	H0710_037_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0710	057	0	1	04	01	H0710_057_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0710	057	0	1	04	01	H0710_057_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H0710	057	0	1	04	01	H0710_057_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0710	057	0	1	04	01	H0710_057_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0710	057	0	1	04	01	H0710_057_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0712	005	0	1	02	01	H0712_005_0	9		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H0712	005	0	1	02	01	H0712_005_0	9		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0712	005	0	1	02	01	H0712_005_0	9		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0712	005	0	1	02	01	H0712_005_0	9		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0712	005	0	1	02	01	H0712_005_0	9		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0712	005	0	1	02	01	H0712_005_0	9		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0712	019	0	1	02	01	H0712_019_0	10			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H0712	019	0	1	02	01	H0712_019_0	10			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0712	019	0	1	02	01	H0712_019_0	10			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0712	019	0	1	02	01	H0712_019_0	10			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0712	019	0	1	02	01	H0712_019_0	10			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0712	019	0	1	02	01	H0712_019_0	10			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0712	029	0	1	01	01	H0712_029_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H0712	029	0	1	01	01	H0712_029_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0712	029	0	1	01	01	H0712_029_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0712	029	0	1	01	01	H0712_029_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0712	029	0	1	01	01	H0712_029_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0712	029	0	1	01	01	H0712_029_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0712	032	0	1	02	01	H0712_032_0	10			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H0712	032	0	1	02	01	H0712_032_0	10			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0712	032	0	1	02	01	H0712_032_0	10			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0712	032	0	1	02	01	H0712_032_0	10			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0712	032	0	1	02	01	H0712_032_0	10			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0712	032	0	1	02	01	H0712_032_0	10			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0738	001	0	1	01	01	H0738_001_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H0738	001	0	1	01	01	H0738_001_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H0738	001	0	1	01	01	H0738_001_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H0738	001	0	1	01	01	H0738_001_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0738	001	0	1	01	01	H0738_001_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0738	001	0	1	01	01	H0738_001_0	6		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H0738	002	0	1	01	01	H0738_002_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H0738	002	0	1	01	01	H0738_002_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H0738	002	0	1	01	01	H0738_002_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H0738	002	0	1	01	01	H0738_002_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0738	002	0	1	01	01	H0738_002_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0738	002	0	1	01	01	H0738_002_0	6		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H0755	030	0	1	02	01	H0755_030_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0755	030	0	1	02	01	H0755_030_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H0755	030	0	1	02	01	H0755_030_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0755	030	0	1	02	01	H0755_030_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0755	030	0	1	02	01	H0755_030_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0755	031	0	1	02	01	H0755_031_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0755	031	0	1	02	01	H0755_031_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H0755	031	0	1	02	01	H0755_031_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0755	031	0	1	02	01	H0755_031_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0755	031	0	1	02	01	H0755_031_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0755	033	0	1	02	01	H0755_033_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0755	033	0	1	02	01	H0755_033_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H0755	033	0	1	02	01	H0755_033_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0755	033	0	1	02	01	H0755_033_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0755	033	0	1	02	01	H0755_033_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0755	038	0	1	02	01	H0755_038_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0755	038	0	1	02	01	H0755_038_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H0755	038	0	1	02	01	H0755_038_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0755	038	0	1	02	01	H0755_038_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0755	038	0	1	02	01	H0755_038_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0755	044	0	1	02	01	H0755_044_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0755	044	0	1	02	01	H0755_044_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H0755	044	0	1	02	01	H0755_044_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0755	044	0	1	02	01	H0755_044_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0755	044	0	1	02	01	H0755_044_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0755	045	0	1	02	01	H0755_045_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0755	045	0	1	02	01	H0755_045_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H0755	045	0	1	02	01	H0755_045_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0755	045	0	1	02	01	H0755_045_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0755	045	0	1	02	01	H0755_045_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0755	046	0	1	02	01	H0755_046_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0755	046	0	1	02	01	H0755_046_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H0755	046	0	1	02	01	H0755_046_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0755	046	0	1	02	01	H0755_046_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0755	046	0	1	02	01	H0755_046_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0764	001	0	1	04	01	H0764_001_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H0764	001	0	1	04	01	H0764_001_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H0764	001	0	1	04	01	H0764_001_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0764	001	0	1	04	01	H0764_001_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0764	001	0	1	04	01	H0764_001_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0783	004	0	1	01	01	H0783_004_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0783	004	0	1	01	01	H0783_004_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0783	004	0	1	01	01	H0783_004_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0783	004	0	1	01	01	H0783_004_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0783	004	0	1	01	01	H0783_004_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0816	001	0	1	02	01	H0816_001_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H0816	001	0	1	02	01	H0816_001_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0816	001	0	1	02	01	H0816_001_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0816	001	0	1	02	01	H0816_001_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0816	001	0	1	02	01	H0816_001_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0816	001	0	1	02	01	H0816_001_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0816	002	0	1	02	01	H0816_002_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H0816	002	0	1	02	01	H0816_002_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0816	002	0	1	02	01	H0816_002_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0816	002	0	1	02	01	H0816_002_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0816	002	0	1	02	01	H0816_002_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0816	002	0	1	02	01	H0816_002_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0885	001	0	1	04	01	H0885_001_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H0885	001	0	1	04	01	H0885_001_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	3	2	0.00	
H0885	001	0	1	04	01	H0885_001_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0885	001	0	1	04	01	H0885_001_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0885	001	0	1	04	01	H0885_001_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0885	001	0	1	04	01	H0885_001_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H0885	002	0	1	04	01	H0885_002_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H0885	002	0	1	04	01	H0885_002_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	3	2	0.00	
H0885	002	0	1	04	01	H0885_002_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0885	002	0	1	04	01	H0885_002_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0885	002	0	1	04	01	H0885_002_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0885	002	0	1	04	01	H0885_002_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H0885	003	0	1	04	01	H0885_003_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H0885	003	0	1	04	01	H0885_003_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	3	2	0.00	
H0885	003	0	1	04	01	H0885_003_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0885	003	0	1	04	01	H0885_003_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0885	003	0	1	04	01	H0885_003_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0885	003	0	1	04	01	H0885_003_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H0885	005	0	1	04	01	H0885_005_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H0885	005	0	1	04	01	H0885_005_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	3	2	0.00	
H0885	005	0	1	04	01	H0885_005_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0885	005	0	1	04	01	H0885_005_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0885	005	0	1	04	01	H0885_005_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0885	005	0	1	04	01	H0885_005_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H0885	006	0	1	04	01	H0885_006_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H0885	006	0	1	04	01	H0885_006_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	3	2	0.00	
H0885	006	0	1	04	01	H0885_006_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0885	006	0	1	04	01	H0885_006_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0885	006	0	1	04	01	H0885_006_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0885	006	0	1	04	01	H0885_006_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H0885	007	0	1	04	01	H0885_007_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H0885	007	0	1	04	01	H0885_007_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	3	2	0.00	
H0885	007	0	1	04	01	H0885_007_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0885	007	0	1	04	01	H0885_007_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0885	007	0	1	04	01	H0885_007_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0885	007	0	1	04	01	H0885_007_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H0885	008	0	1	04	01	H0885_008_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H0885	008	0	1	04	01	H0885_008_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	3	2	0.00	
H0885	008	0	1	04	01	H0885_008_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0885	008	0	1	04	01	H0885_008_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0885	008	0	1	04	01	H0885_008_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0885	008	0	1	04	01	H0885_008_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H0885	009	0	1	04	01	H0885_009_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H0885	009	0	1	04	01	H0885_009_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	3	2	0.00	
H0885	009	0	1	04	01	H0885_009_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0885	009	0	1	04	01	H0885_009_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0885	009	0	1	04	01	H0885_009_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0885	009	0	1	04	01	H0885_009_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H0907	001	0	1	02	01	H0907_001_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H0907	001	0	1	02	01	H0907_001_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0907	001	0	1	02	01	H0907_001_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0907	001	0	1	02	01	H0907_001_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0907	001	0	1	02	01	H0907_001_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0907	001	0	1	02	01	H0907_001_0	4		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0907	003	0	1	02	01	H0907_003_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H0907	003	0	1	02	01	H0907_003_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0907	003	0	1	02	01	H0907_003_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0907	003	0	1	02	01	H0907_003_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0907	003	0	1	02	01	H0907_003_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0907	003	0	1	02	01	H0907_003_0	4		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0908	001	0	1	02	01	H0908_001_0	9		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H0908	001	0	1	02	01	H0908_001_0	9		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0908	001	0	1	02	01	H0908_001_0	9		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0908	001	0	1	02	01	H0908_001_0	9		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0908	001	0	1	02	01	H0908_001_0	9		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0908	001	0	1	02	01	H0908_001_0	9		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0908	003	0	1	02	01	H0908_003_0	10			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H0908	003	0	1	02	01	H0908_003_0	10			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0908	003	0	1	02	01	H0908_003_0	10			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0908	003	0	1	02	01	H0908_003_0	10			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0908	003	0	1	02	01	H0908_003_0	10			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0908	003	0	1	02	01	H0908_003_0	10			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0908	004	0	1	02	01	H0908_004_0	10			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H0908	004	0	1	02	01	H0908_004_0	10			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0908	004	0	1	02	01	H0908_004_0	10			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0908	004	0	1	02	01	H0908_004_0	10			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0908	004	0	1	02	01	H0908_004_0	10			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0908	004	0	1	02	01	H0908_004_0	10			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0908	006	0	1	02	01	H0908_006_0	9		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H0908	006	0	1	02	01	H0908_006_0	9		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0908	006	0	1	02	01	H0908_006_0	9		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0908	006	0	1	02	01	H0908_006_0	9		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0908	006	0	1	02	01	H0908_006_0	9		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0908	006	0	1	02	01	H0908_006_0	9		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0908	007	0	1	02	01	H0908_007_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H0908	007	0	1	02	01	H0908_007_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0908	007	0	1	02	01	H0908_007_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0908	007	0	1	02	01	H0908_007_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0908	007	0	1	02	01	H0908_007_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0908	007	0	1	02	01	H0908_007_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0908	008	0	1	02	01	H0908_008_0	14		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H0908	008	0	1	02	01	H0908_008_0	14		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0908	008	0	1	02	01	H0908_008_0	14		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0908	008	0	1	02	01	H0908_008_0	14		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0908	008	0	1	02	01	H0908_008_0	14		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0908	008	0	1	02	01	H0908_008_0	14		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0913	002	0	1	02	01	H0913_002_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H0913	002	0	1	02	01	H0913_002_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0913	002	0	1	02	01	H0913_002_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0913	002	0	1	02	01	H0913_002_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0913	002	0	1	02	01	H0913_002_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0913	002	0	1	02	01	H0913_002_0	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0913	013	0	1	01	01	H0913_013_0	7		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H0913	013	0	1	01	01	H0913_013_0	7		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0913	013	0	1	01	01	H0913_013_0	7		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0913	013	0	1	01	01	H0913_013_0	7		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0913	013	0	1	01	01	H0913_013_0	7		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0913	013	0	1	01	01	H0913_013_0	7		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0913	015	0	1	02	01	H0913_015_0	9			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H0913	015	0	1	02	01	H0913_015_0	9			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0913	015	0	1	02	01	H0913_015_0	9			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0913	015	0	1	02	01	H0913_015_0	9			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0913	015	0	1	02	01	H0913_015_0	9			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0913	015	0	1	02	01	H0913_015_0	9			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0913	021	0	1	02	01	H0913_021_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H0913	021	0	1	02	01	H0913_021_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0913	021	0	1	02	01	H0913_021_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0913	021	0	1	02	01	H0913_021_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0913	021	0	1	02	01	H0913_021_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0913	021	0	1	02	01	H0913_021_0	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0913	022	0	1	02	01	H0913_022_0	10			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H0913	022	0	1	02	01	H0913_022_0	10			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H0913	022	0	1	02	01	H0913_022_0	10			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H0913	022	0	1	02	01	H0913_022_0	10			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H0913	022	0	1	02	01	H0913_022_0	10			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H0913	022	0	1	02	01	H0913_022_0	10			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H0963	001	0	1	01	01	H0963_001_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0963	001	0	1	01	01	H0963_001_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0963	001	0	1	01	01	H0963_001_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0963	001	0	1	01	01	H0963_001_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0963	001	0	1	01	01	H0963_001_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0976	001	0	1	01	01	H0976_001_0	10		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0976	001	0	1	01	01	H0976_001_0	10		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0976	001	0	1	01	01	H0976_001_0	10		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0976	001	0	1	01	01	H0976_001_0	10		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0976	001	0	1	01	01	H0976_001_0	10		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0976	002	0	1	01	01	H0976_002_0	9		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0976	002	0	1	01	01	H0976_002_0	9		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0976	002	0	1	01	01	H0976_002_0	9		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0976	002	0	1	01	01	H0976_002_0	9		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0976	002	0	1	01	01	H0976_002_0	9		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0978	001	0	1	01	01	H0978_001_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H0978	001	0	1	01	01	H0978_001_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0978	001	0	1	01	01	H0978_001_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0978	001	0	1	01	01	H0978_001_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0978	001	0	1	01	01	H0978_001_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0978	002	0	1	01	01	H0978_002_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0978	002	0	1	01	01	H0978_002_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0978	002	0	1	01	01	H0978_002_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0978	002	0	1	01	01	H0978_002_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0978	002	0	1	01	01	H0978_002_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0978	010	0	1	01	01	H0978_010_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H0978	010	0	1	01	01	H0978_010_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0978	010	0	1	01	01	H0978_010_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0978	010	0	1	01	01	H0978_010_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0978	010	0	1	01	01	H0978_010_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0978	011	0	1	01	01	H0978_011_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H0978	011	0	1	01	01	H0978_011_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H0978	011	0	1	01	01	H0978_011_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H0978	011	0	1	01	01	H0978_011_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H0978	011	0	1	01	01	H0978_011_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H0982	002	0	1	01	01	H0982_002_0	13		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H0982	002	0	1	01	01	H0982_002_0	13		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	01	1	2	0.00	
H0982	002	0	1	01	01	H0982_002_0	13		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H0982	002	0	1	01	01	H0982_002_0	13		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H0982	002	0	1	01	01	H0982_002_0	13		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H0982	002	0	1	01	01	H0982_002_0	13		N	Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H0982	007	0	1	01	01	H0982_007_0	12			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H0982	007	0	1	01	01	H0982_007_0	12			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	01	1	2	0.00	
H0982	007	0	1	01	01	H0982_007_0	12			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H0982	007	0	1	01	01	H0982_007_0	12			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H0982	007	0	1	01	01	H0982_007_0	12			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H0982	007	0	1	01	01	H0982_007_0	12			Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H0982	008	0	1	01	01	H0982_008_0	10			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H0982	008	0	1	01	01	H0982_008_0	10			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	01	1	2	0.00	
H0982	008	0	1	01	01	H0982_008_0	10			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H0982	008	0	1	01	01	H0982_008_0	10			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H0982	008	0	1	01	01	H0982_008_0	10			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H0982	008	0	1	01	01	H0982_008_0	10			Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H0982	009	0	1	01	01	H0982_009_0	10			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H0982	009	0	1	01	01	H0982_009_0	10			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	01	1	2	0.00	
H0982	009	0	1	01	01	H0982_009_0	10			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H0982	009	0	1	01	01	H0982_009_0	10			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H0982	009	0	1	01	01	H0982_009_0	10			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H0982	009	0	1	01	01	H0982_009_0	10			Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H0982	010	0	1	01	01	H0982_010_0	10		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H0982	010	0	1	01	01	H0982_010_0	10		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	01	1	2	0.00	
H0982	010	0	1	01	01	H0982_010_0	10		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H0982	010	0	1	01	01	H0982_010_0	10		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H0982	010	0	1	01	01	H0982_010_0	10		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H0982	010	0	1	01	01	H0982_010_0	10		N	Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H0982	012	0	1	01	01	H0982_012_0	10		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H0982	012	0	1	01	01	H0982_012_0	10		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	01	1	2	0.00	
H0982	012	0	1	01	01	H0982_012_0	10		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H0982	012	0	1	01	01	H0982_012_0	10		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H0982	012	0	1	01	01	H0982_012_0	10		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H0982	012	0	1	01	01	H0982_012_0	10		N	Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H0982	013	0	1	01	01	H0982_013_0	10		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H0982	013	0	1	01	01	H0982_013_0	10		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	01	1	2	0.00	
H0982	013	0	1	01	01	H0982_013_0	10		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H0982	013	0	1	01	01	H0982_013_0	10		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H0982	013	0	1	01	01	H0982_013_0	10		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H0982	013	0	1	01	01	H0982_013_0	10		N	Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H0982	016	0	1	01	01	H0982_016_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H0982	016	0	1	01	01	H0982_016_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	01	1	2	0.00	
H0982	016	0	1	01	01	H0982_016_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H0982	016	0	1	01	01	H0982_016_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H0982	016	0	1	01	01	H0982_016_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H0982	016	0	1	01	01	H0982_016_0	9			Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H0982	017	0	1	01	01	H0982_017_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H0982	017	0	1	01	01	H0982_017_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	01	1	2	0.00	
H0982	017	0	1	01	01	H0982_017_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H0982	017	0	1	01	01	H0982_017_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H0982	017	0	1	01	01	H0982_017_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H0982	017	0	1	01	01	H0982_017_0	9			Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H0982	018	0	1	01	01	H0982_018_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H0982	018	0	1	01	01	H0982_018_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	01	1	2	0.00	
H0982	018	0	1	01	01	H0982_018_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H0982	018	0	1	01	01	H0982_018_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H0982	018	0	1	01	01	H0982_018_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H0982	018	0	1	01	01	H0982_018_0	9			Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H0982	019	0	1	01	01	H0982_019_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H0982	019	0	1	01	01	H0982_019_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	01	1	2	0.00	
H0982	019	0	1	01	01	H0982_019_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H0982	019	0	1	01	01	H0982_019_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H0982	019	0	1	01	01	H0982_019_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H0982	019	0	1	01	01	H0982_019_0	9			Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H0982	020	0	1	01	01	H0982_020_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H0982	020	0	1	01	01	H0982_020_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	01	1	2	0.00	
H0982	020	0	1	01	01	H0982_020_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H0982	020	0	1	01	01	H0982_020_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H0982	020	0	1	01	01	H0982_020_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H0982	020	0	1	01	01	H0982_020_0	9			Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H0982	021	0	1	01	01	H0982_021_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H0982	021	0	1	01	01	H0982_021_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	01	1	2	0.00	
H0982	021	0	1	01	01	H0982_021_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H0982	021	0	1	01	01	H0982_021_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H0982	021	0	1	01	01	H0982_021_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H0982	021	0	1	01	01	H0982_021_0	9			Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H0982	022	0	1	01	01	H0982_022_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H0982	022	0	1	01	01	H0982_022_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	01	1	2	0.00	
H0982	022	0	1	01	01	H0982_022_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H0982	022	0	1	01	01	H0982_022_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H0982	022	0	1	01	01	H0982_022_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H0982	022	0	1	01	01	H0982_022_0	9			Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H0982	023	0	1	01	01	H0982_023_0	10		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H0982	023	0	1	01	01	H0982_023_0	10		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	01	1	2	0.00	
H0982	023	0	1	01	01	H0982_023_0	10		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H0982	023	0	1	01	01	H0982_023_0	10		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H0982	023	0	1	01	01	H0982_023_0	10		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H0982	023	0	1	01	01	H0982_023_0	10		N	Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H0982	024	0	1	01	01	H0982_024_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H0982	024	0	1	01	01	H0982_024_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	01	1	2	0.00	
H0982	024	0	1	01	01	H0982_024_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H0982	024	0	1	01	01	H0982_024_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H0982	024	0	1	01	01	H0982_024_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H0982	024	0	1	01	01	H0982_024_0	9			Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H0982	025	0	1	01	01	H0982_025_0	10		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H0982	025	0	1	01	01	H0982_025_0	10		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	01	1	2	0.00	
H0982	025	0	1	01	01	H0982_025_0	10		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H0982	025	0	1	01	01	H0982_025_0	10		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H0982	025	0	1	01	01	H0982_025_0	10		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H0982	025	0	1	01	01	H0982_025_0	10		N	Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H0982	026	0	1	01	01	H0982_026_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H0982	026	0	1	01	01	H0982_026_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	01	1	2	0.00	
H0982	026	0	1	01	01	H0982_026_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H0982	026	0	1	01	01	H0982_026_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H0982	026	0	1	01	01	H0982_026_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H0982	026	0	1	01	01	H0982_026_0	9			Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H0982	027	0	1	01	01	H0982_027_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H0982	027	0	1	01	01	H0982_027_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	01	1	2	0.00	
H0982	027	0	1	01	01	H0982_027_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H0982	027	0	1	01	01	H0982_027_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H0982	027	0	1	01	01	H0982_027_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H0982	027	0	1	01	01	H0982_027_0	9			Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H0982	028	0	1	01	01	H0982_028_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H0982	028	0	1	01	01	H0982_028_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	01	1	2	0.00	
H0982	028	0	1	01	01	H0982_028_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H0982	028	0	1	01	01	H0982_028_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H0982	028	0	1	01	01	H0982_028_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H0982	028	0	1	01	01	H0982_028_0	9			Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H0982	030	0	1	01	01	H0982_030_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H0982	030	0	1	01	01	H0982_030_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	01	1	2	0.00	
H0982	030	0	1	01	01	H0982_030_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H0982	030	0	1	01	01	H0982_030_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H0982	030	0	1	01	01	H0982_030_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H0982	030	0	1	01	01	H0982_030_0	9			Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H0982	031	0	1	01	01	H0982_031_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H0982	031	0	1	01	01	H0982_031_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	01	1	2	0.00	
H0982	031	0	1	01	01	H0982_031_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H0982	031	0	1	01	01	H0982_031_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H0982	031	0	1	01	01	H0982_031_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H0982	031	0	1	01	01	H0982_031_0	9			Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H0982	032	0	1	01	01	H0982_032_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H0982	032	0	1	01	01	H0982_032_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	01	1	2	0.00	
H0982	032	0	1	01	01	H0982_032_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H0982	032	0	1	01	01	H0982_032_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H0982	032	0	1	01	01	H0982_032_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H0982	032	0	1	01	01	H0982_032_0	9			Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H0982	033	0	1	01	01	H0982_033_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H0982	033	0	1	01	01	H0982_033_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	01	1	2	0.00	
H0982	033	0	1	01	01	H0982_033_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H0982	033	0	1	01	01	H0982_033_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H0982	033	0	1	01	01	H0982_033_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H0982	033	0	1	01	01	H0982_033_0	9			Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H1019	001	0	1	02	01	H1019_001_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H1019	001	0	1	02	01	H1019_001_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1019	001	0	1	02	01	H1019_001_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1019	001	0	1	02	01	H1019_001_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1019	001	0	1	02	01	H1019_001_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1019	006	0	1	01	01	H1019_006_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H1019	006	0	1	01	01	H1019_006_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1019	006	0	1	01	01	H1019_006_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1019	006	0	1	01	01	H1019_006_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1019	006	0	1	01	01	H1019_006_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1019	023	0	1	01	01	H1019_023_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H1019	023	0	1	01	01	H1019_023_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1019	023	0	1	01	01	H1019_023_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1019	023	0	1	01	01	H1019_023_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1019	023	0	1	01	01	H1019_023_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1019	043	0	1	02	01	H1019_043_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H1019	043	0	1	02	01	H1019_043_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1019	043	0	1	02	01	H1019_043_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1019	043	0	1	02	01	H1019_043_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1019	043	0	1	02	01	H1019_043_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1019	057	0	1	02	01	H1019_057_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H1019	057	0	1	02	01	H1019_057_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1019	057	0	1	02	01	H1019_057_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1019	057	0	1	02	01	H1019_057_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1019	057	0	1	02	01	H1019_057_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1019	065	0	1	01	01	H1019_065_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H1019	065	0	1	01	01	H1019_065_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1019	065	0	1	01	01	H1019_065_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1019	065	0	1	01	01	H1019_065_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1019	065	0	1	01	01	H1019_065_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1019	073	0	1	01	01	H1019_073_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H1019	073	0	1	01	01	H1019_073_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1019	073	0	1	01	01	H1019_073_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1019	073	0	1	01	01	H1019_073_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1019	073	0	1	01	01	H1019_073_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1019	094	0	1	01	01	H1019_094_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H1019	094	0	1	01	01	H1019_094_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1019	094	0	1	01	01	H1019_094_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1019	094	0	1	01	01	H1019_094_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1019	094	0	1	01	01	H1019_094_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1019	103	1	1	01	01	H1019_103_1	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H1019	103	1	1	01	01	H1019_103_1	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1019	103	1	1	01	01	H1019_103_1	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1019	103	1	1	01	01	H1019_103_1	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1019	103	1	1	01	01	H1019_103_1	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1019	103	2	1	01	01	H1019_103_2	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H1019	103	2	1	01	01	H1019_103_2	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1019	103	2	1	01	01	H1019_103_2	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1019	103	2	1	01	01	H1019_103_2	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1019	103	2	1	01	01	H1019_103_2	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1019	104	1	1	01	01	H1019_104_1	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H1019	104	1	1	01	01	H1019_104_1	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1019	104	1	1	01	01	H1019_104_1	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1019	104	1	1	01	01	H1019_104_1	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1019	104	1	1	01	01	H1019_104_1	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1019	104	2	1	01	01	H1019_104_2	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H1019	104	2	1	01	01	H1019_104_2	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1019	104	2	1	01	01	H1019_104_2	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1019	104	2	1	01	01	H1019_104_2	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1019	104	2	1	01	01	H1019_104_2	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1019	109	0	1	01	01	H1019_109_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1019	109	0	1	01	01	H1019_109_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1019	109	0	1	01	01	H1019_109_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1019	109	0	1	01	01	H1019_109_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1019	109	0	1	01	01	H1019_109_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1019	109	0	1	01	01	H1019_109_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1019	113	0	1	01	01	H1019_113_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H1019	113	0	1	01	01	H1019_113_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1019	113	0	1	01	01	H1019_113_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1019	113	0	1	01	01	H1019_113_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1019	113	0	1	01	01	H1019_113_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1019	118	0	1	01	01	H1019_118_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1019	118	0	1	01	01	H1019_118_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1019	118	0	1	01	01	H1019_118_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1019	118	0	1	01	01	H1019_118_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1019	118	0	1	01	01	H1019_118_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1019	118	0	1	01	01	H1019_118_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1019	121	0	1	01	01	H1019_121_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1019	121	0	1	01	01	H1019_121_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1019	121	0	1	01	01	H1019_121_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1019	121	0	1	01	01	H1019_121_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1019	121	0	1	01	01	H1019_121_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1019	121	0	1	01	01	H1019_121_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1019	123	0	1	01	01	H1019_123_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1019	123	0	1	01	01	H1019_123_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1019	123	0	1	01	01	H1019_123_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1019	123	0	1	01	01	H1019_123_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1019	123	0	1	01	01	H1019_123_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1019	123	0	1	01	01	H1019_123_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1019	124	0	1	02	01	H1019_124_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1019	124	0	1	02	01	H1019_124_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1019	124	0	1	02	01	H1019_124_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1019	124	0	1	02	01	H1019_124_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1019	124	0	1	02	01	H1019_124_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1019	124	0	1	02	01	H1019_124_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1019	130	0	1	02	01	H1019_130_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1019	130	0	1	02	01	H1019_130_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1019	130	0	1	02	01	H1019_130_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1019	130	0	1	02	01	H1019_130_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1019	130	0	1	02	01	H1019_130_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1019	130	0	1	02	01	H1019_130_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1019	134	0	1	01	01	H1019_134_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H1019	134	0	1	01	01	H1019_134_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1019	134	0	1	01	01	H1019_134_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1019	134	0	1	01	01	H1019_134_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1019	134	0	1	01	01	H1019_134_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1019	135	0	1	02	01	H1019_135_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H1019	135	0	1	02	01	H1019_135_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1019	135	0	1	02	01	H1019_135_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1019	135	0	1	02	01	H1019_135_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1019	135	0	1	02	01	H1019_135_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1019	136	0	1	01	01	H1019_136_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H1019	136	0	1	01	01	H1019_136_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1019	136	0	1	01	01	H1019_136_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1019	136	0	1	01	01	H1019_136_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1019	136	0	1	01	01	H1019_136_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1019	138	0	1	01	01	H1019_138_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H1019	138	0	1	01	01	H1019_138_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1019	138	0	1	01	01	H1019_138_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1019	138	0	1	01	01	H1019_138_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1019	138	0	1	01	01	H1019_138_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1019	139	0	1	01	01	H1019_139_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H1019	139	0	1	01	01	H1019_139_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1019	139	0	1	01	01	H1019_139_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1019	139	0	1	01	01	H1019_139_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1019	139	0	1	01	01	H1019_139_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1019	144	0	1	01	01	H1019_144_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H1019	144	0	1	01	01	H1019_144_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1019	144	0	1	01	01	H1019_144_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1019	144	0	1	01	01	H1019_144_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1019	144	0	1	01	01	H1019_144_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1019	146	0	1	01	01	H1019_146_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H1019	146	0	1	01	01	H1019_146_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1019	146	0	1	01	01	H1019_146_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1019	146	0	1	01	01	H1019_146_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1019	146	0	1	01	01	H1019_146_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1019	147	1	1	01	01	H1019_147_1	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1019	147	1	1	01	01	H1019_147_1	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1019	147	1	1	01	01	H1019_147_1	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1019	147	1	1	01	01	H1019_147_1	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1019	147	1	1	01	01	H1019_147_1	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1019	147	1	1	01	01	H1019_147_1	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1019	147	2	1	01	01	H1019_147_2	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1019	147	2	1	01	01	H1019_147_2	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1019	147	2	1	01	01	H1019_147_2	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1019	147	2	1	01	01	H1019_147_2	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1019	147	2	1	01	01	H1019_147_2	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1019	147	2	1	01	01	H1019_147_2	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1019	148	0	1	01	01	H1019_148_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H1019	148	0	1	01	01	H1019_148_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1019	148	0	1	01	01	H1019_148_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1019	148	0	1	01	01	H1019_148_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1019	148	0	1	01	01	H1019_148_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1019	149	0	1	01	01	H1019_149_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H1019	149	0	1	01	01	H1019_149_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1019	149	0	1	01	01	H1019_149_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1019	149	0	1	01	01	H1019_149_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1019	149	0	1	01	01	H1019_149_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1019	150	0	1	01	01	H1019_150_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1019	150	0	1	01	01	H1019_150_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1019	150	0	1	01	01	H1019_150_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1019	150	0	1	01	01	H1019_150_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1019	150	0	1	01	01	H1019_150_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1019	150	0	1	01	01	H1019_150_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1019	151	1	1	01	01	H1019_151_1	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1019	151	1	1	01	01	H1019_151_1	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1019	151	1	1	01	01	H1019_151_1	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1019	151	1	1	01	01	H1019_151_1	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1019	151	1	1	01	01	H1019_151_1	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1019	151	1	1	01	01	H1019_151_1	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1019	151	2	1	01	01	H1019_151_2	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1019	151	2	1	01	01	H1019_151_2	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1019	151	2	1	01	01	H1019_151_2	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1019	151	2	1	01	01	H1019_151_2	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1019	151	2	1	01	01	H1019_151_2	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1019	151	2	1	01	01	H1019_151_2	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1019	152	0	1	01	01	H1019_152_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H1019	152	0	1	01	01	H1019_152_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1019	152	0	1	01	01	H1019_152_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1019	152	0	1	01	01	H1019_152_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1019	152	0	1	01	01	H1019_152_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1019	153	0	1	01	01	H1019_153_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H1019	153	0	1	01	01	H1019_153_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1019	153	0	1	01	01	H1019_153_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1019	153	0	1	01	01	H1019_153_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1019	153	0	1	01	01	H1019_153_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1019	154	0	1	01	01	H1019_154_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1019	154	0	1	01	01	H1019_154_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1019	154	0	1	01	01	H1019_154_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1019	154	0	1	01	01	H1019_154_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1019	154	0	1	01	01	H1019_154_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1019	154	0	1	01	01	H1019_154_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1032	193	0	1	01	01	H1032_193_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1032	193	0	1	01	01	H1032_193_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1032	193	0	1	01	01	H1032_193_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1032	193	0	1	01	01	H1032_193_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1032	193	0	1	01	01	H1032_193_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1032	193	0	1	01	01	H1032_193_0	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1032	194	0	1	01	01	H1032_194_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1032	194	0	1	01	01	H1032_194_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1032	194	0	1	01	01	H1032_194_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1032	194	0	1	01	01	H1032_194_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1032	194	0	1	01	01	H1032_194_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1032	194	0	1	01	01	H1032_194_0	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1032	195	0	1	01	01	H1032_195_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1032	195	0	1	01	01	H1032_195_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1032	195	0	1	01	01	H1032_195_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1032	195	0	1	01	01	H1032_195_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1032	195	0	1	01	01	H1032_195_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1032	195	0	1	01	01	H1032_195_0	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1032	196	0	1	01	01	H1032_196_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1032	196	0	1	01	01	H1032_196_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1032	196	0	1	01	01	H1032_196_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1032	196	0	1	01	01	H1032_196_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1032	196	0	1	01	01	H1032_196_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1032	196	0	1	01	01	H1032_196_0	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1032	198	0	1	01	01	H1032_198_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1032	198	0	1	01	01	H1032_198_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1032	198	0	1	01	01	H1032_198_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1032	198	0	1	01	01	H1032_198_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1032	198	0	1	01	01	H1032_198_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1032	198	0	1	01	01	H1032_198_0	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1032	199	0	1	01	01	H1032_199_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1032	199	0	1	01	01	H1032_199_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1032	199	0	1	01	01	H1032_199_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1032	199	0	1	01	01	H1032_199_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1032	199	0	1	01	01	H1032_199_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1032	199	0	1	01	01	H1032_199_0	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1032	200	0	1	01	01	H1032_200_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1032	200	0	1	01	01	H1032_200_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1032	200	0	1	01	01	H1032_200_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1032	200	0	1	01	01	H1032_200_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1032	200	0	1	01	01	H1032_200_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1032	200	0	1	01	01	H1032_200_0	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1032	201	0	1	01	01	H1032_201_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1032	201	0	1	01	01	H1032_201_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1032	201	0	1	01	01	H1032_201_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1032	201	0	1	01	01	H1032_201_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1032	201	0	1	01	01	H1032_201_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1032	201	0	1	01	01	H1032_201_0	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1032	202	0	1	01	01	H1032_202_0	9		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1032	202	0	1	01	01	H1032_202_0	9		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1032	202	0	1	01	01	H1032_202_0	9		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1032	202	0	1	01	01	H1032_202_0	9		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1032	202	0	1	01	01	H1032_202_0	9		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1032	202	0	1	01	01	H1032_202_0	9		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1032	204	0	1	01	01	H1032_204_0	10			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1032	204	0	1	01	01	H1032_204_0	10			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1032	204	0	1	01	01	H1032_204_0	10			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1032	204	0	1	01	01	H1032_204_0	10			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1032	204	0	1	01	01	H1032_204_0	10			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1032	204	0	1	01	01	H1032_204_0	10			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1032	205	0	1	01	01	H1032_205_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1032	205	0	1	01	01	H1032_205_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1032	205	0	1	01	01	H1032_205_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1032	205	0	1	01	01	H1032_205_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1032	205	0	1	01	01	H1032_205_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1032	205	0	1	01	01	H1032_205_0	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1032	210	0	1	01	01	H1032_210_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1032	210	0	1	01	01	H1032_210_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1032	210	0	1	01	01	H1032_210_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1032	210	0	1	01	01	H1032_210_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1032	210	0	1	01	01	H1032_210_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1032	210	0	1	01	01	H1032_210_0	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1032	211	0	1	01	01	H1032_211_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1032	211	0	1	01	01	H1032_211_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1032	211	0	1	01	01	H1032_211_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1032	211	0	1	01	01	H1032_211_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1032	211	0	1	01	01	H1032_211_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1032	211	0	1	01	01	H1032_211_0	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1032	212	0	1	01	01	H1032_212_0	10			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1032	212	0	1	01	01	H1032_212_0	10			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1032	212	0	1	01	01	H1032_212_0	10			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1032	212	0	1	01	01	H1032_212_0	10			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1032	212	0	1	01	01	H1032_212_0	10			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1032	212	0	1	01	01	H1032_212_0	10			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1032	213	0	1	01	01	H1032_213_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1032	213	0	1	01	01	H1032_213_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1032	213	0	1	01	01	H1032_213_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1032	213	0	1	01	01	H1032_213_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1032	213	0	1	01	01	H1032_213_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1032	213	0	1	01	01	H1032_213_0	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1032	237	0	1	01	01	H1032_237_0	10			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1032	237	0	1	01	01	H1032_237_0	10			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1032	237	0	1	01	01	H1032_237_0	10			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1032	237	0	1	01	01	H1032_237_0	10			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1032	237	0	1	01	01	H1032_237_0	10			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1032	237	0	1	01	01	H1032_237_0	10			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1032	240	0	1	01	01	H1032_240_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1032	240	0	1	01	01	H1032_240_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1032	240	0	1	01	01	H1032_240_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1032	240	0	1	01	01	H1032_240_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1032	240	0	1	01	01	H1032_240_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1032	240	0	1	01	01	H1032_240_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1032	241	0	1	01	01	H1032_241_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1032	241	0	1	01	01	H1032_241_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1032	241	0	1	01	01	H1032_241_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1032	241	0	1	01	01	H1032_241_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1032	241	0	1	01	01	H1032_241_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1032	241	0	1	01	01	H1032_241_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1032	242	0	1	01	01	H1032_242_0	9		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1032	242	0	1	01	01	H1032_242_0	9		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1032	242	0	1	01	01	H1032_242_0	9		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1032	242	0	1	01	01	H1032_242_0	9		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1032	242	0	1	01	01	H1032_242_0	9		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1032	242	0	1	01	01	H1032_242_0	9		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1032	243	0	1	01	01	H1032_243_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1032	243	0	1	01	01	H1032_243_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1032	243	0	1	01	01	H1032_243_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1032	243	0	1	01	01	H1032_243_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1032	243	0	1	01	01	H1032_243_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1032	243	0	1	01	01	H1032_243_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1032	244	1	1	01	01	H1032_244_1	10		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1032	244	1	1	01	01	H1032_244_1	10		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1032	244	1	1	01	01	H1032_244_1	10		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1032	244	1	1	01	01	H1032_244_1	10		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1032	244	1	1	01	01	H1032_244_1	10		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1032	244	1	1	01	01	H1032_244_1	10		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1032	244	2	1	01	01	H1032_244_2	9		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1032	244	2	1	01	01	H1032_244_2	9		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1032	244	2	1	01	01	H1032_244_2	9		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1032	244	2	1	01	01	H1032_244_2	9		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1032	244	2	1	01	01	H1032_244_2	9		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1032	244	2	1	01	01	H1032_244_2	9		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1032	245	1	1	01	01	H1032_245_1	9		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1032	245	1	1	01	01	H1032_245_1	9		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1032	245	1	1	01	01	H1032_245_1	9		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1032	245	1	1	01	01	H1032_245_1	9		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1032	245	1	1	01	01	H1032_245_1	9		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1032	245	1	1	01	01	H1032_245_1	9		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1032	245	2	1	01	01	H1032_245_2	10		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1032	245	2	1	01	01	H1032_245_2	10		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1032	245	2	1	01	01	H1032_245_2	10		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1032	245	2	1	01	01	H1032_245_2	10		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1032	245	2	1	01	01	H1032_245_2	10		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1032	245	2	1	01	01	H1032_245_2	10		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1035	002	0	1	02	01	H1035_002_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	01	1	2	0.00	
H1035	002	0	1	02	01	H1035_002_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	01	1	2	0.00	
H1035	002	0	1	02	01	H1035_002_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H1035	002	0	1	02	01	H1035_002_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H1035	002	0	1	02	01	H1035_002_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H1035	002	0	1	02	01	H1035_002_0	5			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	11	1	2	0.00	
H1035	017	0	1	01	01	H1035_017_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H1035	017	0	1	01	01	H1035_017_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H1035	017	0	1	01	01	H1035_017_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1035	017	0	1	01	01	H1035_017_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1035	017	0	1	01	01	H1035_017_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1035	017	0	1	01	01	H1035_017_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H1035	019	0	1	01	01	H1035_019_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H1035	019	0	1	01	01	H1035_019_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H1035	019	0	1	01	01	H1035_019_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1035	019	0	1	01	01	H1035_019_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1035	019	0	1	01	01	H1035_019_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1035	019	0	1	01	01	H1035_019_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H1035	020	0	1	01	01	H1035_020_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H1035	020	0	1	01	01	H1035_020_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H1035	020	0	1	01	01	H1035_020_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1035	020	0	1	01	01	H1035_020_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1035	020	0	1	01	01	H1035_020_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1035	020	0	1	01	01	H1035_020_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H1035	021	0	1	01	01	H1035_021_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H1035	021	0	1	01	01	H1035_021_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H1035	021	0	1	01	01	H1035_021_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1035	021	0	1	01	01	H1035_021_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1035	021	0	1	01	01	H1035_021_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1035	021	0	1	01	01	H1035_021_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H1035	022	0	1	01	01	H1035_022_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H1035	022	0	1	01	01	H1035_022_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H1035	022	0	1	01	01	H1035_022_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1035	022	0	1	01	01	H1035_022_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1035	022	0	1	01	01	H1035_022_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1035	022	0	1	01	01	H1035_022_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H1035	025	0	1	01	01	H1035_025_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H1035	025	0	1	01	01	H1035_025_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H1035	025	0	1	01	01	H1035_025_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1035	025	0	1	01	01	H1035_025_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1035	025	0	1	01	01	H1035_025_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1035	025	0	1	01	01	H1035_025_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H1035	026	0	1	01	01	H1035_026_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H1035	026	0	1	01	01	H1035_026_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H1035	026	0	1	01	01	H1035_026_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1035	026	0	1	01	01	H1035_026_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1035	026	0	1	01	01	H1035_026_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1035	026	0	1	01	01	H1035_026_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H1035	033	0	1	01	01	H1035_033_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H1035	033	0	1	01	01	H1035_033_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H1035	033	0	1	01	01	H1035_033_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1035	033	0	1	01	01	H1035_033_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1035	033	0	1	01	01	H1035_033_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1035	033	0	1	01	01	H1035_033_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H1035	034	0	1	01	01	H1035_034_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H1035	034	0	1	01	01	H1035_034_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H1035	034	0	1	01	01	H1035_034_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1035	034	0	1	01	01	H1035_034_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1035	034	0	1	01	01	H1035_034_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1035	034	0	1	01	01	H1035_034_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H1035	040	0	1	01	01	H1035_040_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	01	1	2	0.00	
H1035	040	0	1	01	01	H1035_040_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	01	1	2	0.00	
H1035	040	0	1	01	01	H1035_040_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H1035	040	0	1	01	01	H1035_040_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H1035	040	0	1	01	01	H1035_040_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H1035	040	0	1	01	01	H1035_040_0	5			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	11	1	2	0.00	
H1035	043	0	1	01	01	H1035_043_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H1035	043	0	1	01	01	H1035_043_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H1035	043	0	1	01	01	H1035_043_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1035	043	0	1	01	01	H1035_043_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1035	043	0	1	01	01	H1035_043_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1035	043	0	1	01	01	H1035_043_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H1035	045	0	1	01	01	H1035_045_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H1035	045	0	1	01	01	H1035_045_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H1035	045	0	1	01	01	H1035_045_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1035	045	0	1	01	01	H1035_045_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1035	045	0	1	01	01	H1035_045_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1035	045	0	1	01	01	H1035_045_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H1035	048	0	1	01	01	H1035_048_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H1035	048	0	1	01	01	H1035_048_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H1035	048	0	1	01	01	H1035_048_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1035	048	0	1	01	01	H1035_048_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1035	048	0	1	01	01	H1035_048_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1035	048	0	1	01	01	H1035_048_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H1035	052	0	1	01	01	H1035_052_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H1035	052	0	1	01	01	H1035_052_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H1035	052	0	1	01	01	H1035_052_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1035	052	0	1	01	01	H1035_052_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1035	052	0	1	01	01	H1035_052_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1035	052	0	1	01	01	H1035_052_0	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H1036	025	0	1	01	01	H1036_025_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H1036	025	0	1	01	01	H1036_025_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	025	0	1	01	01	H1036_025_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	025	0	1	01	01	H1036_025_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	025	0	1	01	01	H1036_025_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	044	0	1	01	01	H1036_044_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H1036	044	0	1	01	01	H1036_044_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	044	0	1	01	01	H1036_044_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	044	0	1	01	01	H1036_044_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	044	0	1	01	01	H1036_044_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	054	0	1	01	01	H1036_054_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H1036	054	0	1	01	01	H1036_054_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	054	0	1	01	01	H1036_054_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	054	0	1	01	01	H1036_054_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	054	0	1	01	01	H1036_054_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	062	0	1	01	01	H1036_062_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H1036	062	0	1	01	01	H1036_062_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	062	0	1	01	01	H1036_062_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	062	0	1	01	01	H1036_062_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	062	0	1	01	01	H1036_062_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	065	0	1	01	01	H1036_065_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H1036	065	0	1	01	01	H1036_065_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	065	0	1	01	01	H1036_065_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	065	0	1	01	01	H1036_065_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	065	0	1	01	01	H1036_065_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	068	0	1	01	01	H1036_068_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H1036	068	0	1	01	01	H1036_068_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	068	0	1	01	01	H1036_068_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	068	0	1	01	01	H1036_068_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	068	0	1	01	01	H1036_068_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	074	0	1	01	01	H1036_074_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H1036	074	0	1	01	01	H1036_074_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	074	0	1	01	01	H1036_074_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	074	0	1	01	01	H1036_074_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	074	0	1	01	01	H1036_074_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	077	0	1	01	01	H1036_077_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1036	077	0	1	01	01	H1036_077_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	077	0	1	01	01	H1036_077_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	077	0	1	01	01	H1036_077_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	077	0	1	01	01	H1036_077_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	102	0	1	01	01	H1036_102_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1036	102	0	1	01	01	H1036_102_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	102	0	1	01	01	H1036_102_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	102	0	1	01	01	H1036_102_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	102	0	1	01	01	H1036_102_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	121	0	1	01	01	H1036_121_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1036	121	0	1	01	01	H1036_121_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1036	121	0	1	01	01	H1036_121_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1036	121	0	1	01	01	H1036_121_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1036	121	0	1	01	01	H1036_121_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1036	121	0	1	01	01	H1036_121_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1036	137	0	1	02	01	H1036_137_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1036	137	0	1	02	01	H1036_137_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	137	0	1	02	01	H1036_137_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	137	0	1	02	01	H1036_137_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	137	0	1	02	01	H1036_137_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	143	0	1	01	01	H1036_143_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H1036	143	0	1	01	01	H1036_143_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	143	0	1	01	01	H1036_143_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	143	0	1	01	01	H1036_143_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	143	0	1	01	01	H1036_143_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	146	0	1	01	01	H1036_146_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H1036	146	0	1	01	01	H1036_146_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	146	0	1	01	01	H1036_146_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	146	0	1	01	01	H1036_146_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	146	0	1	01	01	H1036_146_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	151	0	1	01	01	H1036_151_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1036	151	0	1	01	01	H1036_151_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	151	0	1	01	01	H1036_151_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	151	0	1	01	01	H1036_151_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	151	0	1	01	01	H1036_151_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	153	0	1	01	01	H1036_153_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1036	153	0	1	01	01	H1036_153_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	153	0	1	01	01	H1036_153_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	153	0	1	01	01	H1036_153_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	153	0	1	01	01	H1036_153_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	157	0	1	01	01	H1036_157_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H1036	157	0	1	01	01	H1036_157_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	157	0	1	01	01	H1036_157_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	157	0	1	01	01	H1036_157_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	157	0	1	01	01	H1036_157_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	167	0	1	01	01	H1036_167_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1036	167	0	1	01	01	H1036_167_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	167	0	1	01	01	H1036_167_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	167	0	1	01	01	H1036_167_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	167	0	1	01	01	H1036_167_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	209	0	1	01	01	H1036_209_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1036	209	0	1	01	01	H1036_209_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	209	0	1	01	01	H1036_209_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	209	0	1	01	01	H1036_209_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	209	0	1	01	01	H1036_209_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	210	0	1	01	01	H1036_210_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1036	210	0	1	01	01	H1036_210_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	210	0	1	01	01	H1036_210_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	210	0	1	01	01	H1036_210_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	210	0	1	01	01	H1036_210_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	213	0	1	01	01	H1036_213_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1036	213	0	1	01	01	H1036_213_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	213	0	1	01	01	H1036_213_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	213	0	1	01	01	H1036_213_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	213	0	1	01	01	H1036_213_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	214	0	1	01	01	H1036_214_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1036	214	0	1	01	01	H1036_214_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	214	0	1	01	01	H1036_214_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	214	0	1	01	01	H1036_214_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	214	0	1	01	01	H1036_214_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	217	0	1	01	01	H1036_217_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H1036	217	0	1	01	01	H1036_217_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	217	0	1	01	01	H1036_217_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	217	0	1	01	01	H1036_217_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	217	0	1	01	01	H1036_217_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	222	0	1	01	01	H1036_222_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1036	222	0	1	01	01	H1036_222_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	222	0	1	01	01	H1036_222_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	222	0	1	01	01	H1036_222_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	222	0	1	01	01	H1036_222_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	226	0	1	01	01	H1036_226_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1036	226	0	1	01	01	H1036_226_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	226	0	1	01	01	H1036_226_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	226	0	1	01	01	H1036_226_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	226	0	1	01	01	H1036_226_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	229	0	1	01	01	H1036_229_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H1036	229	0	1	01	01	H1036_229_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	229	0	1	01	01	H1036_229_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	229	0	1	01	01	H1036_229_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	229	0	1	01	01	H1036_229_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	230	0	1	01	01	H1036_230_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H1036	230	0	1	01	01	H1036_230_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	230	0	1	01	01	H1036_230_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	230	0	1	01	01	H1036_230_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	230	0	1	01	01	H1036_230_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	233	0	1	02	01	H1036_233_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1036	233	0	1	02	01	H1036_233_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	233	0	1	02	01	H1036_233_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	233	0	1	02	01	H1036_233_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	233	0	1	02	01	H1036_233_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	234	0	1	01	01	H1036_234_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1036	234	0	1	01	01	H1036_234_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1036	234	0	1	01	01	H1036_234_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1036	234	0	1	01	01	H1036_234_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1036	234	0	1	01	01	H1036_234_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1036	234	0	1	01	01	H1036_234_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1036	235	0	1	01	01	H1036_235_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1036	235	0	1	01	01	H1036_235_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	235	0	1	01	01	H1036_235_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	235	0	1	01	01	H1036_235_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	235	0	1	01	01	H1036_235_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	236	0	1	01	01	H1036_236_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1036	236	0	1	01	01	H1036_236_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	236	0	1	01	01	H1036_236_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	236	0	1	01	01	H1036_236_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	236	0	1	01	01	H1036_236_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	265	1	1	01	01	H1036_265_1	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H1036	265	1	1	01	01	H1036_265_1	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	265	1	1	01	01	H1036_265_1	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	265	1	1	01	01	H1036_265_1	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	265	1	1	01	01	H1036_265_1	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	265	2	1	01	01	H1036_265_2	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H1036	265	2	1	01	01	H1036_265_2	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	265	2	1	01	01	H1036_265_2	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	265	2	1	01	01	H1036_265_2	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	265	2	1	01	01	H1036_265_2	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	266	0	1	01	01	H1036_266_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H1036	266	0	1	01	01	H1036_266_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	266	0	1	01	01	H1036_266_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	266	0	1	01	01	H1036_266_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	266	0	1	01	01	H1036_266_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	269	0	1	01	01	H1036_269_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H1036	269	0	1	01	01	H1036_269_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	269	0	1	01	01	H1036_269_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	269	0	1	01	01	H1036_269_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	269	0	1	01	01	H1036_269_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	270	0	1	01	01	H1036_270_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H1036	270	0	1	01	01	H1036_270_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	270	0	1	01	01	H1036_270_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	270	0	1	01	01	H1036_270_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	270	0	1	01	01	H1036_270_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	271	0	1	01	01	H1036_271_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H1036	271	0	1	01	01	H1036_271_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	271	0	1	01	01	H1036_271_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	271	0	1	01	01	H1036_271_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	271	0	1	01	01	H1036_271_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	278	0	1	01	01	H1036_278_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H1036	278	0	1	01	01	H1036_278_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	278	0	1	01	01	H1036_278_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	278	0	1	01	01	H1036_278_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	278	0	1	01	01	H1036_278_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	280	0	1	01	01	H1036_280_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1036	280	0	1	01	01	H1036_280_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	280	0	1	01	01	H1036_280_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	280	0	1	01	01	H1036_280_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	280	0	1	01	01	H1036_280_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	285	0	1	01	01	H1036_285_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1036	285	0	1	01	01	H1036_285_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	285	0	1	01	01	H1036_285_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	285	0	1	01	01	H1036_285_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	285	0	1	01	01	H1036_285_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	286	0	1	01	01	H1036_286_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H1036	286	0	1	01	01	H1036_286_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	286	0	1	01	01	H1036_286_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	286	0	1	01	01	H1036_286_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	286	0	1	01	01	H1036_286_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	292	0	1	01	01	H1036_292_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1036	292	0	1	01	01	H1036_292_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1036	292	0	1	01	01	H1036_292_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1036	292	0	1	01	01	H1036_292_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1036	292	0	1	01	01	H1036_292_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1036	292	0	1	01	01	H1036_292_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1036	297	0	1	01	01	H1036_297_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1036	297	0	1	01	01	H1036_297_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1036	297	0	1	01	01	H1036_297_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1036	297	0	1	01	01	H1036_297_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1036	297	0	1	01	01	H1036_297_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1036	297	0	1	01	01	H1036_297_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1036	298	0	1	01	01	H1036_298_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1036	298	0	1	01	01	H1036_298_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1036	298	0	1	01	01	H1036_298_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1036	298	0	1	01	01	H1036_298_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1036	298	0	1	01	01	H1036_298_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1036	298	0	1	01	01	H1036_298_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1036	299	0	1	01	01	H1036_299_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1036	299	0	1	01	01	H1036_299_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1036	299	0	1	01	01	H1036_299_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1036	299	0	1	01	01	H1036_299_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1036	299	0	1	01	01	H1036_299_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1036	299	0	1	01	01	H1036_299_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1036	300	0	1	01	01	H1036_300_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1036	300	0	1	01	01	H1036_300_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1036	300	0	1	01	01	H1036_300_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1036	300	0	1	01	01	H1036_300_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1036	300	0	1	01	01	H1036_300_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1036	300	0	1	01	01	H1036_300_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1036	301	0	1	01	01	H1036_301_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1036	301	0	1	01	01	H1036_301_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1036	301	0	1	01	01	H1036_301_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1036	301	0	1	01	01	H1036_301_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1036	301	0	1	01	01	H1036_301_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1036	301	0	1	01	01	H1036_301_0	3			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1036	302	0	1	01	01	H1036_302_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1036	302	0	1	01	01	H1036_302_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1036	302	0	1	01	01	H1036_302_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1036	302	0	1	01	01	H1036_302_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1036	302	0	1	01	01	H1036_302_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1036	302	0	1	01	01	H1036_302_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1036	304	0	1	01	01	H1036_304_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1036	304	0	1	01	01	H1036_304_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	304	0	1	01	01	H1036_304_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	304	0	1	01	01	H1036_304_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	304	0	1	01	01	H1036_304_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	305	0	1	01	01	H1036_305_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H1036	305	0	1	01	01	H1036_305_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	305	0	1	01	01	H1036_305_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	305	0	1	01	01	H1036_305_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	305	0	1	01	01	H1036_305_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	306	0	1	01	01	H1036_306_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1036	306	0	1	01	01	H1036_306_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1036	306	0	1	01	01	H1036_306_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1036	306	0	1	01	01	H1036_306_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1036	306	0	1	01	01	H1036_306_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1036	306	0	1	01	01	H1036_306_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1036	307	0	1	01	01	H1036_307_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1036	307	0	1	01	01	H1036_307_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	307	0	1	01	01	H1036_307_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	307	0	1	01	01	H1036_307_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	307	0	1	01	01	H1036_307_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	308	0	1	01	01	H1036_308_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1036	308	0	1	01	01	H1036_308_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1036	308	0	1	01	01	H1036_308_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1036	308	0	1	01	01	H1036_308_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1036	308	0	1	01	01	H1036_308_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1036	308	0	1	01	01	H1036_308_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1036	310	0	1	01	01	H1036_310_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1036	310	0	1	01	01	H1036_310_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1036	310	0	1	01	01	H1036_310_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1036	310	0	1	01	01	H1036_310_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1036	310	0	1	01	01	H1036_310_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1036	310	0	1	01	01	H1036_310_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1036	311	0	1	01	01	H1036_311_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1036	311	0	1	01	01	H1036_311_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1036	311	0	1	01	01	H1036_311_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1036	311	0	1	01	01	H1036_311_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1036	311	0	1	01	01	H1036_311_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1036	311	0	1	01	01	H1036_311_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1036	312	0	1	01	01	H1036_312_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1036	312	0	1	01	01	H1036_312_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1036	312	0	1	01	01	H1036_312_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1036	312	0	1	01	01	H1036_312_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1036	312	0	1	01	01	H1036_312_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1036	312	0	1	01	01	H1036_312_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1036	313	0	1	01	01	H1036_313_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1036	313	0	1	01	01	H1036_313_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1036	313	0	1	01	01	H1036_313_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1036	313	0	1	01	01	H1036_313_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1036	313	0	1	01	01	H1036_313_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1036	313	0	1	01	01	H1036_313_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1036	314	0	1	01	01	H1036_314_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1036	314	0	1	01	01	H1036_314_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	314	0	1	01	01	H1036_314_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	314	0	1	01	01	H1036_314_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	314	0	1	01	01	H1036_314_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	315	0	1	01	01	H1036_315_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1036	315	0	1	01	01	H1036_315_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1036	315	0	1	01	01	H1036_315_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1036	315	0	1	01	01	H1036_315_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1036	315	0	1	01	01	H1036_315_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1036	315	0	1	01	01	H1036_315_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1036	316	0	1	01	01	H1036_316_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1036	316	0	1	01	01	H1036_316_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1036	316	0	1	01	01	H1036_316_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1036	316	0	1	01	01	H1036_316_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1036	316	0	1	01	01	H1036_316_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1036	316	0	1	01	01	H1036_316_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1036	317	0	1	01	01	H1036_317_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1036	317	0	1	01	01	H1036_317_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1036	317	0	1	01	01	H1036_317_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1036	317	0	1	01	01	H1036_317_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1036	317	0	1	01	01	H1036_317_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1036	317	0	1	01	01	H1036_317_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1036	318	0	1	02	01	H1036_318_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1036	318	0	1	02	01	H1036_318_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	318	0	1	02	01	H1036_318_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	318	0	1	02	01	H1036_318_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	318	0	1	02	01	H1036_318_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	319	0	1	01	01	H1036_319_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1036	319	0	1	01	01	H1036_319_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	319	0	1	01	01	H1036_319_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	319	0	1	01	01	H1036_319_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	319	0	1	01	01	H1036_319_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	320	0	1	01	01	H1036_320_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1036	320	0	1	01	01	H1036_320_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	320	0	1	01	01	H1036_320_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	320	0	1	01	01	H1036_320_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	320	0	1	01	01	H1036_320_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	321	0	1	01	01	H1036_321_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1036	321	0	1	01	01	H1036_321_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	321	0	1	01	01	H1036_321_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	321	0	1	01	01	H1036_321_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	321	0	1	01	01	H1036_321_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	322	0	1	01	01	H1036_322_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1036	322	0	1	01	01	H1036_322_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	322	0	1	01	01	H1036_322_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	322	0	1	01	01	H1036_322_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	322	0	1	01	01	H1036_322_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	323	0	1	01	01	H1036_323_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1036	323	0	1	01	01	H1036_323_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	323	0	1	01	01	H1036_323_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	323	0	1	01	01	H1036_323_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	323	0	1	01	01	H1036_323_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	324	0	1	01	01	H1036_324_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1036	324	0	1	01	01	H1036_324_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	324	0	1	01	01	H1036_324_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	324	0	1	01	01	H1036_324_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	324	0	1	01	01	H1036_324_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	325	0	1	01	01	H1036_325_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1036	325	0	1	01	01	H1036_325_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	325	0	1	01	01	H1036_325_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	325	0	1	01	01	H1036_325_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	325	0	1	01	01	H1036_325_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	326	0	1	01	01	H1036_326_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1036	326	0	1	01	01	H1036_326_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	326	0	1	01	01	H1036_326_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	326	0	1	01	01	H1036_326_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	326	0	1	01	01	H1036_326_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	327	0	1	01	01	H1036_327_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1036	327	0	1	01	01	H1036_327_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	327	0	1	01	01	H1036_327_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	327	0	1	01	01	H1036_327_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	327	0	1	01	01	H1036_327_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	328	0	1	01	01	H1036_328_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1036	328	0	1	01	01	H1036_328_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	328	0	1	01	01	H1036_328_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	328	0	1	01	01	H1036_328_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	328	0	1	01	01	H1036_328_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	329	0	1	01	01	H1036_329_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1036	329	0	1	01	01	H1036_329_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	329	0	1	01	01	H1036_329_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	329	0	1	01	01	H1036_329_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	329	0	1	01	01	H1036_329_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	330	0	1	01	01	H1036_330_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1036	330	0	1	01	01	H1036_330_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1036	330	0	1	01	01	H1036_330_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1036	330	0	1	01	01	H1036_330_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1036	330	0	1	01	01	H1036_330_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1036	330	0	1	01	01	H1036_330_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1036	331	0	1	01	01	H1036_331_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1036	331	0	1	01	01	H1036_331_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	331	0	1	01	01	H1036_331_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	331	0	1	01	01	H1036_331_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	331	0	1	01	01	H1036_331_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	332	0	1	01	01	H1036_332_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H1036	332	0	1	01	01	H1036_332_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	332	0	1	01	01	H1036_332_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	332	0	1	01	01	H1036_332_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	332	0	1	01	01	H1036_332_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	333	0	1	01	01	H1036_333_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1036	333	0	1	01	01	H1036_333_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	333	0	1	01	01	H1036_333_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	333	0	1	01	01	H1036_333_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	333	0	1	01	01	H1036_333_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	334	0	1	01	01	H1036_334_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1036	334	0	1	01	01	H1036_334_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	334	0	1	01	01	H1036_334_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	334	0	1	01	01	H1036_334_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	334	0	1	01	01	H1036_334_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	335	1	1	02	01	H1036_335_1	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1036	335	1	1	02	01	H1036_335_1	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	335	1	1	02	01	H1036_335_1	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	335	1	1	02	01	H1036_335_1	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	335	1	1	02	01	H1036_335_1	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	335	2	1	02	01	H1036_335_2	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1036	335	2	1	02	01	H1036_335_2	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	335	2	1	02	01	H1036_335_2	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	335	2	1	02	01	H1036_335_2	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	335	2	1	02	01	H1036_335_2	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	336	0	1	01	01	H1036_336_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1036	336	0	1	01	01	H1036_336_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1036	336	0	1	01	01	H1036_336_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1036	336	0	1	01	01	H1036_336_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1036	336	0	1	01	01	H1036_336_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1036	336	0	1	01	01	H1036_336_0	3			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1036	337	0	1	01	01	H1036_337_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1036	337	0	1	01	01	H1036_337_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1036	337	0	1	01	01	H1036_337_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1036	337	0	1	01	01	H1036_337_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1036	337	0	1	01	01	H1036_337_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1036	337	0	1	01	01	H1036_337_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1036	338	0	1	01	01	H1036_338_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1036	338	0	1	01	01	H1036_338_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1036	338	0	1	01	01	H1036_338_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1036	338	0	1	01	01	H1036_338_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1036	338	0	1	01	01	H1036_338_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1036	338	0	1	01	01	H1036_338_0	3			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1036	339	0	1	01	01	H1036_339_0	3		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1036	339	0	1	01	01	H1036_339_0	3		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	339	0	1	01	01	H1036_339_0	3		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	339	0	1	01	01	H1036_339_0	3		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	339	0	1	01	01	H1036_339_0	3		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	340	0	1	01	01	H1036_340_0	3		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1036	340	0	1	01	01	H1036_340_0	3		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	340	0	1	01	01	H1036_340_0	3		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	340	0	1	01	01	H1036_340_0	3		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	340	0	1	01	01	H1036_340_0	3		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1036	341	0	1	01	01	H1036_341_0	3		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1036	341	0	1	01	01	H1036_341_0	3		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1036	341	0	1	01	01	H1036_341_0	3		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1036	341	0	1	01	01	H1036_341_0	3		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1036	341	0	1	01	01	H1036_341_0	3		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1045	001	0	1	01	01	H1045_001_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1045	001	0	1	01	01	H1045_001_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H1045	001	0	1	01	01	H1045_001_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1045	001	0	1	01	01	H1045_001_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1045	001	0	1	01	01	H1045_001_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1045	005	0	1	01	01	H1045_005_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1045	005	0	1	01	01	H1045_005_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H1045	005	0	1	01	01	H1045_005_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1045	005	0	1	01	01	H1045_005_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1045	005	0	1	01	01	H1045_005_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1045	012	0	1	01	01	H1045_012_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1045	012	0	1	01	01	H1045_012_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1045	012	0	1	01	01	H1045_012_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1045	012	0	1	01	01	H1045_012_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1045	012	0	1	01	01	H1045_012_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1045	018	0	1	01	01	H1045_018_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1045	018	0	1	01	01	H1045_018_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H1045	018	0	1	01	01	H1045_018_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1045	018	0	1	01	01	H1045_018_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1045	018	0	1	01	01	H1045_018_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1045	025	0	1	02	01	H1045_025_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1045	025	0	1	02	01	H1045_025_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H1045	025	0	1	02	01	H1045_025_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1045	025	0	1	02	01	H1045_025_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1045	025	0	1	02	01	H1045_025_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1045	026	0	1	02	01	H1045_026_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1045	026	0	1	02	01	H1045_026_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H1045	026	0	1	02	01	H1045_026_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1045	026	0	1	02	01	H1045_026_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1045	026	0	1	02	01	H1045_026_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1045	028	0	1	02	01	H1045_028_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1045	028	0	1	02	01	H1045_028_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H1045	028	0	1	02	01	H1045_028_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1045	028	0	1	02	01	H1045_028_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1045	028	0	1	02	01	H1045_028_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1045	030	0	1	02	01	H1045_030_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1045	030	0	1	02	01	H1045_030_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H1045	030	0	1	02	01	H1045_030_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1045	030	0	1	02	01	H1045_030_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1045	030	0	1	02	01	H1045_030_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1045	031	0	1	02	01	H1045_031_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1045	031	0	1	02	01	H1045_031_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H1045	031	0	1	02	01	H1045_031_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1045	031	0	1	02	01	H1045_031_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1045	031	0	1	02	01	H1045_031_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1045	033	0	1	02	01	H1045_033_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1045	033	0	1	02	01	H1045_033_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H1045	033	0	1	02	01	H1045_033_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1045	033	0	1	02	01	H1045_033_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1045	033	0	1	02	01	H1045_033_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1045	034	0	1	02	01	H1045_034_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1045	034	0	1	02	01	H1045_034_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H1045	034	0	1	02	01	H1045_034_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1045	034	0	1	02	01	H1045_034_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1045	034	0	1	02	01	H1045_034_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1045	036	0	1	02	01	H1045_036_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1045	036	0	1	02	01	H1045_036_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H1045	036	0	1	02	01	H1045_036_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1045	036	0	1	02	01	H1045_036_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1045	036	0	1	02	01	H1045_036_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1045	037	0	1	01	01	H1045_037_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1045	037	0	1	01	01	H1045_037_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H1045	037	0	1	01	01	H1045_037_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1045	037	0	1	01	01	H1045_037_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1045	037	0	1	01	01	H1045_037_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1045	038	0	1	01	01	H1045_038_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1045	038	0	1	01	01	H1045_038_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1045	038	0	1	01	01	H1045_038_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1045	038	0	1	01	01	H1045_038_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1045	038	0	1	01	01	H1045_038_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1045	039	0	1	02	01	H1045_039_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1045	039	0	1	02	01	H1045_039_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1045	039	0	1	02	01	H1045_039_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1045	039	0	1	02	01	H1045_039_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1045	039	0	1	02	01	H1045_039_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1045	041	0	1	02	01	H1045_041_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1045	041	0	1	02	01	H1045_041_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H1045	041	0	1	02	01	H1045_041_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1045	041	0	1	02	01	H1045_041_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1045	041	0	1	02	01	H1045_041_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1045	042	0	1	02	01	H1045_042_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1045	042	0	1	02	01	H1045_042_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H1045	042	0	1	02	01	H1045_042_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1045	042	0	1	02	01	H1045_042_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1045	042	0	1	02	01	H1045_042_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1045	043	0	1	02	01	H1045_043_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1045	043	0	1	02	01	H1045_043_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H1045	043	0	1	02	01	H1045_043_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1045	043	0	1	02	01	H1045_043_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1045	043	0	1	02	01	H1045_043_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1045	045	0	1	02	01	H1045_045_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1045	045	0	1	02	01	H1045_045_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H1045	045	0	1	02	01	H1045_045_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1045	045	0	1	02	01	H1045_045_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1045	045	0	1	02	01	H1045_045_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1045	048	1	1	02	01	H1045_048_1	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1045	048	1	1	02	01	H1045_048_1	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H1045	048	1	1	02	01	H1045_048_1	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1045	048	1	1	02	01	H1045_048_1	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1045	048	1	1	02	01	H1045_048_1	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1045	048	2	1	02	01	H1045_048_2	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1045	048	2	1	02	01	H1045_048_2	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H1045	048	2	1	02	01	H1045_048_2	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1045	048	2	1	02	01	H1045_048_2	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1045	048	2	1	02	01	H1045_048_2	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1045	048	3	1	02	01	H1045_048_3	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1045	048	3	1	02	01	H1045_048_3	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H1045	048	3	1	02	01	H1045_048_3	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1045	048	3	1	02	01	H1045_048_3	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1045	048	3	1	02	01	H1045_048_3	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1045	048	4	1	02	01	H1045_048_4	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1045	048	4	1	02	01	H1045_048_4	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H1045	048	4	1	02	01	H1045_048_4	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1045	048	4	1	02	01	H1045_048_4	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1045	048	4	1	02	01	H1045_048_4	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1045	055	0	1	02	01	H1045_055_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1045	055	0	1	02	01	H1045_055_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H1045	055	0	1	02	01	H1045_055_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1045	055	0	1	02	01	H1045_055_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1045	055	0	1	02	01	H1045_055_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1045	056	0	1	02	01	H1045_056_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1045	056	0	1	02	01	H1045_056_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H1045	056	0	1	02	01	H1045_056_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1045	056	0	1	02	01	H1045_056_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1045	056	0	1	02	01	H1045_056_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1045	057	0	1	02	01	H1045_057_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1045	057	0	1	02	01	H1045_057_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H1045	057	0	1	02	01	H1045_057_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1045	057	0	1	02	01	H1045_057_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1045	057	0	1	02	01	H1045_057_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1045	058	0	1	02	01	H1045_058_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1045	058	0	1	02	01	H1045_058_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H1045	058	0	1	02	01	H1045_058_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1045	058	0	1	02	01	H1045_058_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1045	058	0	1	02	01	H1045_058_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1045	059	0	1	02	01	H1045_059_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1045	059	0	1	02	01	H1045_059_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	5.00	
H1045	059	0	1	02	01	H1045_059_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1045	059	0	1	02	01	H1045_059_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1045	059	0	1	02	01	H1045_059_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1045	060	0	1	02	01	H1045_060_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1045	060	0	1	02	01	H1045_060_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	6.00	
H1045	060	0	1	02	01	H1045_060_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1045	060	0	1	02	01	H1045_060_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1045	060	0	1	02	01	H1045_060_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1045	061	0	1	01	01	H1045_061_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1045	061	0	1	01	01	H1045_061_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1045	061	0	1	01	01	H1045_061_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1045	061	0	1	01	01	H1045_061_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1045	061	0	1	01	01	H1045_061_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1045	063	0	1	02	01	H1045_063_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1045	063	0	1	02	01	H1045_063_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1045	063	0	1	02	01	H1045_063_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1045	063	0	1	02	01	H1045_063_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1045	063	0	1	02	01	H1045_063_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1045	064	0	1	01	01	H1045_064_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1045	064	0	1	01	01	H1045_064_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1045	064	0	1	01	01	H1045_064_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1045	064	0	1	01	01	H1045_064_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1045	064	0	1	01	01	H1045_064_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1045	065	0	1	02	01	H1045_065_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1045	065	0	1	02	01	H1045_065_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1045	065	0	1	02	01	H1045_065_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1045	065	0	1	02	01	H1045_065_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1045	065	0	1	02	01	H1045_065_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1045	067	0	1	02	01	H1045_067_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1045	067	0	1	02	01	H1045_067_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	6.00	
H1045	067	0	1	02	01	H1045_067_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1045	067	0	1	02	01	H1045_067_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1045	067	0	1	02	01	H1045_067_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1045	069	0	1	02	01	H1045_069_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1045	069	0	1	02	01	H1045_069_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	5.00	
H1045	069	0	1	02	01	H1045_069_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1045	069	0	1	02	01	H1045_069_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1045	069	0	1	02	01	H1045_069_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1099	001	0	1	02	01	H1099_001_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1099	001	0	1	02	01	H1099_001_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1099	001	0	1	02	01	H1099_001_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1099	001	0	1	02	01	H1099_001_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1099	001	0	1	02	01	H1099_001_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1099	006	0	1	01	01	H1099_006_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1099	006	0	1	01	01	H1099_006_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1099	006	0	1	01	01	H1099_006_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1099	006	0	1	01	01	H1099_006_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1099	006	0	1	01	01	H1099_006_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1099	014	0	1	01	01	H1099_014_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1099	014	0	1	01	01	H1099_014_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1099	014	0	1	01	01	H1099_014_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1099	014	0	1	01	01	H1099_014_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1099	014	0	1	01	01	H1099_014_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1099	016	0	1	01	01	H1099_016_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1099	016	0	1	01	01	H1099_016_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1099	016	0	1	01	01	H1099_016_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1099	016	0	1	01	01	H1099_016_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1099	016	0	1	01	01	H1099_016_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1099	023	0	1	01	01	H1099_023_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1099	023	0	1	01	01	H1099_023_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1099	023	0	1	01	01	H1099_023_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1099	023	0	1	01	01	H1099_023_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1099	023	0	1	01	01	H1099_023_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1099	024	0	1	01	01	H1099_024_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1099	024	0	1	01	01	H1099_024_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1099	024	0	1	01	01	H1099_024_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1099	024	0	1	01	01	H1099_024_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1099	024	0	1	01	01	H1099_024_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1099	025	0	1	02	01	H1099_025_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1099	025	0	1	02	01	H1099_025_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1099	025	0	1	02	01	H1099_025_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1099	025	0	1	02	01	H1099_025_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1099	025	0	1	02	01	H1099_025_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1099	026	0	1	01	01	H1099_026_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1099	026	0	1	01	01	H1099_026_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1099	026	0	1	01	01	H1099_026_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1099	026	0	1	01	01	H1099_026_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1099	026	0	1	01	01	H1099_026_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1099	027	0	1	02	01	H1099_027_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1099	027	0	1	02	01	H1099_027_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1099	027	0	1	02	01	H1099_027_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1099	027	0	1	02	01	H1099_027_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1099	027	0	1	02	01	H1099_027_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1099	028	0	1	01	01	H1099_028_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1099	028	0	1	01	01	H1099_028_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1099	028	0	1	01	01	H1099_028_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1099	028	0	1	01	01	H1099_028_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1099	028	0	1	01	01	H1099_028_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1109	005	0	1	01	01	H1109_005_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1109	005	0	1	01	01	H1109_005_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1109	005	0	1	01	01	H1109_005_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1109	005	0	1	01	01	H1109_005_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1109	005	0	1	01	01	H1109_005_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1112	006	0	1	02	01	H1112_006_0	9		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1112	006	0	1	02	01	H1112_006_0	9		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1112	006	0	1	02	01	H1112_006_0	9		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1112	006	0	1	02	01	H1112_006_0	9		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1112	006	0	1	02	01	H1112_006_0	9		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1112	006	0	1	02	01	H1112_006_0	9		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1112	033	0	1	02	01	H1112_033_0	9		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1112	033	0	1	02	01	H1112_033_0	9		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1112	033	0	1	02	01	H1112_033_0	9		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1112	033	0	1	02	01	H1112_033_0	9		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1112	033	0	1	02	01	H1112_033_0	9		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1112	033	0	1	02	01	H1112_033_0	9		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1112	038	0	1	02	01	H1112_038_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1112	038	0	1	02	01	H1112_038_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1112	038	0	1	02	01	H1112_038_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1112	038	0	1	02	01	H1112_038_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1112	038	0	1	02	01	H1112_038_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1112	038	0	1	02	01	H1112_038_0	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1112	039	0	1	02	01	H1112_039_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1112	039	0	1	02	01	H1112_039_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1112	039	0	1	02	01	H1112_039_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1112	039	0	1	02	01	H1112_039_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1112	039	0	1	02	01	H1112_039_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1112	039	0	1	02	01	H1112_039_0	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1112	042	0	1	02	01	H1112_042_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1112	042	0	1	02	01	H1112_042_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1112	042	0	1	02	01	H1112_042_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1112	042	0	1	02	01	H1112_042_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1112	042	0	1	02	01	H1112_042_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1112	042	0	1	02	01	H1112_042_0	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1112	043	0	1	02	01	H1112_043_0	9			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1112	043	0	1	02	01	H1112_043_0	9			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1112	043	0	1	02	01	H1112_043_0	9			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1112	043	0	1	02	01	H1112_043_0	9			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1112	043	0	1	02	01	H1112_043_0	9			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1112	043	0	1	02	01	H1112_043_0	9			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1112	044	0	1	02	01	H1112_044_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1112	044	0	1	02	01	H1112_044_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1112	044	0	1	02	01	H1112_044_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1112	044	0	1	02	01	H1112_044_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1112	044	0	1	02	01	H1112_044_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1112	044	0	1	02	01	H1112_044_0	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1112	046	0	1	02	01	H1112_046_0	9		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1112	046	0	1	02	01	H1112_046_0	9		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1112	046	0	1	02	01	H1112_046_0	9		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1112	046	0	1	02	01	H1112_046_0	9		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1112	046	0	1	02	01	H1112_046_0	9		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1112	046	0	1	02	01	H1112_046_0	9		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1112	047	0	1	02	01	H1112_047_0	9		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1112	047	0	1	02	01	H1112_047_0	9		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1112	047	0	1	02	01	H1112_047_0	9		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1112	047	0	1	02	01	H1112_047_0	9		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1112	047	0	1	02	01	H1112_047_0	9		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1112	047	0	1	02	01	H1112_047_0	9		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1112	048	0	1	02	01	H1112_048_0	9		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1112	048	0	1	02	01	H1112_048_0	9		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1112	048	0	1	02	01	H1112_048_0	9		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1112	048	0	1	02	01	H1112_048_0	9		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1112	048	0	1	02	01	H1112_048_0	9		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1112	048	0	1	02	01	H1112_048_0	9		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1112	049	0	1	02	01	H1112_049_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1112	049	0	1	02	01	H1112_049_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1112	049	0	1	02	01	H1112_049_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1112	049	0	1	02	01	H1112_049_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1112	049	0	1	02	01	H1112_049_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1112	049	0	1	02	01	H1112_049_0	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1170	002	0	1	01	01	H1170_002_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H1170	002	0	1	01	01	H1170_002_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H1170	002	0	1	01	01	H1170_002_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H1170	002	0	1	01	01	H1170_002_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H1170	002	0	1	01	01	H1170_002_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H1170	002	0	1	01	01	H1170_002_0	6			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H1170	008	0	1	01	01	H1170_008_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H1170	008	0	1	01	01	H1170_008_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H1170	008	0	1	01	01	H1170_008_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H1170	008	0	1	01	01	H1170_008_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H1170	008	0	1	01	01	H1170_008_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H1170	008	0	1	01	01	H1170_008_0	6		N	Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H1170	009	0	1	01	01	H1170_009_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H1170	009	0	1	01	01	H1170_009_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H1170	009	0	1	01	01	H1170_009_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H1170	009	0	1	01	01	H1170_009_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H1170	009	0	1	01	01	H1170_009_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H1170	009	0	1	01	01	H1170_009_0	6			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H1170	011	0	1	01	01	H1170_011_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H1170	011	0	1	01	01	H1170_011_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H1170	011	0	1	01	01	H1170_011_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H1170	011	0	1	01	01	H1170_011_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H1170	011	0	1	01	01	H1170_011_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H1170	011	0	1	01	01	H1170_011_0	6		N	Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H1170	012	0	1	01	01	H1170_012_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H1170	012	0	1	01	01	H1170_012_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H1170	012	0	1	01	01	H1170_012_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H1170	012	0	1	01	01	H1170_012_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H1170	012	0	1	01	01	H1170_012_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H1170	012	0	1	01	01	H1170_012_0	6			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H1170	013	0	1	02	01	H1170_013_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H1170	013	0	1	02	01	H1170_013_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H1170	013	0	1	02	01	H1170_013_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H1170	013	0	1	02	01	H1170_013_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H1170	013	0	1	02	01	H1170_013_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H1170	013	0	1	02	01	H1170_013_0	6			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H1170	015	0	1	01	01	H1170_015_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H1170	015	0	1	01	01	H1170_015_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H1170	015	0	1	01	01	H1170_015_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H1170	015	0	1	01	01	H1170_015_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H1170	015	0	1	01	01	H1170_015_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H1170	015	0	1	01	01	H1170_015_0	6		N	Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H1170	016	0	1	01	01	H1170_016_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H1170	016	0	1	01	01	H1170_016_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H1170	016	0	1	01	01	H1170_016_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H1170	016	0	1	01	01	H1170_016_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H1170	016	0	1	01	01	H1170_016_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H1170	016	0	1	01	01	H1170_016_0	6			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H1189	002	0	1	01	01	H1189_002_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H1189	002	0	1	01	01	H1189_002_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H1189	002	0	1	01	01	H1189_002_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H1189	002	0	1	01	01	H1189_002_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	10	1	2	0.00	
H1189	002	0	1	01	01	H1189_002_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1189	002	0	1	01	01	H1189_002_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1189	003	0	1	01	01	H1189_003_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H1189	003	0	1	01	01	H1189_003_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H1189	003	0	1	01	01	H1189_003_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H1189	003	0	1	01	01	H1189_003_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	10	1	2	0.00	
H1189	003	0	1	01	01	H1189_003_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1189	003	0	1	01	01	H1189_003_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1189	004	0	1	01	01	H1189_004_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H1189	004	0	1	01	01	H1189_004_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H1189	004	0	1	01	01	H1189_004_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H1189	004	0	1	01	01	H1189_004_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	10	1	2	0.00	
H1189	004	0	1	01	01	H1189_004_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1189	004	0	1	01	01	H1189_004_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1189	005	0	1	01	01	H1189_005_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H1189	005	0	1	01	01	H1189_005_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H1189	005	0	1	01	01	H1189_005_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H1189	005	0	1	01	01	H1189_005_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	10	1	2	0.00	
H1189	005	0	1	01	01	H1189_005_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1189	005	0	1	01	01	H1189_005_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1189	009	0	1	01	01	H1189_009_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H1189	009	0	1	01	01	H1189_009_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H1189	009	0	1	01	01	H1189_009_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H1189	009	0	1	01	01	H1189_009_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	10	1	2	0.00	
H1189	009	0	1	01	01	H1189_009_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1189	009	0	1	01	01	H1189_009_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1189	010	0	1	01	01	H1189_010_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H1189	010	0	1	01	01	H1189_010_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H1189	010	0	1	01	01	H1189_010_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H1189	010	0	1	01	01	H1189_010_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	10	1	2	0.00	
H1189	010	0	1	01	01	H1189_010_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1189	010	0	1	01	01	H1189_010_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1206	002	0	1	02	01	H1206_002_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1206	002	0	1	02	01	H1206_002_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1206	002	0	1	02	01	H1206_002_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1206	002	0	1	02	01	H1206_002_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1206	002	0	1	02	01	H1206_002_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1206	003	0	1	02	01	H1206_003_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1206	003	0	1	02	01	H1206_003_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1206	003	0	1	02	01	H1206_003_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1206	003	0	1	02	01	H1206_003_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1206	003	0	1	02	01	H1206_003_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1206	004	0	1	01	01	H1206_004_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1206	004	0	1	01	01	H1206_004_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1206	004	0	1	01	01	H1206_004_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1206	004	0	1	01	01	H1206_004_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1206	004	0	1	01	01	H1206_004_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1206	008	0	1	02	01	H1206_008_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1206	008	0	1	02	01	H1206_008_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1206	008	0	1	02	01	H1206_008_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1206	008	0	1	02	01	H1206_008_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1206	008	0	1	02	01	H1206_008_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1206	009	0	1	01	01	H1206_009_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1206	009	0	1	01	01	H1206_009_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1206	009	0	1	01	01	H1206_009_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1206	009	0	1	01	01	H1206_009_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1206	009	0	1	01	01	H1206_009_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1212	001	0	1	01	01	H1212_001_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H1212	001	0	1	01	01	H1212_001_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1212	001	0	1	01	01	H1212_001_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1212	001	0	1	01	01	H1212_001_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1212	001	0	1	01	01	H1212_001_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1212	001	0	1	01	01	H1212_001_0	6		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1212	002	0	1	01	01	H1212_002_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H1212	002	0	1	01	01	H1212_002_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1212	002	0	1	01	01	H1212_002_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1212	002	0	1	01	01	H1212_002_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1212	002	0	1	01	01	H1212_002_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1212	002	0	1	01	01	H1212_002_0	7		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1212	003	0	1	02	01	H1212_003_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1212	003	0	1	02	01	H1212_003_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1212	003	0	1	02	01	H1212_003_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1212	003	0	1	02	01	H1212_003_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1212	003	0	1	02	01	H1212_003_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1215	001	0	1	02	01	H1215_001_0	9		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1215	001	0	1	02	01	H1215_001_0	9		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1215	001	0	1	02	01	H1215_001_0	9		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1215	001	0	1	02	01	H1215_001_0	9		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1215	001	0	1	02	01	H1215_001_0	9		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1215	001	0	1	02	01	H1215_001_0	9		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1215	003	0	1	02	01	H1215_003_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1215	003	0	1	02	01	H1215_003_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1215	003	0	1	02	01	H1215_003_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1215	003	0	1	02	01	H1215_003_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1215	003	0	1	02	01	H1215_003_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1215	003	0	1	02	01	H1215_003_0	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1215	005	0	1	02	01	H1215_005_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1215	005	0	1	02	01	H1215_005_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1215	005	0	1	02	01	H1215_005_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1215	005	0	1	02	01	H1215_005_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1215	005	0	1	02	01	H1215_005_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1215	005	0	1	02	01	H1215_005_0	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1224	001	0	1	01	01	H1224_001_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1224	001	0	1	01	01	H1224_001_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1224	001	0	1	01	01	H1224_001_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H1224	001	0	1	01	01	H1224_001_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1224	001	0	1	01	01	H1224_001_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1225	001	0	1	01	01	H1225_001_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1225	001	0	1	01	01	H1225_001_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H1225	001	0	1	01	01	H1225_001_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1225	001	0	1	01	01	H1225_001_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1225	001	0	1	01	01	H1225_001_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1230	001	0	1	01	01	H1230_001_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H1230	001	0	1	01	01	H1230_001_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H1230	001	0	1	01	01	H1230_001_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H1230	001	0	1	01	01	H1230_001_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H1230	001	0	1	01	01	H1230_001_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H1230	001	0	1	01	01	H1230_001_0	3			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H1230	003	0	1	01	01	H1230_003_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H1230	003	0	1	01	01	H1230_003_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H1230	003	0	1	01	01	H1230_003_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H1230	003	0	1	01	01	H1230_003_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H1230	003	0	1	01	01	H1230_003_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H1230	003	0	1	01	01	H1230_003_0	3			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H1230	013	0	1	01	01	H1230_013_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H1230	013	0	1	01	01	H1230_013_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H1230	013	0	1	01	01	H1230_013_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H1230	013	0	1	01	01	H1230_013_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H1230	013	0	1	01	01	H1230_013_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H1230	013	0	1	01	01	H1230_013_0	3			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H1230	014	0	1	01	01	H1230_014_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H1230	014	0	1	01	01	H1230_014_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H1230	014	0	1	01	01	H1230_014_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H1230	014	0	1	01	01	H1230_014_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H1230	014	0	1	01	01	H1230_014_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H1230	014	0	1	01	01	H1230_014_0	3			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H1248	004	0	1	04	01	H1248_004_0	13			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1248	004	0	1	04	01	H1248_004_0	13			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1248	004	0	1	04	01	H1248_004_0	13			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1248	004	0	1	04	01	H1248_004_0	13			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1248	004	0	1	04	01	H1248_004_0	13			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1248	007	0	1	04	01	H1248_007_0	12			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1248	007	0	1	04	01	H1248_007_0	12			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1248	007	0	1	04	01	H1248_007_0	12			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1248	007	0	1	04	01	H1248_007_0	12			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1248	007	0	1	04	01	H1248_007_0	12			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1248	014	0	1	04	01	H1248_014_0	12			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1248	014	0	1	04	01	H1248_014_0	12			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1248	014	0	1	04	01	H1248_014_0	12			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1248	014	0	1	04	01	H1248_014_0	12			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1248	014	0	1	04	01	H1248_014_0	12			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1278	003	0	1	04	01	H1278_003_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1278	003	0	1	04	01	H1278_003_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H1278	003	0	1	04	01	H1278_003_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1278	003	0	1	04	01	H1278_003_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1278	003	0	1	04	01	H1278_003_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1278	005	0	1	04	01	H1278_005_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1278	005	0	1	04	01	H1278_005_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H1278	005	0	1	04	01	H1278_005_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1278	005	0	1	04	01	H1278_005_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1278	005	0	1	04	01	H1278_005_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1278	010	0	1	04	01	H1278_010_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1278	010	0	1	04	01	H1278_010_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H1278	010	0	1	04	01	H1278_010_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1278	010	0	1	04	01	H1278_010_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1278	010	0	1	04	01	H1278_010_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1278	013	0	1	04	01	H1278_013_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1278	013	0	1	04	01	H1278_013_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H1278	013	0	1	04	01	H1278_013_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1278	013	0	1	04	01	H1278_013_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1278	013	0	1	04	01	H1278_013_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1278	014	0	1	04	01	H1278_014_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1278	014	0	1	04	01	H1278_014_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H1278	014	0	1	04	01	H1278_014_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1278	014	0	1	04	01	H1278_014_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1278	014	0	1	04	01	H1278_014_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1278	015	0	1	04	01	H1278_015_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1278	015	0	1	04	01	H1278_015_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H1278	015	0	1	04	01	H1278_015_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1278	015	0	1	04	01	H1278_015_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1278	015	0	1	04	01	H1278_015_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1278	016	0	1	04	01	H1278_016_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1278	016	0	1	04	01	H1278_016_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H1278	016	0	1	04	01	H1278_016_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1278	016	0	1	04	01	H1278_016_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1278	016	0	1	04	01	H1278_016_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1278	020	0	1	04	01	H1278_020_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1278	020	0	1	04	01	H1278_020_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H1278	020	0	1	04	01	H1278_020_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1278	020	0	1	04	01	H1278_020_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1278	020	0	1	04	01	H1278_020_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1278	021	0	1	04	01	H1278_021_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1278	021	0	1	04	01	H1278_021_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H1278	021	0	1	04	01	H1278_021_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1278	021	0	1	04	01	H1278_021_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1278	021	0	1	04	01	H1278_021_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1278	024	0	1	04	01	H1278_024_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1278	024	0	1	04	01	H1278_024_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H1278	024	0	1	04	01	H1278_024_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1278	024	0	1	04	01	H1278_024_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1278	024	0	1	04	01	H1278_024_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1278	028	0	1	04	01	H1278_028_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1278	028	0	1	04	01	H1278_028_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H1278	028	0	1	04	01	H1278_028_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1278	028	0	1	04	01	H1278_028_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1278	028	0	1	04	01	H1278_028_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1278	029	0	1	04	01	H1278_029_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1278	029	0	1	04	01	H1278_029_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H1278	029	0	1	04	01	H1278_029_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1278	029	0	1	04	01	H1278_029_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1278	029	0	1	04	01	H1278_029_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1278	030	0	1	04	01	H1278_030_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1278	030	0	1	04	01	H1278_030_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H1278	030	0	1	04	01	H1278_030_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1278	030	0	1	04	01	H1278_030_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1278	030	0	1	04	01	H1278_030_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1278	032	0	1	04	01	H1278_032_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1278	032	0	1	04	01	H1278_032_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H1278	032	0	1	04	01	H1278_032_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1278	032	0	1	04	01	H1278_032_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1278	032	0	1	04	01	H1278_032_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1280	001	0	1	01	01	H1280_001_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1280	001	0	1	01	01	H1280_001_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1280	001	0	1	01	01	H1280_001_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H1280	001	0	1	01	01	H1280_001_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1280	001	0	1	01	01	H1280_001_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1285	001	0	1	01	01	H1285_001_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	0.00	
H1285	001	0	1	01	01	H1285_001_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1285	001	0	1	01	01	H1285_001_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1285	001	0	1	01	01	H1285_001_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1285	001	0	1	01	01	H1285_001_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1285	002	0	1	02	01	H1285_002_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	0.00	
H1285	002	0	1	02	01	H1285_002_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1285	002	0	1	02	01	H1285_002_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1285	002	0	1	02	01	H1285_002_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1285	002	0	1	02	01	H1285_002_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1290	001	0	1	01	01	H1290_001_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1290	001	0	1	01	01	H1290_001_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H1290	001	0	1	01	01	H1290_001_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1290	001	0	1	01	01	H1290_001_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1290	001	0	1	01	01	H1290_001_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1290	002	0	1	01	01	H1290_002_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1290	002	0	1	01	01	H1290_002_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H1290	002	0	1	01	01	H1290_002_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1290	002	0	1	01	01	H1290_002_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1290	002	0	1	01	01	H1290_002_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1290	003	0	1	01	01	H1290_003_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1290	003	0	1	01	01	H1290_003_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H1290	003	0	1	01	01	H1290_003_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1290	003	0	1	01	01	H1290_003_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1290	003	0	1	01	01	H1290_003_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1290	005	0	1	01	01	H1290_005_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1290	005	0	1	01	01	H1290_005_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H1290	005	0	1	01	01	H1290_005_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1290	005	0	1	01	01	H1290_005_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1290	005	0	1	01	01	H1290_005_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1290	013	0	1	01	01	H1290_013_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1290	013	0	1	01	01	H1290_013_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	5.00	
H1290	013	0	1	01	01	H1290_013_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1290	013	0	1	01	01	H1290_013_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1290	013	0	1	01	01	H1290_013_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1290	014	0	1	01	01	H1290_014_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1290	014	0	1	01	01	H1290_014_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	5.00	
H1290	014	0	1	01	01	H1290_014_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1290	014	0	1	01	01	H1290_014_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1290	014	0	1	01	01	H1290_014_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1290	015	0	1	01	01	H1290_015_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1290	015	0	1	01	01	H1290_015_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	5.00	
H1290	015	0	1	01	01	H1290_015_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1290	015	0	1	01	01	H1290_015_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1290	015	0	1	01	01	H1290_015_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1290	018	0	1	01	01	H1290_018_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1290	018	0	1	01	01	H1290_018_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	5.00	
H1290	018	0	1	01	01	H1290_018_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1290	018	0	1	01	01	H1290_018_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1290	018	0	1	01	01	H1290_018_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1290	019	0	1	01	01	H1290_019_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1290	019	0	1	01	01	H1290_019_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1290	019	0	1	01	01	H1290_019_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1290	019	0	1	01	01	H1290_019_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1290	019	0	1	01	01	H1290_019_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1290	019	0	1	01	01	H1290_019_0	7		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H1290	020	0	1	01	01	H1290_020_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1290	020	0	1	01	01	H1290_020_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1290	020	0	1	01	01	H1290_020_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1290	020	0	1	01	01	H1290_020_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1290	020	0	1	01	01	H1290_020_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1290	020	0	1	01	01	H1290_020_0	7		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H1290	021	0	1	01	01	H1290_021_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1290	021	0	1	01	01	H1290_021_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1290	021	0	1	01	01	H1290_021_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1290	021	0	1	01	01	H1290_021_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1290	021	0	1	01	01	H1290_021_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1290	021	0	1	01	01	H1290_021_0	7		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H1290	022	0	1	01	01	H1290_022_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1290	022	0	1	01	01	H1290_022_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1290	022	0	1	01	01	H1290_022_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1290	022	0	1	01	01	H1290_022_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1290	022	0	1	01	01	H1290_022_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1290	022	0	1	01	01	H1290_022_0	7		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H1290	023	0	1	01	01	H1290_023_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1290	023	0	1	01	01	H1290_023_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1290	023	0	1	01	01	H1290_023_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1290	023	0	1	01	01	H1290_023_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1290	023	0	1	01	01	H1290_023_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1290	023	0	1	01	01	H1290_023_0	7		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H1290	024	0	1	01	01	H1290_024_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1290	024	0	1	01	01	H1290_024_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1290	024	0	1	01	01	H1290_024_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1290	024	0	1	01	01	H1290_024_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1290	024	0	1	01	01	H1290_024_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1290	024	0	1	01	01	H1290_024_0	7		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H1290	025	0	1	01	01	H1290_025_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1290	025	0	1	01	01	H1290_025_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H1290	025	0	1	01	01	H1290_025_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1290	025	0	1	01	01	H1290_025_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1290	025	0	1	01	01	H1290_025_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1290	027	0	1	01	01	H1290_027_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1290	027	0	1	01	01	H1290_027_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H1290	027	0	1	01	01	H1290_027_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1290	027	0	1	01	01	H1290_027_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1290	027	0	1	01	01	H1290_027_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1290	029	0	1	01	01	H1290_029_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1290	029	0	1	01	01	H1290_029_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H1290	029	0	1	01	01	H1290_029_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1290	029	0	1	01	01	H1290_029_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1290	029	0	1	01	01	H1290_029_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1290	031	0	1	01	01	H1290_031_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1290	031	0	1	01	01	H1290_031_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	5.00	
H1290	031	0	1	01	01	H1290_031_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1290	031	0	1	01	01	H1290_031_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1290	031	0	1	01	01	H1290_031_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1290	032	0	1	01	01	H1290_032_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1290	032	0	1	01	01	H1290_032_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	5.00	
H1290	032	0	1	01	01	H1290_032_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1290	032	0	1	01	01	H1290_032_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1290	032	0	1	01	01	H1290_032_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1290	033	0	1	01	01	H1290_033_0	8		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1290	033	0	1	01	01	H1290_033_0	8		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1290	033	0	1	01	01	H1290_033_0	8		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1290	033	0	1	01	01	H1290_033_0	8		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1290	033	0	1	01	01	H1290_033_0	8		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1290	033	0	1	01	01	H1290_033_0	8		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H1290	034	0	1	01	01	H1290_034_0	8		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1290	034	0	1	01	01	H1290_034_0	8		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1290	034	0	1	01	01	H1290_034_0	8		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1290	034	0	1	01	01	H1290_034_0	8		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1290	034	0	1	01	01	H1290_034_0	8		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1290	034	0	1	01	01	H1290_034_0	8		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H1290	035	0	1	01	01	H1290_035_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1290	035	0	1	01	01	H1290_035_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	5.00	
H1290	035	0	1	01	01	H1290_035_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1290	035	0	1	01	01	H1290_035_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1290	035	0	1	01	01	H1290_035_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1290	036	1	1	01	01	H1290_036_1	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1290	036	1	1	01	01	H1290_036_1	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H1290	036	1	1	01	01	H1290_036_1	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1290	036	1	1	01	01	H1290_036_1	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1290	036	1	1	01	01	H1290_036_1	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1290	036	2	1	01	01	H1290_036_2	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1290	036	2	1	01	01	H1290_036_2	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H1290	036	2	1	01	01	H1290_036_2	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1290	036	2	1	01	01	H1290_036_2	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1290	036	2	1	01	01	H1290_036_2	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1290	037	1	1	01	01	H1290_037_1	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1290	037	1	1	01	01	H1290_037_1	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H1290	037	1	1	01	01	H1290_037_1	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1290	037	1	1	01	01	H1290_037_1	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1290	037	1	1	01	01	H1290_037_1	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1290	037	2	1	01	01	H1290_037_2	11			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1290	037	2	1	01	01	H1290_037_2	11			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H1290	037	2	1	01	01	H1290_037_2	11			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1290	037	2	1	01	01	H1290_037_2	11			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1290	037	2	1	01	01	H1290_037_2	11			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1290	037	3	1	01	01	H1290_037_3	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1290	037	3	1	01	01	H1290_037_3	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H1290	037	3	1	01	01	H1290_037_3	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1290	037	3	1	01	01	H1290_037_3	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1290	037	3	1	01	01	H1290_037_3	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1290	037	4	1	01	01	H1290_037_4	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1290	037	4	1	01	01	H1290_037_4	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H1290	037	4	1	01	01	H1290_037_4	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1290	037	4	1	01	01	H1290_037_4	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1290	037	4	1	01	01	H1290_037_4	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1290	037	5	1	01	01	H1290_037_5	10			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1290	037	5	1	01	01	H1290_037_5	10			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H1290	037	5	1	01	01	H1290_037_5	10			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1290	037	5	1	01	01	H1290_037_5	10			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1290	037	5	1	01	01	H1290_037_5	10			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1290	039	0	1	01	01	H1290_039_0	8		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1290	039	0	1	01	01	H1290_039_0	8		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1290	039	0	1	01	01	H1290_039_0	8		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1290	039	0	1	01	01	H1290_039_0	8		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1290	039	0	1	01	01	H1290_039_0	8		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1290	039	0	1	01	01	H1290_039_0	8		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H1290	041	0	1	01	01	H1290_041_0	8		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1290	041	0	1	01	01	H1290_041_0	8		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1290	041	0	1	01	01	H1290_041_0	8		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1290	041	0	1	01	01	H1290_041_0	8		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1290	041	0	1	01	01	H1290_041_0	8		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1290	041	0	1	01	01	H1290_041_0	8		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H1290	042	0	1	01	01	H1290_042_0	9		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1290	042	0	1	01	01	H1290_042_0	9		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1290	042	0	1	01	01	H1290_042_0	9		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1290	042	0	1	01	01	H1290_042_0	9		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1290	042	0	1	01	01	H1290_042_0	9		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1290	042	0	1	01	01	H1290_042_0	9		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H1290	043	0	1	01	01	H1290_043_0	9		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1290	043	0	1	01	01	H1290_043_0	9		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1290	043	0	1	01	01	H1290_043_0	9		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1290	043	0	1	01	01	H1290_043_0	9		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1290	043	0	1	01	01	H1290_043_0	9		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1290	043	0	1	01	01	H1290_043_0	9		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H1290	044	1	1	01	01	H1290_044_1	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1290	044	1	1	01	01	H1290_044_1	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H1290	044	1	1	01	01	H1290_044_1	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1290	044	1	1	01	01	H1290_044_1	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1290	044	1	1	01	01	H1290_044_1	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1290	044	2	1	01	01	H1290_044_2	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1290	044	2	1	01	01	H1290_044_2	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H1290	044	2	1	01	01	H1290_044_2	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1290	044	2	1	01	01	H1290_044_2	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1290	044	2	1	01	01	H1290_044_2	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1290	044	3	1	01	01	H1290_044_3	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1290	044	3	1	01	01	H1290_044_3	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H1290	044	3	1	01	01	H1290_044_3	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1290	044	3	1	01	01	H1290_044_3	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1290	044	3	1	01	01	H1290_044_3	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1290	045	0	1	01	01	H1290_045_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1290	045	0	1	01	01	H1290_045_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	5.00	
H1290	045	0	1	01	01	H1290_045_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1290	045	0	1	01	01	H1290_045_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1290	045	0	1	01	01	H1290_045_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1290	046	0	1	01	01	H1290_046_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1290	046	0	1	01	01	H1290_046_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H1290	046	0	1	01	01	H1290_046_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1290	046	0	1	01	01	H1290_046_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1290	046	0	1	01	01	H1290_046_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1290	049	0	1	01	01	H1290_049_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1290	049	0	1	01	01	H1290_049_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	5.00	
H1290	049	0	1	01	01	H1290_049_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1290	049	0	1	01	01	H1290_049_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1290	049	0	1	01	01	H1290_049_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1290	050	0	1	01	01	H1290_050_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1290	050	0	1	01	01	H1290_050_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H1290	050	0	1	01	01	H1290_050_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1290	050	0	1	01	01	H1290_050_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1290	050	0	1	01	01	H1290_050_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1290	051	1	1	01	01	H1290_051_1	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1290	051	1	1	01	01	H1290_051_1	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	10.00	
H1290	051	1	1	01	01	H1290_051_1	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1290	051	1	1	01	01	H1290_051_1	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1290	051	1	1	01	01	H1290_051_1	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1290	051	2	1	01	01	H1290_051_2	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1290	051	2	1	01	01	H1290_051_2	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	10.00	
H1290	051	2	1	01	01	H1290_051_2	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1290	051	2	1	01	01	H1290_051_2	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1290	051	2	1	01	01	H1290_051_2	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1290	052	0	1	01	01	H1290_052_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1290	052	0	1	01	01	H1290_052_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1290	052	0	1	01	01	H1290_052_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1290	052	0	1	01	01	H1290_052_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1290	052	0	1	01	01	H1290_052_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1290	052	0	1	01	01	H1290_052_0	6		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H1290	053	0	1	01	01	H1290_053_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1290	053	0	1	01	01	H1290_053_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1290	053	0	1	01	01	H1290_053_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1290	053	0	1	01	01	H1290_053_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1290	053	0	1	01	01	H1290_053_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1290	053	0	1	01	01	H1290_053_0	7		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H1290	054	0	1	01	01	H1290_054_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1290	054	0	1	01	01	H1290_054_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1290	054	0	1	01	01	H1290_054_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1290	054	0	1	01	01	H1290_054_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1290	054	0	1	01	01	H1290_054_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1290	054	0	1	01	01	H1290_054_0	7		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H1290	055	0	1	01	01	H1290_055_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1290	055	0	1	01	01	H1290_055_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1290	055	0	1	01	01	H1290_055_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1290	055	0	1	01	01	H1290_055_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1290	055	0	1	01	01	H1290_055_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1290	055	0	1	01	01	H1290_055_0	7		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H1290	056	0	1	01	01	H1290_056_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1290	056	0	1	01	01	H1290_056_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H1290	056	0	1	01	01	H1290_056_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1290	056	0	1	01	01	H1290_056_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1290	056	0	1	01	01	H1290_056_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1290	057	0	1	01	01	H1290_057_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1290	057	0	1	01	01	H1290_057_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H1290	057	0	1	01	01	H1290_057_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1290	057	0	1	01	01	H1290_057_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1290	057	0	1	01	01	H1290_057_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1290	058	0	1	01	01	H1290_058_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1290	058	0	1	01	01	H1290_058_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H1290	058	0	1	01	01	H1290_058_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1290	058	0	1	01	01	H1290_058_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1290	058	0	1	01	01	H1290_058_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1290	059	0	1	01	01	H1290_059_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1290	059	0	1	01	01	H1290_059_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H1290	059	0	1	01	01	H1290_059_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1290	059	0	1	01	01	H1290_059_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1290	059	0	1	01	01	H1290_059_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1290	060	0	1	01	01	H1290_060_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1290	060	0	1	01	01	H1290_060_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H1290	060	0	1	01	01	H1290_060_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1290	060	0	1	01	01	H1290_060_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1290	060	0	1	01	01	H1290_060_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1290	061	0	1	01	01	H1290_061_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1290	061	0	1	01	01	H1290_061_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H1290	061	0	1	01	01	H1290_061_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1290	061	0	1	01	01	H1290_061_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1290	061	0	1	01	01	H1290_061_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1290	062	0	1	01	01	H1290_062_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1290	062	0	1	01	01	H1290_062_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H1290	062	0	1	01	01	H1290_062_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1290	062	0	1	01	01	H1290_062_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1290	062	0	1	01	01	H1290_062_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1290	063	0	1	01	01	H1290_063_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1290	063	0	1	01	01	H1290_063_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H1290	063	0	1	01	01	H1290_063_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1290	063	0	1	01	01	H1290_063_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1290	063	0	1	01	01	H1290_063_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1290	064	0	1	01	01	H1290_064_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1290	064	0	1	01	01	H1290_064_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H1290	064	0	1	01	01	H1290_064_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1290	064	0	1	01	01	H1290_064_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1290	064	0	1	01	01	H1290_064_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1290	065	0	1	01	01	H1290_065_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1290	065	0	1	01	01	H1290_065_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H1290	065	0	1	01	01	H1290_065_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1290	065	0	1	01	01	H1290_065_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1290	065	0	1	01	01	H1290_065_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1290	066	0	1	01	01	H1290_066_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1290	066	0	1	01	01	H1290_066_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H1290	066	0	1	01	01	H1290_066_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1290	066	0	1	01	01	H1290_066_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1290	066	0	1	01	01	H1290_066_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1290	067	0	1	01	01	H1290_067_0	7			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1290	067	0	1	01	01	H1290_067_0	7			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1290	067	0	1	01	01	H1290_067_0	7			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1290	067	0	1	01	01	H1290_067_0	7			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1290	067	0	1	01	01	H1290_067_0	7			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1290	067	0	1	01	01	H1290_067_0	7			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1290	068	0	1	01	01	H1290_068_0	7			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1290	068	0	1	01	01	H1290_068_0	7			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1290	068	0	1	01	01	H1290_068_0	7			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1290	068	0	1	01	01	H1290_068_0	7			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1290	068	0	1	01	01	H1290_068_0	7			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1290	068	0	1	01	01	H1290_068_0	7			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1290	069	0	1	01	01	H1290_069_0	7			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1290	069	0	1	01	01	H1290_069_0	7			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1290	069	0	1	01	01	H1290_069_0	7			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1290	069	0	1	01	01	H1290_069_0	7			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1290	069	0	1	01	01	H1290_069_0	7			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1290	069	0	1	01	01	H1290_069_0	7			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1290	070	0	1	01	01	H1290_070_0	7			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1290	070	0	1	01	01	H1290_070_0	7			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1290	070	0	1	01	01	H1290_070_0	7			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1290	070	0	1	01	01	H1290_070_0	7			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1290	070	0	1	01	01	H1290_070_0	7			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1290	070	0	1	01	01	H1290_070_0	7			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1290	071	0	1	01	01	H1290_071_0	7			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1290	071	0	1	01	01	H1290_071_0	7			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1290	071	0	1	01	01	H1290_071_0	7			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1290	071	0	1	01	01	H1290_071_0	7			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1290	071	0	1	01	01	H1290_071_0	7			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1290	071	0	1	01	01	H1290_071_0	7			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1290	072	0	1	01	01	H1290_072_0	7			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1290	072	0	1	01	01	H1290_072_0	7			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1290	072	0	1	01	01	H1290_072_0	7			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1290	072	0	1	01	01	H1290_072_0	7			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1290	072	0	1	01	01	H1290_072_0	7			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1290	072	0	1	01	01	H1290_072_0	7			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1290	073	0	1	01	01	H1290_073_0	7			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1290	073	0	1	01	01	H1290_073_0	7			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1290	073	0	1	01	01	H1290_073_0	7			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1290	073	0	1	01	01	H1290_073_0	7			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1290	073	0	1	01	01	H1290_073_0	7			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1290	073	0	1	01	01	H1290_073_0	7			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1290	074	0	1	01	01	H1290_074_0	7			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1290	074	0	1	01	01	H1290_074_0	7			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1290	074	0	1	01	01	H1290_074_0	7			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1290	074	0	1	01	01	H1290_074_0	7			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1290	074	0	1	01	01	H1290_074_0	7			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1290	074	0	1	01	01	H1290_074_0	7			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1290	077	0	1	01	01	H1290_077_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1290	077	0	1	01	01	H1290_077_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1290	077	0	1	01	01	H1290_077_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1290	077	0	1	01	01	H1290_077_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1290	077	0	1	01	01	H1290_077_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1290	077	0	1	01	01	H1290_077_0	7		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H1290	078	0	1	01	01	H1290_078_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1290	078	0	1	01	01	H1290_078_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1290	078	0	1	01	01	H1290_078_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1290	078	0	1	01	01	H1290_078_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1290	078	0	1	01	01	H1290_078_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1290	078	0	1	01	01	H1290_078_0	7		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H1290	079	0	1	01	01	H1290_079_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1290	079	0	1	01	01	H1290_079_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1290	079	0	1	01	01	H1290_079_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1290	079	0	1	01	01	H1290_079_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1290	079	0	1	01	01	H1290_079_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1290	079	0	1	01	01	H1290_079_0	7		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H1290	080	0	1	01	01	H1290_080_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1290	080	0	1	01	01	H1290_080_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1290	080	0	1	01	01	H1290_080_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1290	080	0	1	01	01	H1290_080_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1290	080	0	1	01	01	H1290_080_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1290	080	0	1	01	01	H1290_080_0	7		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H1290	081	0	1	01	01	H1290_081_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1290	081	0	1	01	01	H1290_081_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1290	081	0	1	01	01	H1290_081_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1290	081	0	1	01	01	H1290_081_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1290	081	0	1	01	01	H1290_081_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1290	081	0	1	01	01	H1290_081_0	7		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H1290	082	0	1	01	01	H1290_082_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1290	082	0	1	01	01	H1290_082_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1290	082	0	1	01	01	H1290_082_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1290	082	0	1	01	01	H1290_082_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1290	082	0	1	01	01	H1290_082_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1290	082	0	1	01	01	H1290_082_0	7		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H1290	083	0	1	01	01	H1290_083_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1290	083	0	1	01	01	H1290_083_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1290	083	0	1	01	01	H1290_083_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1290	083	0	1	01	01	H1290_083_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1290	083	0	1	01	01	H1290_083_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1290	083	0	1	01	01	H1290_083_0	7		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H1290	084	0	1	01	01	H1290_084_0	9			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1290	084	0	1	01	01	H1290_084_0	9			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1290	084	0	1	01	01	H1290_084_0	9			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1290	084	0	1	01	01	H1290_084_0	9			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1290	084	0	1	01	01	H1290_084_0	9			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1290	084	0	1	01	01	H1290_084_0	9			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1290	085	0	1	01	01	H1290_085_0	7			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1290	085	0	1	01	01	H1290_085_0	7			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1290	085	0	1	01	01	H1290_085_0	7			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1290	085	0	1	01	01	H1290_085_0	7			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1290	085	0	1	01	01	H1290_085_0	7			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1290	085	0	1	01	01	H1290_085_0	7			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1290	086	0	1	01	01	H1290_086_0	7			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1290	086	0	1	01	01	H1290_086_0	7			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1290	086	0	1	01	01	H1290_086_0	7			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1290	086	0	1	01	01	H1290_086_0	7			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1290	086	0	1	01	01	H1290_086_0	7			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1290	086	0	1	01	01	H1290_086_0	7			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1290	087	0	1	01	01	H1290_087_0	7			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1290	087	0	1	01	01	H1290_087_0	7			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1290	087	0	1	01	01	H1290_087_0	7			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1290	087	0	1	01	01	H1290_087_0	7			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1290	087	0	1	01	01	H1290_087_0	7			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1290	087	0	1	01	01	H1290_087_0	7			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1290	088	0	1	01	01	H1290_088_0	7			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1290	088	0	1	01	01	H1290_088_0	7			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1290	088	0	1	01	01	H1290_088_0	7			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1290	088	0	1	01	01	H1290_088_0	7			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1290	088	0	1	01	01	H1290_088_0	7			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1290	088	0	1	01	01	H1290_088_0	7			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1290	089	0	1	01	01	H1290_089_0	7			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1290	089	0	1	01	01	H1290_089_0	7			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1290	089	0	1	01	01	H1290_089_0	7			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1290	089	0	1	01	01	H1290_089_0	7			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1290	089	0	1	01	01	H1290_089_0	7			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1290	089	0	1	01	01	H1290_089_0	7			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1290	090	0	1	01	01	H1290_090_0	7			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1290	090	0	1	01	01	H1290_090_0	7			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1290	090	0	1	01	01	H1290_090_0	7			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1290	090	0	1	01	01	H1290_090_0	7			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1290	090	0	1	01	01	H1290_090_0	7			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1290	090	0	1	01	01	H1290_090_0	7			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1290	091	0	1	01	01	H1290_091_0	7			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1290	091	0	1	01	01	H1290_091_0	7			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1290	091	0	1	01	01	H1290_091_0	7			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1290	091	0	1	01	01	H1290_091_0	7			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1290	091	0	1	01	01	H1290_091_0	7			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1290	091	0	1	01	01	H1290_091_0	7			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1339	001	0	1	01	01	H1339_001_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1339	001	0	1	01	01	H1339_001_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H1339	001	0	1	01	01	H1339_001_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1339	001	0	1	01	01	H1339_001_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1339	001	0	1	01	01	H1339_001_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1347	001	0	1	04	01	H1347_001_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1347	001	0	1	04	01	H1347_001_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1347	001	0	1	04	01	H1347_001_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1347	001	0	1	04	01	H1347_001_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1347	001	0	1	04	01	H1347_001_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	10	1	2	0.00	
H1347	002	0	1	04	01	H1347_002_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1347	002	0	1	04	01	H1347_002_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1347	002	0	1	04	01	H1347_002_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1347	002	0	1	04	01	H1347_002_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1347	002	0	1	04	01	H1347_002_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	10	1	2	0.00	
H1347	003	0	1	04	01	H1347_003_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1347	003	0	1	04	01	H1347_003_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1347	003	0	1	04	01	H1347_003_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1347	003	0	1	04	01	H1347_003_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1347	003	0	1	04	01	H1347_003_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	10	1	2	0.00	
H1350	032	0	1	01	01	H1350_032_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1350	032	0	1	01	01	H1350_032_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1350	032	0	1	01	01	H1350_032_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H1350	032	0	1	01	01	H1350_032_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1350	032	0	1	01	01	H1350_032_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1350	033	0	1	01	01	H1350_033_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1350	033	0	1	01	01	H1350_033_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1350	033	0	1	01	01	H1350_033_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H1350	033	0	1	01	01	H1350_033_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1350	033	0	1	01	01	H1350_033_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1350	034	0	1	01	01	H1350_034_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1350	034	0	1	01	01	H1350_034_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1350	034	0	1	01	01	H1350_034_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H1350	034	0	1	01	01	H1350_034_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1350	034	0	1	01	01	H1350_034_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1350	035	0	1	01	01	H1350_035_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1350	035	0	1	01	01	H1350_035_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1350	035	0	1	01	01	H1350_035_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H1350	035	0	1	01	01	H1350_035_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1350	035	0	1	01	01	H1350_035_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1350	036	0	1	01	01	H1350_036_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1350	036	0	1	01	01	H1350_036_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1350	036	0	1	01	01	H1350_036_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H1350	036	0	1	01	01	H1350_036_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1350	036	0	1	01	01	H1350_036_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1350	037	0	1	01	01	H1350_037_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1350	037	0	1	01	01	H1350_037_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1350	037	0	1	01	01	H1350_037_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H1350	037	0	1	01	01	H1350_037_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1350	037	0	1	01	01	H1350_037_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1360	001	0	1	02	01	H1360_001_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1360	001	0	1	02	01	H1360_001_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1360	001	0	1	02	01	H1360_001_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1360	001	0	1	02	01	H1360_001_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1360	001	0	1	02	01	H1360_001_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1360	002	0	1	02	01	H1360_002_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1360	002	0	1	02	01	H1360_002_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1360	002	0	1	02	01	H1360_002_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1360	002	0	1	02	01	H1360_002_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1360	002	0	1	02	01	H1360_002_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1360	003	0	1	02	01	H1360_003_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1360	003	0	1	02	01	H1360_003_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1360	003	0	1	02	01	H1360_003_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1360	003	0	1	02	01	H1360_003_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1360	003	0	1	02	01	H1360_003_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1365	001	0	1	04	01	H1365_001_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H1365	001	0	1	04	01	H1365_001_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H1365	001	0	1	04	01	H1365_001_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H1365	001	0	1	04	01	H1365_001_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1365	001	0	1	04	01	H1365_001_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1365	001	0	1	04	01	H1365_001_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H1365	005	0	1	04	01	H1365_005_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H1365	005	0	1	04	01	H1365_005_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H1365	005	0	1	04	01	H1365_005_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H1365	005	0	1	04	01	H1365_005_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1365	005	0	1	04	01	H1365_005_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1365	005	0	1	04	01	H1365_005_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H1372	002	0	1	01	01	H1372_002_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1372	002	0	1	01	01	H1372_002_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1372	002	0	1	01	01	H1372_002_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H1372	002	0	1	01	01	H1372_002_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	10	1	2	0.00	
H1372	002	0	1	01	01	H1372_002_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1372	003	0	1	01	01	H1372_003_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1372	003	0	1	01	01	H1372_003_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1372	003	0	1	01	01	H1372_003_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H1372	003	0	1	01	01	H1372_003_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	10	1	2	0.00	
H1372	003	0	1	01	01	H1372_003_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1395	001	0	1	04	01	H1395_001_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1395	001	0	1	04	01	H1395_001_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1395	001	0	1	04	01	H1395_001_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1395	001	0	1	04	01	H1395_001_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1395	001	0	1	04	01	H1395_001_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1395	001	0	1	04	01	H1395_001_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1395	002	0	1	04	01	H1395_002_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1395	002	0	1	04	01	H1395_002_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1395	002	0	1	04	01	H1395_002_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1395	002	0	1	04	01	H1395_002_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1395	002	0	1	04	01	H1395_002_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1395	002	0	1	04	01	H1395_002_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1395	003	0	1	04	01	H1395_003_0	8			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1395	003	0	1	04	01	H1395_003_0	8			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1395	003	0	1	04	01	H1395_003_0	8			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1395	003	0	1	04	01	H1395_003_0	8			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1395	003	0	1	04	01	H1395_003_0	8			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1395	003	0	1	04	01	H1395_003_0	8			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1396	001	0	1	01	01	H1396_001_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1396	001	0	1	01	01	H1396_001_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1396	001	0	1	01	01	H1396_001_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1396	001	0	1	01	01	H1396_001_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1396	001	0	1	01	01	H1396_001_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1416	009	0	1	02	01	H1416_009_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1416	009	0	1	02	01	H1416_009_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1416	009	0	1	02	01	H1416_009_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1416	009	0	1	02	01	H1416_009_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1416	009	0	1	02	01	H1416_009_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1416	009	0	1	02	01	H1416_009_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1416	026	0	1	02	01	H1416_026_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1416	026	0	1	02	01	H1416_026_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1416	026	0	1	02	01	H1416_026_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1416	026	0	1	02	01	H1416_026_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1416	026	0	1	02	01	H1416_026_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1416	026	0	1	02	01	H1416_026_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1416	033	0	1	02	01	H1416_033_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1416	033	0	1	02	01	H1416_033_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1416	033	0	1	02	01	H1416_033_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1416	033	0	1	02	01	H1416_033_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1416	033	0	1	02	01	H1416_033_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1416	033	0	1	02	01	H1416_033_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1416	034	0	1	02	01	H1416_034_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1416	034	0	1	02	01	H1416_034_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1416	034	0	1	02	01	H1416_034_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1416	034	0	1	02	01	H1416_034_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1416	034	0	1	02	01	H1416_034_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1416	034	0	1	02	01	H1416_034_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1416	035	0	1	02	01	H1416_035_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1416	035	0	1	02	01	H1416_035_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1416	035	0	1	02	01	H1416_035_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1416	035	0	1	02	01	H1416_035_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1416	035	0	1	02	01	H1416_035_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1416	035	0	1	02	01	H1416_035_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1416	042	0	1	02	01	H1416_042_0	8			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1416	042	0	1	02	01	H1416_042_0	8			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1416	042	0	1	02	01	H1416_042_0	8			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1416	042	0	1	02	01	H1416_042_0	8			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1416	042	0	1	02	01	H1416_042_0	8			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1416	042	0	1	02	01	H1416_042_0	8			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1416	043	0	1	02	01	H1416_043_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1416	043	0	1	02	01	H1416_043_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1416	043	0	1	02	01	H1416_043_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1416	043	0	1	02	01	H1416_043_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1416	043	0	1	02	01	H1416_043_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1416	043	0	1	02	01	H1416_043_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1416	044	0	1	02	01	H1416_044_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1416	044	0	1	02	01	H1416_044_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1416	044	0	1	02	01	H1416_044_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1416	044	0	1	02	01	H1416_044_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1416	044	0	1	02	01	H1416_044_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1416	044	0	1	02	01	H1416_044_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1416	055	0	1	02	01	H1416_055_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1416	055	0	1	02	01	H1416_055_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1416	055	0	1	02	01	H1416_055_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1416	055	0	1	02	01	H1416_055_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1416	055	0	1	02	01	H1416_055_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1416	055	0	1	02	01	H1416_055_0	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1416	064	0	1	02	01	H1416_064_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1416	064	0	1	02	01	H1416_064_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1416	064	0	1	02	01	H1416_064_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1416	064	0	1	02	01	H1416_064_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1416	064	0	1	02	01	H1416_064_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1416	064	0	1	02	01	H1416_064_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1416	065	0	1	02	01	H1416_065_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1416	065	0	1	02	01	H1416_065_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1416	065	0	1	02	01	H1416_065_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1416	065	0	1	02	01	H1416_065_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1416	065	0	1	02	01	H1416_065_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1416	065	0	1	02	01	H1416_065_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1416	068	0	1	02	01	H1416_068_0	8			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1416	068	0	1	02	01	H1416_068_0	8			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1416	068	0	1	02	01	H1416_068_0	8			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1416	068	0	1	02	01	H1416_068_0	8			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1416	068	0	1	02	01	H1416_068_0	8			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1416	068	0	1	02	01	H1416_068_0	8			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1416	071	0	1	02	01	H1416_071_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1416	071	0	1	02	01	H1416_071_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1416	071	0	1	02	01	H1416_071_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1416	071	0	1	02	01	H1416_071_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1416	071	0	1	02	01	H1416_071_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1416	071	0	1	02	01	H1416_071_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1416	072	0	1	02	01	H1416_072_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1416	072	0	1	02	01	H1416_072_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1416	072	0	1	02	01	H1416_072_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1416	072	0	1	02	01	H1416_072_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1416	072	0	1	02	01	H1416_072_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1416	072	0	1	02	01	H1416_072_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1416	077	0	1	02	01	H1416_077_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1416	077	0	1	02	01	H1416_077_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1416	077	0	1	02	01	H1416_077_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1416	077	0	1	02	01	H1416_077_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1416	077	0	1	02	01	H1416_077_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1416	077	0	1	02	01	H1416_077_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1416	079	0	1	02	01	H1416_079_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1416	079	0	1	02	01	H1416_079_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1416	079	0	1	02	01	H1416_079_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1416	079	0	1	02	01	H1416_079_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1416	079	0	1	02	01	H1416_079_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1416	079	0	1	02	01	H1416_079_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1416	081	0	1	02	01	H1416_081_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1416	081	0	1	02	01	H1416_081_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1416	081	0	1	02	01	H1416_081_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1416	081	0	1	02	01	H1416_081_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1416	081	0	1	02	01	H1416_081_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1416	081	0	1	02	01	H1416_081_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1416	082	0	1	02	01	H1416_082_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1416	082	0	1	02	01	H1416_082_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1416	082	0	1	02	01	H1416_082_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1416	082	0	1	02	01	H1416_082_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1416	082	0	1	02	01	H1416_082_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1416	082	0	1	02	01	H1416_082_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1416	083	0	1	02	01	H1416_083_0	8			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1416	083	0	1	02	01	H1416_083_0	8			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1416	083	0	1	02	01	H1416_083_0	8			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1416	083	0	1	02	01	H1416_083_0	8			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1416	083	0	1	02	01	H1416_083_0	8			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1416	083	0	1	02	01	H1416_083_0	8			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1423	001	0	1	02	01	H1423_001_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H1423	001	0	1	02	01	H1423_001_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1423	001	0	1	02	01	H1423_001_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1423	001	0	1	02	01	H1423_001_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1423	001	0	1	02	01	H1423_001_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1423	001	0	1	02	01	H1423_001_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1423	002	0	1	02	01	H1423_002_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H1423	002	0	1	02	01	H1423_002_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1423	002	0	1	02	01	H1423_002_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1423	002	0	1	02	01	H1423_002_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1423	002	0	1	02	01	H1423_002_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1423	002	0	1	02	01	H1423_002_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1423	004	0	1	02	01	H1423_004_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H1423	004	0	1	02	01	H1423_004_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1423	004	0	1	02	01	H1423_004_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1423	004	0	1	02	01	H1423_004_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1423	004	0	1	02	01	H1423_004_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1423	004	0	1	02	01	H1423_004_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1423	005	0	1	01	01	H1423_005_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H1423	005	0	1	01	01	H1423_005_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1423	005	0	1	01	01	H1423_005_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1423	005	0	1	01	01	H1423_005_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1423	005	0	1	01	01	H1423_005_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1423	005	0	1	01	01	H1423_005_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1423	007	0	1	01	01	H1423_007_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H1423	007	0	1	01	01	H1423_007_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1423	007	0	1	01	01	H1423_007_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1423	007	0	1	01	01	H1423_007_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1423	007	0	1	01	01	H1423_007_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1423	007	0	1	01	01	H1423_007_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1423	008	0	1	01	01	H1423_008_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H1423	008	0	1	01	01	H1423_008_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1423	008	0	1	01	01	H1423_008_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1423	008	0	1	01	01	H1423_008_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1423	008	0	1	01	01	H1423_008_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1423	008	0	1	01	01	H1423_008_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1423	009	0	1	02	01	H1423_009_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1423	009	0	1	02	01	H1423_009_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1423	009	0	1	02	01	H1423_009_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1423	009	0	1	02	01	H1423_009_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1423	009	0	1	02	01	H1423_009_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1468	007	0	1	01	01	H1468_007_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H1468	007	0	1	01	01	H1468_007_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1468	007	0	1	01	01	H1468_007_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1468	007	0	1	01	01	H1468_007_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1468	007	0	1	01	01	H1468_007_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1468	013	0	1	01	01	H1468_013_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H1468	013	0	1	01	01	H1468_013_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1468	013	0	1	01	01	H1468_013_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1468	013	0	1	01	01	H1468_013_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1468	013	0	1	01	01	H1468_013_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1468	017	0	1	01	01	H1468_017_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1468	017	0	1	01	01	H1468_017_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1468	017	0	1	01	01	H1468_017_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1468	017	0	1	01	01	H1468_017_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1468	017	0	1	01	01	H1468_017_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1468	017	0	1	01	01	H1468_017_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1468	021	0	1	01	01	H1468_021_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H1468	021	0	1	01	01	H1468_021_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1468	021	0	1	01	01	H1468_021_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1468	021	0	1	01	01	H1468_021_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1468	021	0	1	01	01	H1468_021_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1526	001	0	1	02	01	H1526_001_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Diabetic Drugs	1	2	01	1	2	0.00	
H1526	001	0	1	02	01	H1526_001_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Diabetic Drugs	2	2	01	1	2	0.00	
H1526	001	0	1	02	01	H1526_001_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Diabetic Drugs	3	2	11	1	2	0.00	
H1526	001	0	1	02	01	H1526_001_0	5			Non-Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Diabetic Drugs	4	2	11	1	2	0.00	
H1526	001	0	1	02	01	H1526_001_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Diabetic Drugs	5	2	11	1	2	0.00	
H1526	001	0	1	02	01	H1526_001_0	5			Select Diabetic Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Diabetic Drugs	6	2	11	1	2	0.00	
H1526	002	0	1	02	01	H1526_002_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Diabetic Drugs	1	2	01	1	2	0.00	
H1526	002	0	1	02	01	H1526_002_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Diabetic Drugs	2	2	01	1	2	0.00	
H1526	002	0	1	02	01	H1526_002_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Diabetic Drugs	3	2	10	1	2	0.00	
H1526	002	0	1	02	01	H1526_002_0	5			Non-Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Diabetic Drugs	4	2	10	1	2	0.00	
H1526	002	0	1	02	01	H1526_002_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Diabetic Drugs	5	2	11	1	2	0.00	
H1526	002	0	1	02	01	H1526_002_0	5			Select Diabetic Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Diabetic Drugs	6	2	11	1	2	0.00	
H1526	003	0	1	02	01	H1526_003_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Diabetic Drugs	1	2	01	1	2	0.00	
H1526	003	0	1	02	01	H1526_003_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Diabetic Drugs	2	2	01	1	2	0.00	
H1526	003	0	1	02	01	H1526_003_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Diabetic Drugs	3	2	11	1	2	0.00	
H1526	003	0	1	02	01	H1526_003_0	5			Non-Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Diabetic Drugs	4	2	11	1	2	0.00	
H1526	003	0	1	02	01	H1526_003_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Diabetic Drugs	5	2	11	1	2	0.00	
H1526	003	0	1	02	01	H1526_003_0	5			Select Diabetic Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Diabetic Drugs	6	2	11	1	2	0.00	
H1526	008	0	1	02	01	H1526_008_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Diabetic Drugs	1	2	01	1	2	0.00	
H1526	008	0	1	02	01	H1526_008_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Diabetic Drugs	2	2	01	1	2	0.00	
H1526	008	0	1	02	01	H1526_008_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Diabetic Drugs	3	2	11	1	2	0.00	
H1526	008	0	1	02	01	H1526_008_0	4			Non-Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Diabetic Drugs	4	2	11	1	2	0.00	
H1526	008	0	1	02	01	H1526_008_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Diabetic Drugs	5	2	11	1	2	0.00	
H1526	008	0	1	02	01	H1526_008_0	4			Select Diabetic Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Diabetic Drugs	6	2	11	1	2	0.00	
H1526	009	0	1	02	01	H1526_009_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Diabetic Drugs	1	2	01	1	2	0.00	
H1526	009	0	1	02	01	H1526_009_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Diabetic Drugs	2	2	01	1	2	0.00	
H1526	009	0	1	02	01	H1526_009_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Diabetic Drugs	3	2	11	1	2	0.00	
H1526	009	0	1	02	01	H1526_009_0	4			Non-Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Diabetic Drugs	4	2	11	1	2	0.00	
H1526	009	0	1	02	01	H1526_009_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Diabetic Drugs	5	2	11	1	2	0.00	
H1526	009	0	1	02	01	H1526_009_0	4			Select Diabetic Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Diabetic Drugs	6	2	11	1	2	0.00	
H1607	012	0	1	04	01	H1607_012_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H1607	012	0	1	04	01	H1607_012_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1607	012	0	1	04	01	H1607_012_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1607	012	0	1	04	01	H1607_012_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1607	012	0	1	04	01	H1607_012_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1607	012	0	1	04	01	H1607_012_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1607	015	0	1	04	01	H1607_015_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H1607	015	0	1	04	01	H1607_015_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1607	015	0	1	04	01	H1607_015_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1607	015	0	1	04	01	H1607_015_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1607	015	0	1	04	01	H1607_015_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1607	015	0	1	04	01	H1607_015_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1608	001	0	1	04	01	H1608_001_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1608	001	0	1	04	01	H1608_001_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1608	001	0	1	04	01	H1608_001_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1608	001	0	1	04	01	H1608_001_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1608	001	0	1	04	01	H1608_001_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1608	012	0	1	04	01	H1608_012_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1608	012	0	1	04	01	H1608_012_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1608	012	0	1	04	01	H1608_012_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1608	012	0	1	04	01	H1608_012_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1608	012	0	1	04	01	H1608_012_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1608	013	0	1	04	01	H1608_013_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1608	013	0	1	04	01	H1608_013_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1608	013	0	1	04	01	H1608_013_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1608	013	0	1	04	01	H1608_013_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1608	013	0	1	04	01	H1608_013_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1608	016	0	1	04	01	H1608_016_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1608	016	0	1	04	01	H1608_016_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1608	016	0	1	04	01	H1608_016_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1608	016	0	1	04	01	H1608_016_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1608	016	0	1	04	01	H1608_016_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1608	017	0	1	04	01	H1608_017_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1608	017	0	1	04	01	H1608_017_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1608	017	0	1	04	01	H1608_017_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1608	017	0	1	04	01	H1608_017_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1608	017	0	1	04	01	H1608_017_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1608	018	0	1	04	01	H1608_018_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1608	018	0	1	04	01	H1608_018_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1608	018	0	1	04	01	H1608_018_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1608	018	0	1	04	01	H1608_018_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1608	018	0	1	04	01	H1608_018_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1608	021	0	1	04	01	H1608_021_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1608	021	0	1	04	01	H1608_021_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1608	021	0	1	04	01	H1608_021_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1608	021	0	1	04	01	H1608_021_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1608	021	0	1	04	01	H1608_021_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1608	024	0	1	04	01	H1608_024_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1608	024	0	1	04	01	H1608_024_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1608	024	0	1	04	01	H1608_024_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1608	024	0	1	04	01	H1608_024_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1608	024	0	1	04	01	H1608_024_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1608	027	0	1	04	01	H1608_027_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1608	027	0	1	04	01	H1608_027_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1608	027	0	1	04	01	H1608_027_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1608	027	0	1	04	01	H1608_027_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1608	027	0	1	04	01	H1608_027_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1608	028	0	1	04	01	H1608_028_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1608	028	0	1	04	01	H1608_028_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1608	028	0	1	04	01	H1608_028_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1608	028	0	1	04	01	H1608_028_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1608	028	0	1	04	01	H1608_028_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1608	029	0	1	04	01	H1608_029_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1608	029	0	1	04	01	H1608_029_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1608	029	0	1	04	01	H1608_029_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1608	029	0	1	04	01	H1608_029_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1608	029	0	1	04	01	H1608_029_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1608	031	0	1	04	01	H1608_031_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1608	031	0	1	04	01	H1608_031_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1608	031	0	1	04	01	H1608_031_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1608	031	0	1	04	01	H1608_031_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1608	031	0	1	04	01	H1608_031_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1608	037	0	1	04	01	H1608_037_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1608	037	0	1	04	01	H1608_037_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1608	037	0	1	04	01	H1608_037_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1608	037	0	1	04	01	H1608_037_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1608	037	0	1	04	01	H1608_037_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1608	038	0	1	04	01	H1608_038_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1608	038	0	1	04	01	H1608_038_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1608	038	0	1	04	01	H1608_038_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1608	038	0	1	04	01	H1608_038_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1608	038	0	1	04	01	H1608_038_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1608	040	0	1	04	01	H1608_040_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1608	040	0	1	04	01	H1608_040_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1608	040	0	1	04	01	H1608_040_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1608	040	0	1	04	01	H1608_040_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1608	040	0	1	04	01	H1608_040_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1608	050	0	1	04	01	H1608_050_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1608	050	0	1	04	01	H1608_050_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1608	050	0	1	04	01	H1608_050_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1608	050	0	1	04	01	H1608_050_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1608	050	0	1	04	01	H1608_050_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1608	051	0	1	04	01	H1608_051_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1608	051	0	1	04	01	H1608_051_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1608	051	0	1	04	01	H1608_051_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1608	051	0	1	04	01	H1608_051_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1608	051	0	1	04	01	H1608_051_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1608	052	0	1	04	01	H1608_052_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1608	052	0	1	04	01	H1608_052_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1608	052	0	1	04	01	H1608_052_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1608	052	0	1	04	01	H1608_052_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1608	052	0	1	04	01	H1608_052_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1608	054	0	1	04	01	H1608_054_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1608	054	0	1	04	01	H1608_054_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1608	054	0	1	04	01	H1608_054_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1608	054	0	1	04	01	H1608_054_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1608	054	0	1	04	01	H1608_054_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1608	062	0	1	04	01	H1608_062_0	2		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1608	062	0	1	04	01	H1608_062_0	2		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1608	062	0	1	04	01	H1608_062_0	2		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1608	062	0	1	04	01	H1608_062_0	2		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1608	062	0	1	04	01	H1608_062_0	2		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1608	067	0	1	04	01	H1608_067_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1608	067	0	1	04	01	H1608_067_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1608	067	0	1	04	01	H1608_067_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1608	067	0	1	04	01	H1608_067_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1608	067	0	1	04	01	H1608_067_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1608	070	0	1	04	01	H1608_070_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1608	070	0	1	04	01	H1608_070_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1608	070	0	1	04	01	H1608_070_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1608	070	0	1	04	01	H1608_070_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1608	070	0	1	04	01	H1608_070_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1608	072	0	1	04	01	H1608_072_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1608	072	0	1	04	01	H1608_072_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1608	072	0	1	04	01	H1608_072_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1608	072	0	1	04	01	H1608_072_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1608	072	0	1	04	01	H1608_072_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1608	076	0	1	04	01	H1608_076_0	2		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1608	076	0	1	04	01	H1608_076_0	2		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1608	076	0	1	04	01	H1608_076_0	2		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1608	076	0	1	04	01	H1608_076_0	2		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1608	076	0	1	04	01	H1608_076_0	2		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1608	077	0	1	04	01	H1608_077_0	2		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1608	077	0	1	04	01	H1608_077_0	2		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1608	077	0	1	04	01	H1608_077_0	2		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1608	077	0	1	04	01	H1608_077_0	2		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1608	077	0	1	04	01	H1608_077_0	2		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1608	079	0	1	04	01	H1608_079_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1608	079	0	1	04	01	H1608_079_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1608	079	0	1	04	01	H1608_079_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1608	079	0	1	04	01	H1608_079_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1608	079	0	1	04	01	H1608_079_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1608	081	0	1	04	01	H1608_081_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1608	081	0	1	04	01	H1608_081_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1608	081	0	1	04	01	H1608_081_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1608	081	0	1	04	01	H1608_081_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1608	081	0	1	04	01	H1608_081_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1608	085	0	1	04	01	H1608_085_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1608	085	0	1	04	01	H1608_085_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1608	085	0	1	04	01	H1608_085_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1608	085	0	1	04	01	H1608_085_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1608	085	0	1	04	01	H1608_085_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1608	105	0	1	04	01	H1608_105_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1608	105	0	1	04	01	H1608_105_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1608	105	0	1	04	01	H1608_105_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1608	105	0	1	04	01	H1608_105_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1608	105	0	1	04	01	H1608_105_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1608	109	0	1	04	01	H1608_109_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1608	109	0	1	04	01	H1608_109_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1608	109	0	1	04	01	H1608_109_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1608	109	0	1	04	01	H1608_109_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1608	109	0	1	04	01	H1608_109_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1608	117	0	1	04	01	H1608_117_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1608	117	0	1	04	01	H1608_117_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1608	117	0	1	04	01	H1608_117_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1608	117	0	1	04	01	H1608_117_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1608	117	0	1	04	01	H1608_117_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1608	118	0	1	04	01	H1608_118_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1608	118	0	1	04	01	H1608_118_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1608	118	0	1	04	01	H1608_118_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1608	118	0	1	04	01	H1608_118_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1608	118	0	1	04	01	H1608_118_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1608	119	0	1	04	01	H1608_119_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1608	119	0	1	04	01	H1608_119_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1608	119	0	1	04	01	H1608_119_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1608	119	0	1	04	01	H1608_119_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1608	119	0	1	04	01	H1608_119_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1608	120	0	1	04	01	H1608_120_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1608	120	0	1	04	01	H1608_120_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1608	120	0	1	04	01	H1608_120_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1608	120	0	1	04	01	H1608_120_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1608	120	0	1	04	01	H1608_120_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1608	121	0	1	04	01	H1608_121_0	2		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1608	121	0	1	04	01	H1608_121_0	2		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1608	121	0	1	04	01	H1608_121_0	2		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1608	121	0	1	04	01	H1608_121_0	2		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1608	121	0	1	04	01	H1608_121_0	2		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1609	001	0	1	02	01	H1609_001_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1609	001	0	1	02	01	H1609_001_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1609	001	0	1	02	01	H1609_001_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1609	001	0	1	02	01	H1609_001_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1609	001	0	1	02	01	H1609_001_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1609	017	0	1	01	01	H1609_017_0	3		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1609	017	0	1	01	01	H1609_017_0	3		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1609	017	0	1	01	01	H1609_017_0	3		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1609	017	0	1	01	01	H1609_017_0	3		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1609	017	0	1	01	01	H1609_017_0	3		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1609	018	0	1	01	01	H1609_018_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1609	018	0	1	01	01	H1609_018_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1609	018	0	1	01	01	H1609_018_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1609	018	0	1	01	01	H1609_018_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1609	018	0	1	01	01	H1609_018_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1609	019	0	1	01	01	H1609_019_0	3		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1609	019	0	1	01	01	H1609_019_0	3		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1609	019	0	1	01	01	H1609_019_0	3		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1609	019	0	1	01	01	H1609_019_0	3		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1609	019	0	1	01	01	H1609_019_0	3		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1609	020	0	1	01	01	H1609_020_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1609	020	0	1	01	01	H1609_020_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1609	020	0	1	01	01	H1609_020_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1609	020	0	1	01	01	H1609_020_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1609	020	0	1	01	01	H1609_020_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1609	021	0	1	01	01	H1609_021_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1609	021	0	1	01	01	H1609_021_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1609	021	0	1	01	01	H1609_021_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1609	021	0	1	01	01	H1609_021_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1609	021	0	1	01	01	H1609_021_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1609	022	0	1	01	01	H1609_022_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1609	022	0	1	01	01	H1609_022_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1609	022	0	1	01	01	H1609_022_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1609	022	0	1	01	01	H1609_022_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1609	022	0	1	01	01	H1609_022_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1609	025	0	1	01	01	H1609_025_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1609	025	0	1	01	01	H1609_025_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1609	025	0	1	01	01	H1609_025_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1609	025	0	1	01	01	H1609_025_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1609	025	0	1	01	01	H1609_025_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1609	027	0	1	01	01	H1609_027_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1609	027	0	1	01	01	H1609_027_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1609	027	0	1	01	01	H1609_027_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1609	027	0	1	01	01	H1609_027_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1609	027	0	1	01	01	H1609_027_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1609	028	0	1	02	01	H1609_028_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1609	028	0	1	02	01	H1609_028_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1609	028	0	1	02	01	H1609_028_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1609	028	0	1	02	01	H1609_028_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1609	028	0	1	02	01	H1609_028_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1609	041	0	1	01	01	H1609_041_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1609	041	0	1	01	01	H1609_041_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1609	041	0	1	01	01	H1609_041_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1609	041	0	1	01	01	H1609_041_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1609	041	0	1	01	01	H1609_041_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1609	043	0	1	01	01	H1609_043_0	3		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1609	043	0	1	01	01	H1609_043_0	3		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1609	043	0	1	01	01	H1609_043_0	3		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1609	043	0	1	01	01	H1609_043_0	3		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1609	043	0	1	01	01	H1609_043_0	3		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1609	044	0	1	01	01	H1609_044_0	3		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1609	044	0	1	01	01	H1609_044_0	3		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1609	044	0	1	01	01	H1609_044_0	3		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1609	044	0	1	01	01	H1609_044_0	3		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1609	044	0	1	01	01	H1609_044_0	3		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1609	045	0	1	01	01	H1609_045_0	3		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1609	045	0	1	01	01	H1609_045_0	3		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1609	045	0	1	01	01	H1609_045_0	3		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1609	045	0	1	01	01	H1609_045_0	3		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1609	045	0	1	01	01	H1609_045_0	3		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1609	046	0	1	01	01	H1609_046_0	3		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1609	046	0	1	01	01	H1609_046_0	3		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1609	046	0	1	01	01	H1609_046_0	3		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1609	046	0	1	01	01	H1609_046_0	3		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1609	046	0	1	01	01	H1609_046_0	3		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1609	047	0	1	01	01	H1609_047_0	3		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1609	047	0	1	01	01	H1609_047_0	3		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1609	047	0	1	01	01	H1609_047_0	3		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1609	047	0	1	01	01	H1609_047_0	3		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1609	047	0	1	01	01	H1609_047_0	3		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1609	048	0	1	01	01	H1609_048_0	3		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1609	048	0	1	01	01	H1609_048_0	3		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1609	048	0	1	01	01	H1609_048_0	3		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1609	048	0	1	01	01	H1609_048_0	3		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1609	048	0	1	01	01	H1609_048_0	3		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1609	049	0	1	01	01	H1609_049_0	3		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1609	049	0	1	01	01	H1609_049_0	3		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1609	049	0	1	01	01	H1609_049_0	3		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1609	049	0	1	01	01	H1609_049_0	3		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1609	049	0	1	01	01	H1609_049_0	3		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1609	055	0	1	01	01	H1609_055_0	3		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1609	055	0	1	01	01	H1609_055_0	3		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1609	055	0	1	01	01	H1609_055_0	3		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1609	055	0	1	01	01	H1609_055_0	3		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1609	055	0	1	01	01	H1609_055_0	3		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1609	056	0	1	01	01	H1609_056_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1609	056	0	1	01	01	H1609_056_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1609	056	0	1	01	01	H1609_056_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1609	056	0	1	01	01	H1609_056_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1609	056	0	1	01	01	H1609_056_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1609	059	0	1	01	01	H1609_059_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1609	059	0	1	01	01	H1609_059_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1609	059	0	1	01	01	H1609_059_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1609	059	0	1	01	01	H1609_059_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1609	059	0	1	01	01	H1609_059_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1609	061	0	1	01	01	H1609_061_0	3		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1609	061	0	1	01	01	H1609_061_0	3		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1609	061	0	1	01	01	H1609_061_0	3		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1609	061	0	1	01	01	H1609_061_0	3		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1609	061	0	1	01	01	H1609_061_0	3		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1609	062	0	1	01	01	H1609_062_0	3		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1609	062	0	1	01	01	H1609_062_0	3		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1609	062	0	1	01	01	H1609_062_0	3		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1609	062	0	1	01	01	H1609_062_0	3		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1609	062	0	1	01	01	H1609_062_0	3		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1609	063	0	1	01	01	H1609_063_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1609	063	0	1	01	01	H1609_063_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1609	063	0	1	01	01	H1609_063_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1609	063	0	1	01	01	H1609_063_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1609	063	0	1	01	01	H1609_063_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1609	064	0	1	01	01	H1609_064_0	3		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1609	064	0	1	01	01	H1609_064_0	3		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1609	064	0	1	01	01	H1609_064_0	3		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1609	064	0	1	01	01	H1609_064_0	3		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1609	064	0	1	01	01	H1609_064_0	3		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1609	068	0	1	02	01	H1609_068_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1609	068	0	1	02	01	H1609_068_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1609	068	0	1	02	01	H1609_068_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1609	068	0	1	02	01	H1609_068_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1609	068	0	1	02	01	H1609_068_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1609	069	0	1	02	01	H1609_069_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1609	069	0	1	02	01	H1609_069_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1609	069	0	1	02	01	H1609_069_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1609	069	0	1	02	01	H1609_069_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1609	069	0	1	02	01	H1609_069_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1609	073	0	1	01	01	H1609_073_0	3		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1609	073	0	1	01	01	H1609_073_0	3		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1609	073	0	1	01	01	H1609_073_0	3		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1609	073	0	1	01	01	H1609_073_0	3		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1609	073	0	1	01	01	H1609_073_0	3		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1609	074	0	1	01	01	H1609_074_0	3		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1609	074	0	1	01	01	H1609_074_0	3		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1609	074	0	1	01	01	H1609_074_0	3		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1609	074	0	1	01	01	H1609_074_0	3		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1609	074	0	1	01	01	H1609_074_0	3		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1609	075	0	1	01	01	H1609_075_0	3		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1609	075	0	1	01	01	H1609_075_0	3		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1609	075	0	1	01	01	H1609_075_0	3		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1609	075	0	1	01	01	H1609_075_0	3		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1609	075	0	1	01	01	H1609_075_0	3		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1609	076	0	1	01	01	H1609_076_0	3		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1609	076	0	1	01	01	H1609_076_0	3		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1609	076	0	1	01	01	H1609_076_0	3		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1609	076	0	1	01	01	H1609_076_0	3		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1609	076	0	1	01	01	H1609_076_0	3		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1609	077	0	1	01	01	H1609_077_0	3		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1609	077	0	1	01	01	H1609_077_0	3		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1609	077	0	1	01	01	H1609_077_0	3		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1609	077	0	1	01	01	H1609_077_0	3		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1609	077	0	1	01	01	H1609_077_0	3		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1609	078	0	1	01	01	H1609_078_0	3		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1609	078	0	1	01	01	H1609_078_0	3		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1609	078	0	1	01	01	H1609_078_0	3		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1609	078	0	1	01	01	H1609_078_0	3		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1609	078	0	1	01	01	H1609_078_0	3		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1609	079	0	1	01	01	H1609_079_0	3		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1609	079	0	1	01	01	H1609_079_0	3		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1609	079	0	1	01	01	H1609_079_0	3		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1609	079	0	1	01	01	H1609_079_0	3		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1609	079	0	1	01	01	H1609_079_0	3		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1609	080	0	1	01	01	H1609_080_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1609	080	0	1	01	01	H1609_080_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1609	080	0	1	01	01	H1609_080_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1609	080	0	1	01	01	H1609_080_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1609	080	0	1	01	01	H1609_080_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1609	081	0	1	01	01	H1609_081_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1609	081	0	1	01	01	H1609_081_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1609	081	0	1	01	01	H1609_081_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1609	081	0	1	01	01	H1609_081_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1609	081	0	1	01	01	H1609_081_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1609	082	0	1	01	01	H1609_082_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1609	082	0	1	01	01	H1609_082_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1609	082	0	1	01	01	H1609_082_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1609	082	0	1	01	01	H1609_082_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1609	082	0	1	01	01	H1609_082_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1609	083	0	1	01	01	H1609_083_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1609	083	0	1	01	01	H1609_083_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1609	083	0	1	01	01	H1609_083_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1609	083	0	1	01	01	H1609_083_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1609	083	0	1	01	01	H1609_083_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1609	084	0	1	01	01	H1609_084_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1609	084	0	1	01	01	H1609_084_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1609	084	0	1	01	01	H1609_084_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1609	084	0	1	01	01	H1609_084_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1609	084	0	1	01	01	H1609_084_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1609	085	0	1	01	01	H1609_085_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1609	085	0	1	01	01	H1609_085_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1609	085	0	1	01	01	H1609_085_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1609	085	0	1	01	01	H1609_085_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1609	085	0	1	01	01	H1609_085_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1609	086	0	1	01	01	H1609_086_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1609	086	0	1	01	01	H1609_086_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1609	086	0	1	01	01	H1609_086_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1609	086	0	1	01	01	H1609_086_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1609	086	0	1	01	01	H1609_086_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1609	087	0	1	01	01	H1609_087_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1609	087	0	1	01	01	H1609_087_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1609	087	0	1	01	01	H1609_087_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1609	087	0	1	01	01	H1609_087_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1609	087	0	1	01	01	H1609_087_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1609	088	0	1	01	01	H1609_088_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1609	088	0	1	01	01	H1609_088_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1609	088	0	1	01	01	H1609_088_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1609	088	0	1	01	01	H1609_088_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1609	088	0	1	01	01	H1609_088_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1609	089	0	1	01	01	H1609_089_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1609	089	0	1	01	01	H1609_089_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1609	089	0	1	01	01	H1609_089_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1609	089	0	1	01	01	H1609_089_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1609	089	0	1	01	01	H1609_089_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1609	090	0	1	01	01	H1609_090_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1609	090	0	1	01	01	H1609_090_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1609	090	0	1	01	01	H1609_090_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1609	090	0	1	01	01	H1609_090_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1609	090	0	1	01	01	H1609_090_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1609	092	0	1	01	01	H1609_092_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1609	092	0	1	01	01	H1609_092_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1609	092	0	1	01	01	H1609_092_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1609	092	0	1	01	01	H1609_092_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1609	092	0	1	01	01	H1609_092_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1609	093	0	1	01	01	H1609_093_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1609	093	0	1	01	01	H1609_093_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1609	093	0	1	01	01	H1609_093_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1609	093	0	1	01	01	H1609_093_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1609	093	0	1	01	01	H1609_093_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1609	094	0	1	01	01	H1609_094_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1609	094	0	1	01	01	H1609_094_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1609	094	0	1	01	01	H1609_094_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1609	094	0	1	01	01	H1609_094_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1609	094	0	1	01	01	H1609_094_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1610	001	0	1	01	01	H1610_001_0	2		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1610	001	0	1	01	01	H1610_001_0	2		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1610	001	0	1	01	01	H1610_001_0	2		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1610	001	0	1	01	01	H1610_001_0	2		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1610	001	0	1	01	01	H1610_001_0	2		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1619	001	0	1	04	01	H1619_001_0	20			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1619	001	0	1	04	01	H1619_001_0	20			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1619	001	0	1	04	01	H1619_001_0	20			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1619	001	0	1	04	01	H1619_001_0	20			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1619	001	0	1	04	01	H1619_001_0	20			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1619	002	0	1	04	01	H1619_002_0	19			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1619	002	0	1	04	01	H1619_002_0	19			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1619	002	0	1	04	01	H1619_002_0	19			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1619	002	0	1	04	01	H1619_002_0	19			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1619	002	0	1	04	01	H1619_002_0	19			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1619	003	0	1	04	01	H1619_003_0	20			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1619	003	0	1	04	01	H1619_003_0	20			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1619	003	0	1	04	01	H1619_003_0	20			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1619	003	0	1	04	01	H1619_003_0	20			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1619	003	0	1	04	01	H1619_003_0	20			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1659	002	0	1	04	01	H1659_002_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1659	002	0	1	04	01	H1659_002_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H1659	002	0	1	04	01	H1659_002_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1659	002	0	1	04	01	H1659_002_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1659	002	0	1	04	01	H1659_002_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1664	001	0	1	02	01	H1664_001_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1664	001	0	1	02	01	H1664_001_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1664	001	0	1	02	01	H1664_001_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1664	001	0	1	02	01	H1664_001_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1664	001	0	1	02	01	H1664_001_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1664	001	0	1	02	01	H1664_001_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1664	005	0	1	02	01	H1664_005_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1664	005	0	1	02	01	H1664_005_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1664	005	0	1	02	01	H1664_005_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1664	005	0	1	02	01	H1664_005_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1664	005	0	1	02	01	H1664_005_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1664	005	0	1	02	01	H1664_005_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1664	006	0	1	02	01	H1664_006_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1664	006	0	1	02	01	H1664_006_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1664	006	0	1	02	01	H1664_006_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1664	006	0	1	02	01	H1664_006_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1664	006	0	1	02	01	H1664_006_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1664	006	0	1	02	01	H1664_006_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1664	012	0	1	02	01	H1664_012_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1664	012	0	1	02	01	H1664_012_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1664	012	0	1	02	01	H1664_012_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1664	012	0	1	02	01	H1664_012_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1664	012	0	1	02	01	H1664_012_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1664	012	0	1	02	01	H1664_012_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1666	003	0	1	04	01	H1666_003_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1666	003	0	1	04	01	H1666_003_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1666	003	0	1	04	01	H1666_003_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1666	003	0	1	04	01	H1666_003_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1666	003	0	1	04	01	H1666_003_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1666	006	0	1	04	01	H1666_006_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1666	006	0	1	04	01	H1666_006_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1666	006	0	1	04	01	H1666_006_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1666	006	0	1	04	01	H1666_006_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1666	006	0	1	04	01	H1666_006_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1666	008	0	1	04	01	H1666_008_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1666	008	0	1	04	01	H1666_008_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1666	008	0	1	04	01	H1666_008_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1666	008	0	1	04	01	H1666_008_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1666	008	0	1	04	01	H1666_008_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1666	012	0	1	04	01	H1666_012_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1666	012	0	1	04	01	H1666_012_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1666	012	0	1	04	01	H1666_012_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1666	012	0	1	04	01	H1666_012_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1666	012	0	1	04	01	H1666_012_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1666	014	0	1	04	01	H1666_014_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1666	014	0	1	04	01	H1666_014_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1666	014	0	1	04	01	H1666_014_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1666	014	0	1	04	01	H1666_014_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1666	014	0	1	04	01	H1666_014_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1666	016	0	1	04	01	H1666_016_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1666	016	0	1	04	01	H1666_016_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1666	016	0	1	04	01	H1666_016_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1666	016	0	1	04	01	H1666_016_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1666	016	0	1	04	01	H1666_016_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1666	019	0	1	04	01	H1666_019_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1666	019	0	1	04	01	H1666_019_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1666	019	0	1	04	01	H1666_019_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1666	019	0	1	04	01	H1666_019_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1666	019	0	1	04	01	H1666_019_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1666	020	0	1	04	01	H1666_020_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1666	020	0	1	04	01	H1666_020_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1666	020	0	1	04	01	H1666_020_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1666	020	0	1	04	01	H1666_020_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1666	020	0	1	04	01	H1666_020_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1666	021	0	1	04	01	H1666_021_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1666	021	0	1	04	01	H1666_021_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1666	021	0	1	04	01	H1666_021_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1666	021	0	1	04	01	H1666_021_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1666	021	0	1	04	01	H1666_021_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1666	022	0	1	04	01	H1666_022_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1666	022	0	1	04	01	H1666_022_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1666	022	0	1	04	01	H1666_022_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1666	022	0	1	04	01	H1666_022_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1666	022	0	1	04	01	H1666_022_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1666	023	0	1	04	01	H1666_023_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1666	023	0	1	04	01	H1666_023_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1666	023	0	1	04	01	H1666_023_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1666	023	0	1	04	01	H1666_023_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1666	023	0	1	04	01	H1666_023_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1666	024	0	1	04	01	H1666_024_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1666	024	0	1	04	01	H1666_024_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1666	024	0	1	04	01	H1666_024_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1666	024	0	1	04	01	H1666_024_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1666	024	0	1	04	01	H1666_024_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1671	001	0	1	01	01	H1671_001_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H1671	001	0	1	01	01	H1671_001_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H1671	001	0	1	01	01	H1671_001_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H1671	001	0	1	01	01	H1671_001_0	6		N	Non-Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	4	2	10	1	2	0.00	
H1671	001	0	1	01	01	H1671_001_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1671	001	0	1	01	01	H1671_001_0	6		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H1692	002	0	1	01	01	H1692_002_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1692	002	0	1	01	01	H1692_002_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1692	002	0	1	01	01	H1692_002_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1692	002	0	1	01	01	H1692_002_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1692	002	0	1	01	01	H1692_002_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1692	003	0	1	01	01	H1692_003_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1692	003	0	1	01	01	H1692_003_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1692	003	0	1	01	01	H1692_003_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1692	003	0	1	01	01	H1692_003_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1692	003	0	1	01	01	H1692_003_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1692	005	0	1	01	01	H1692_005_0	2		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1692	005	0	1	01	01	H1692_005_0	2		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1692	005	0	1	01	01	H1692_005_0	2		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1692	005	0	1	01	01	H1692_005_0	2		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1692	005	0	1	01	01	H1692_005_0	2		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1692	007	0	1	01	01	H1692_007_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1692	007	0	1	01	01	H1692_007_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1692	007	0	1	01	01	H1692_007_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1692	007	0	1	01	01	H1692_007_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1692	007	0	1	01	01	H1692_007_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1722	002	0	1	01	01	H1722_002_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1722	002	0	1	01	01	H1722_002_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	3	2	2.00	
H1722	002	0	1	01	01	H1722_002_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1722	002	0	1	01	01	H1722_002_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1722	002	0	1	01	01	H1722_002_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1722	002	0	1	01	01	H1722_002_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H1787	002	0	1	01	01	H1787_002_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H1787	002	0	1	01	01	H1787_002_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H1787	002	0	1	01	01	H1787_002_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H1787	002	0	1	01	01	H1787_002_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	10	1	2	0.00	
H1787	002	0	1	01	01	H1787_002_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1787	002	0	1	01	01	H1787_002_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1799	003	1	1	01	01	H1799_003_1	9		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1799	003	1	1	01	01	H1799_003_1	9		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1799	003	1	1	01	01	H1799_003_1	9		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1799	003	1	1	01	01	H1799_003_1	9		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1799	003	1	1	01	01	H1799_003_1	9		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1799	003	1	1	01	01	H1799_003_1	9		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H1799	003	2	1	01	01	H1799_003_2	9		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1799	003	2	1	01	01	H1799_003_2	9		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1799	003	2	1	01	01	H1799_003_2	9		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1799	003	2	1	01	01	H1799_003_2	9		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1799	003	2	1	01	01	H1799_003_2	9		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1799	003	2	1	01	01	H1799_003_2	9		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H1799	003	3	1	01	01	H1799_003_3	9		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1799	003	3	1	01	01	H1799_003_3	9		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1799	003	3	1	01	01	H1799_003_3	9		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1799	003	3	1	01	01	H1799_003_3	9		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1799	003	3	1	01	01	H1799_003_3	9		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1799	003	3	1	01	01	H1799_003_3	9		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H1799	004	0	1	01	01	H1799_004_0	9		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1799	004	0	1	01	01	H1799_004_0	9		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1799	004	0	1	01	01	H1799_004_0	9		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1799	004	0	1	01	01	H1799_004_0	9		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1799	004	0	1	01	01	H1799_004_0	9		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1799	004	0	1	01	01	H1799_004_0	9		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H1799	005	0	1	01	01	H1799_005_0	9		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1799	005	0	1	01	01	H1799_005_0	9		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1799	005	0	1	01	01	H1799_005_0	9		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1799	005	0	1	01	01	H1799_005_0	9		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1799	005	0	1	01	01	H1799_005_0	9		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1799	005	0	1	01	01	H1799_005_0	9		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H1822	001	0	1	01	01	H1822_001_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H1822	001	0	1	01	01	H1822_001_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1822	001	0	1	01	01	H1822_001_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1822	001	0	1	01	01	H1822_001_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1822	001	0	1	01	01	H1822_001_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1822	002	0	1	01	01	H1822_002_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1822	002	0	1	01	01	H1822_002_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1822	002	0	1	01	01	H1822_002_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1822	002	0	1	01	01	H1822_002_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1822	002	0	1	01	01	H1822_002_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1822	005	0	1	02	01	H1822_005_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1822	005	0	1	02	01	H1822_005_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1822	005	0	1	02	01	H1822_005_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1822	005	0	1	02	01	H1822_005_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1822	005	0	1	02	01	H1822_005_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1822	006	0	1	01	01	H1822_006_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1822	006	0	1	01	01	H1822_006_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1822	006	0	1	01	01	H1822_006_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1822	006	0	1	01	01	H1822_006_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1822	006	0	1	01	01	H1822_006_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1822	007	0	1	01	01	H1822_007_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H1822	007	0	1	01	01	H1822_007_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1822	007	0	1	01	01	H1822_007_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1822	007	0	1	01	01	H1822_007_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1822	007	0	1	01	01	H1822_007_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1822	008	0	1	02	01	H1822_008_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1822	008	0	1	02	01	H1822_008_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1822	008	0	1	02	01	H1822_008_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1822	008	0	1	02	01	H1822_008_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1822	008	0	1	02	01	H1822_008_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1846	005	0	1	04	01	H1846_005_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1846	005	0	1	04	01	H1846_005_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	5.00	
H1846	005	0	1	04	01	H1846_005_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1846	005	0	1	04	01	H1846_005_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1846	005	0	1	04	01	H1846_005_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1846	006	0	1	04	01	H1846_006_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1846	006	0	1	04	01	H1846_006_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	5.00	
H1846	006	0	1	04	01	H1846_006_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1846	006	0	1	04	01	H1846_006_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1846	006	0	1	04	01	H1846_006_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1846	007	0	1	04	01	H1846_007_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1846	007	0	1	04	01	H1846_007_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	5.00	
H1846	007	0	1	04	01	H1846_007_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1846	007	0	1	04	01	H1846_007_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1846	007	0	1	04	01	H1846_007_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1862	003	0	1	02	01	H1862_003_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1862	003	0	1	02	01	H1862_003_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1862	003	0	1	02	01	H1862_003_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1862	003	0	1	02	01	H1862_003_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1862	003	0	1	02	01	H1862_003_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1862	003	0	1	02	01	H1862_003_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1862	004	0	1	02	01	H1862_004_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1862	004	0	1	02	01	H1862_004_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1862	004	0	1	02	01	H1862_004_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1862	004	0	1	02	01	H1862_004_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1862	004	0	1	02	01	H1862_004_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1862	004	0	1	02	01	H1862_004_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1862	005	0	1	02	01	H1862_005_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1862	005	0	1	02	01	H1862_005_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1862	005	0	1	02	01	H1862_005_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1862	005	0	1	02	01	H1862_005_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1862	005	0	1	02	01	H1862_005_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1862	005	0	1	02	01	H1862_005_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1862	006	0	1	02	01	H1862_006_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1862	006	0	1	02	01	H1862_006_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1862	006	0	1	02	01	H1862_006_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1862	006	0	1	02	01	H1862_006_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1862	006	0	1	02	01	H1862_006_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1862	006	0	1	02	01	H1862_006_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1889	002	1	1	04	01	H1889_002_1	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1889	002	1	1	04	01	H1889_002_1	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1889	002	1	1	04	01	H1889_002_1	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1889	002	1	1	04	01	H1889_002_1	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1889	002	1	1	04	01	H1889_002_1	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1889	002	2	1	04	01	H1889_002_2	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1889	002	2	1	04	01	H1889_002_2	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1889	002	2	1	04	01	H1889_002_2	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1889	002	2	1	04	01	H1889_002_2	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1889	002	2	1	04	01	H1889_002_2	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1889	005	0	1	04	01	H1889_005_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1889	005	0	1	04	01	H1889_005_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1889	005	0	1	04	01	H1889_005_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1889	005	0	1	04	01	H1889_005_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1889	005	0	1	04	01	H1889_005_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1889	007	0	1	04	01	H1889_007_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1889	007	0	1	04	01	H1889_007_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1889	007	0	1	04	01	H1889_007_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1889	007	0	1	04	01	H1889_007_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1889	007	0	1	04	01	H1889_007_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1889	008	0	1	04	01	H1889_008_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1889	008	0	1	04	01	H1889_008_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1889	008	0	1	04	01	H1889_008_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1889	008	0	1	04	01	H1889_008_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1889	008	0	1	04	01	H1889_008_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1889	009	0	1	04	01	H1889_009_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1889	009	0	1	04	01	H1889_009_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1889	009	0	1	04	01	H1889_009_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1889	009	0	1	04	01	H1889_009_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1889	009	0	1	04	01	H1889_009_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1889	010	0	1	04	01	H1889_010_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1889	010	0	1	04	01	H1889_010_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1889	010	0	1	04	01	H1889_010_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1889	010	0	1	04	01	H1889_010_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1889	010	0	1	04	01	H1889_010_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1889	011	0	1	04	01	H1889_011_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1889	011	0	1	04	01	H1889_011_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1889	011	0	1	04	01	H1889_011_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1889	011	0	1	04	01	H1889_011_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1889	011	0	1	04	01	H1889_011_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1889	012	0	1	04	01	H1889_012_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1889	012	0	1	04	01	H1889_012_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1889	012	0	1	04	01	H1889_012_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1889	012	0	1	04	01	H1889_012_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1889	012	0	1	04	01	H1889_012_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1889	013	0	1	04	01	H1889_013_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1889	013	0	1	04	01	H1889_013_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H1889	013	0	1	04	01	H1889_013_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1889	013	0	1	04	01	H1889_013_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1889	013	0	1	04	01	H1889_013_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1889	014	0	1	04	01	H1889_014_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1889	014	0	1	04	01	H1889_014_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H1889	014	0	1	04	01	H1889_014_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1889	014	0	1	04	01	H1889_014_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1889	014	0	1	04	01	H1889_014_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1889	015	0	1	04	01	H1889_015_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1889	015	0	1	04	01	H1889_015_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H1889	015	0	1	04	01	H1889_015_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1889	015	0	1	04	01	H1889_015_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1889	015	0	1	04	01	H1889_015_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1889	016	0	1	04	01	H1889_016_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1889	016	0	1	04	01	H1889_016_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H1889	016	0	1	04	01	H1889_016_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1889	016	0	1	04	01	H1889_016_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1889	016	0	1	04	01	H1889_016_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1889	017	0	1	04	01	H1889_017_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1889	017	0	1	04	01	H1889_017_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H1889	017	0	1	04	01	H1889_017_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1889	017	0	1	04	01	H1889_017_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1889	017	0	1	04	01	H1889_017_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1889	019	0	1	04	01	H1889_019_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1889	019	0	1	04	01	H1889_019_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H1889	019	0	1	04	01	H1889_019_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1889	019	0	1	04	01	H1889_019_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1889	019	0	1	04	01	H1889_019_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1889	020	0	1	04	01	H1889_020_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1889	020	0	1	04	01	H1889_020_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	5.00	
H1889	020	0	1	04	01	H1889_020_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1889	020	0	1	04	01	H1889_020_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1889	020	0	1	04	01	H1889_020_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1889	025	0	1	04	01	H1889_025_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1889	025	0	1	04	01	H1889_025_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H1889	025	0	1	04	01	H1889_025_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1889	025	0	1	04	01	H1889_025_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1889	025	0	1	04	01	H1889_025_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1889	026	0	1	04	01	H1889_026_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1889	026	0	1	04	01	H1889_026_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1889	026	0	1	04	01	H1889_026_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1889	026	0	1	04	01	H1889_026_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1889	026	0	1	04	01	H1889_026_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1889	030	0	1	04	01	H1889_030_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1889	030	0	1	04	01	H1889_030_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1889	030	0	1	04	01	H1889_030_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1889	030	0	1	04	01	H1889_030_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1889	030	0	1	04	01	H1889_030_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1889	031	0	1	04	01	H1889_031_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1889	031	0	1	04	01	H1889_031_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1889	031	0	1	04	01	H1889_031_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1889	031	0	1	04	01	H1889_031_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1889	031	0	1	04	01	H1889_031_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1889	032	0	1	04	01	H1889_032_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1889	032	0	1	04	01	H1889_032_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1889	032	0	1	04	01	H1889_032_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1889	032	0	1	04	01	H1889_032_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1889	032	0	1	04	01	H1889_032_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1889	034	0	1	04	01	H1889_034_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1889	034	0	1	04	01	H1889_034_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1889	034	0	1	04	01	H1889_034_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1889	034	0	1	04	01	H1889_034_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1889	034	0	1	04	01	H1889_034_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1889	035	0	1	04	01	H1889_035_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1889	035	0	1	04	01	H1889_035_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1889	035	0	1	04	01	H1889_035_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1889	035	0	1	04	01	H1889_035_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1889	035	0	1	04	01	H1889_035_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1894	002	0	1	01	01	H1894_002_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H1894	002	0	1	01	01	H1894_002_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1894	002	0	1	01	01	H1894_002_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1894	002	0	1	01	01	H1894_002_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1894	002	0	1	01	01	H1894_002_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1894	002	0	1	01	01	H1894_002_0	7		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1894	011	0	1	01	01	H1894_011_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H1894	011	0	1	01	01	H1894_011_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1894	011	0	1	01	01	H1894_011_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1894	011	0	1	01	01	H1894_011_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1894	011	0	1	01	01	H1894_011_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1894	011	0	1	01	01	H1894_011_0	7		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1914	001	0	1	04	01	H1914_001_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1914	001	0	1	04	01	H1914_001_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1914	001	0	1	04	01	H1914_001_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1914	001	0	1	04	01	H1914_001_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1914	001	0	1	04	01	H1914_001_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1914	001	0	1	04	01	H1914_001_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1914	002	0	1	04	01	H1914_002_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1914	002	0	1	04	01	H1914_002_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1914	002	0	1	04	01	H1914_002_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1914	002	0	1	04	01	H1914_002_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1914	002	0	1	04	01	H1914_002_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1914	002	0	1	04	01	H1914_002_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1914	007	0	1	04	01	H1914_007_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1914	007	0	1	04	01	H1914_007_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1914	007	0	1	04	01	H1914_007_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1914	007	0	1	04	01	H1914_007_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1914	007	0	1	04	01	H1914_007_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1914	007	0	1	04	01	H1914_007_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1914	008	0	1	04	01	H1914_008_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1914	008	0	1	04	01	H1914_008_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1914	008	0	1	04	01	H1914_008_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1914	008	0	1	04	01	H1914_008_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1914	008	0	1	04	01	H1914_008_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1914	008	0	1	04	01	H1914_008_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1914	009	0	1	04	01	H1914_009_0	9			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H1914	009	0	1	04	01	H1914_009_0	9			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1914	009	0	1	04	01	H1914_009_0	9			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1914	009	0	1	04	01	H1914_009_0	9			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1914	009	0	1	04	01	H1914_009_0	9			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1914	009	0	1	04	01	H1914_009_0	9			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1914	010	0	1	04	01	H1914_010_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1914	010	0	1	04	01	H1914_010_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1914	010	0	1	04	01	H1914_010_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1914	010	0	1	04	01	H1914_010_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1914	010	0	1	04	01	H1914_010_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1914	010	0	1	04	01	H1914_010_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1947	001	0	1	01	01	H1947_001_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H1947	001	0	1	01	01	H1947_001_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1947	001	0	1	01	01	H1947_001_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1947	001	0	1	01	01	H1947_001_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1947	001	0	1	01	01	H1947_001_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1947	001	0	1	01	01	H1947_001_0	5		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1947	003	0	1	01	01	H1947_003_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H1947	003	0	1	01	01	H1947_003_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1947	003	0	1	01	01	H1947_003_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1947	003	0	1	01	01	H1947_003_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1947	003	0	1	01	01	H1947_003_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1947	003	0	1	01	01	H1947_003_0	5		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1947	004	0	1	01	01	H1947_004_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H1947	004	0	1	01	01	H1947_004_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1947	004	0	1	01	01	H1947_004_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1947	004	0	1	01	01	H1947_004_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1947	004	0	1	01	01	H1947_004_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1947	004	0	1	01	01	H1947_004_0	5		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1951	013	0	1	01	01	H1951_013_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1951	013	0	1	01	01	H1951_013_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1951	013	0	1	01	01	H1951_013_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1951	013	0	1	01	01	H1951_013_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1951	013	0	1	01	01	H1951_013_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1951	024	0	1	01	01	H1951_024_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1951	024	0	1	01	01	H1951_024_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1951	024	0	1	01	01	H1951_024_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1951	024	0	1	01	01	H1951_024_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1951	024	0	1	01	01	H1951_024_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1951	028	0	1	01	01	H1951_028_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1951	028	0	1	01	01	H1951_028_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1951	028	0	1	01	01	H1951_028_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1951	028	0	1	01	01	H1951_028_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1951	028	0	1	01	01	H1951_028_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1951	032	0	1	01	01	H1951_032_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1951	032	0	1	01	01	H1951_032_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1951	032	0	1	01	01	H1951_032_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1951	032	0	1	01	01	H1951_032_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1951	032	0	1	01	01	H1951_032_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1951	038	0	1	01	01	H1951_038_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1951	038	0	1	01	01	H1951_038_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1951	038	0	1	01	01	H1951_038_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1951	038	0	1	01	01	H1951_038_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1951	038	0	1	01	01	H1951_038_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1951	039	0	1	01	01	H1951_039_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1951	039	0	1	01	01	H1951_039_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1951	039	0	1	01	01	H1951_039_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1951	039	0	1	01	01	H1951_039_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1951	039	0	1	01	01	H1951_039_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1951	041	0	1	01	01	H1951_041_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1951	041	0	1	01	01	H1951_041_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1951	041	0	1	01	01	H1951_041_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1951	041	0	1	01	01	H1951_041_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1951	041	0	1	01	01	H1951_041_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1951	044	0	1	01	01	H1951_044_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H1951	044	0	1	01	01	H1951_044_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H1951	044	0	1	01	01	H1951_044_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1951	044	0	1	01	01	H1951_044_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1951	044	0	1	01	01	H1951_044_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1951	044	0	1	01	01	H1951_044_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1951	047	1	1	01	01	H1951_047_1	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1951	047	1	1	01	01	H1951_047_1	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1951	047	1	1	01	01	H1951_047_1	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1951	047	1	1	01	01	H1951_047_1	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1951	047	1	1	01	01	H1951_047_1	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1951	047	2	1	01	01	H1951_047_2	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1951	047	2	1	01	01	H1951_047_2	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1951	047	2	1	01	01	H1951_047_2	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1951	047	2	1	01	01	H1951_047_2	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1951	047	2	1	01	01	H1951_047_2	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1951	048	1	1	01	01	H1951_048_1	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1951	048	1	1	01	01	H1951_048_1	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1951	048	1	1	01	01	H1951_048_1	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1951	048	1	1	01	01	H1951_048_1	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1951	048	1	1	01	01	H1951_048_1	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1951	048	2	1	01	01	H1951_048_2	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1951	048	2	1	01	01	H1951_048_2	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1951	048	2	1	01	01	H1951_048_2	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1951	048	2	1	01	01	H1951_048_2	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1951	048	2	1	01	01	H1951_048_2	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1951	049	1	1	01	01	H1951_049_1	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1951	049	1	1	01	01	H1951_049_1	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1951	049	1	1	01	01	H1951_049_1	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1951	049	1	1	01	01	H1951_049_1	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1951	049	1	1	01	01	H1951_049_1	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1951	049	2	1	01	01	H1951_049_2	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1951	049	2	1	01	01	H1951_049_2	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1951	049	2	1	01	01	H1951_049_2	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1951	049	2	1	01	01	H1951_049_2	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1951	049	2	1	01	01	H1951_049_2	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1951	049	3	1	01	01	H1951_049_3	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1951	049	3	1	01	01	H1951_049_3	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1951	049	3	1	01	01	H1951_049_3	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1951	049	3	1	01	01	H1951_049_3	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1951	049	3	1	01	01	H1951_049_3	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1951	051	0	1	01	01	H1951_051_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1951	051	0	1	01	01	H1951_051_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1951	051	0	1	01	01	H1951_051_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1951	051	0	1	01	01	H1951_051_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1951	051	0	1	01	01	H1951_051_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1951	052	0	1	01	01	H1951_052_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1951	052	0	1	01	01	H1951_052_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1951	052	0	1	01	01	H1951_052_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1951	052	0	1	01	01	H1951_052_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1951	052	0	1	01	01	H1951_052_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1951	053	0	1	01	01	H1951_053_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1951	053	0	1	01	01	H1951_053_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1951	053	0	1	01	01	H1951_053_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1951	053	0	1	01	01	H1951_053_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1951	053	0	1	01	01	H1951_053_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1951	056	0	1	01	01	H1951_056_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1951	056	0	1	01	01	H1951_056_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1951	056	0	1	01	01	H1951_056_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1951	056	0	1	01	01	H1951_056_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1951	056	0	1	01	01	H1951_056_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1951	057	0	1	01	01	H1951_057_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1951	057	0	1	01	01	H1951_057_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1951	057	0	1	01	01	H1951_057_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1951	057	0	1	01	01	H1951_057_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1951	057	0	1	01	01	H1951_057_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1951	058	0	1	01	01	H1951_058_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1951	058	0	1	01	01	H1951_058_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1951	058	0	1	01	01	H1951_058_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1951	058	0	1	01	01	H1951_058_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1951	058	0	1	01	01	H1951_058_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1951	059	0	1	01	01	H1951_059_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1951	059	0	1	01	01	H1951_059_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1951	059	0	1	01	01	H1951_059_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1951	059	0	1	01	01	H1951_059_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1951	059	0	1	01	01	H1951_059_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1951	061	0	1	01	01	H1951_061_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1951	061	0	1	01	01	H1951_061_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1951	061	0	1	01	01	H1951_061_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1951	061	0	1	01	01	H1951_061_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1951	061	0	1	01	01	H1951_061_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1961	003	0	1	02	01	H1961_003_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1961	003	0	1	02	01	H1961_003_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1961	003	0	1	02	01	H1961_003_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1961	003	0	1	02	01	H1961_003_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1961	003	0	1	02	01	H1961_003_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1961	014	1	1	02	01	H1961_014_1	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1961	014	1	1	02	01	H1961_014_1	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	5.00	
H1961	014	1	1	02	01	H1961_014_1	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1961	014	1	1	02	01	H1961_014_1	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1961	014	1	1	02	01	H1961_014_1	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1961	014	2	1	02	01	H1961_014_2	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1961	014	2	1	02	01	H1961_014_2	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	5.00	
H1961	014	2	1	02	01	H1961_014_2	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1961	014	2	1	02	01	H1961_014_2	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1961	014	2	1	02	01	H1961_014_2	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1961	014	3	1	02	01	H1961_014_3	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1961	014	3	1	02	01	H1961_014_3	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	5.00	
H1961	014	3	1	02	01	H1961_014_3	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1961	014	3	1	02	01	H1961_014_3	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1961	014	3	1	02	01	H1961_014_3	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1961	014	4	1	02	01	H1961_014_4	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1961	014	4	1	02	01	H1961_014_4	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	5.00	
H1961	014	4	1	02	01	H1961_014_4	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1961	014	4	1	02	01	H1961_014_4	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1961	014	4	1	02	01	H1961_014_4	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1961	017	0	1	02	01	H1961_017_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1961	017	0	1	02	01	H1961_017_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H1961	017	0	1	02	01	H1961_017_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1961	017	0	1	02	01	H1961_017_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1961	017	0	1	02	01	H1961_017_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1961	019	0	1	02	01	H1961_019_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1961	019	0	1	02	01	H1961_019_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1961	019	0	1	02	01	H1961_019_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1961	019	0	1	02	01	H1961_019_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1961	019	0	1	02	01	H1961_019_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1961	020	0	1	02	01	H1961_020_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1961	020	0	1	02	01	H1961_020_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H1961	020	0	1	02	01	H1961_020_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1961	020	0	1	02	01	H1961_020_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1961	020	0	1	02	01	H1961_020_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1961	022	0	1	02	01	H1961_022_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1961	022	0	1	02	01	H1961_022_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	5.00	
H1961	022	0	1	02	01	H1961_022_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1961	022	0	1	02	01	H1961_022_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1961	022	0	1	02	01	H1961_022_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1961	023	0	1	02	01	H1961_023_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1961	023	0	1	02	01	H1961_023_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H1961	023	0	1	02	01	H1961_023_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1961	023	0	1	02	01	H1961_023_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1961	023	0	1	02	01	H1961_023_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1961	024	0	1	02	01	H1961_024_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1961	024	0	1	02	01	H1961_024_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1961	024	0	1	02	01	H1961_024_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1961	024	0	1	02	01	H1961_024_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1961	024	0	1	02	01	H1961_024_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1961	025	0	1	02	01	H1961_025_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1961	025	0	1	02	01	H1961_025_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	5.00	
H1961	025	0	1	02	01	H1961_025_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1961	025	0	1	02	01	H1961_025_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1961	025	0	1	02	01	H1961_025_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1993	001	0	1	01	01	H1993_001_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H1993	001	0	1	01	01	H1993_001_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	3	2	0.00	
H1993	001	0	1	01	01	H1993_001_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1993	001	0	1	01	01	H1993_001_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1993	001	0	1	01	01	H1993_001_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1993	001	0	1	01	01	H1993_001_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1993	007	0	1	01	01	H1993_007_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H1993	007	0	1	01	01	H1993_007_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	3	2	0.00	
H1993	007	0	1	01	01	H1993_007_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1993	007	0	1	01	01	H1993_007_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1993	007	0	1	01	01	H1993_007_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1993	007	0	1	01	01	H1993_007_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1993	008	0	1	01	01	H1993_008_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H1993	008	0	1	01	01	H1993_008_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	3	2	0.00	
H1993	008	0	1	01	01	H1993_008_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1993	008	0	1	01	01	H1993_008_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1993	008	0	1	01	01	H1993_008_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1993	008	0	1	01	01	H1993_008_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1993	011	0	1	01	01	H1993_011_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H1993	011	0	1	01	01	H1993_011_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	3	2	0.00	
H1993	011	0	1	01	01	H1993_011_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1993	011	0	1	01	01	H1993_011_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1993	011	0	1	01	01	H1993_011_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1993	011	0	1	01	01	H1993_011_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1993	012	0	1	01	01	H1993_012_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H1993	012	0	1	01	01	H1993_012_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	3	2	0.00	
H1993	012	0	1	01	01	H1993_012_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1993	012	0	1	01	01	H1993_012_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1993	012	0	1	01	01	H1993_012_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1993	012	0	1	01	01	H1993_012_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1993	013	0	1	01	01	H1993_013_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H1993	013	0	1	01	01	H1993_013_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	3	2	0.00	
H1993	013	0	1	01	01	H1993_013_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1993	013	0	1	01	01	H1993_013_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1993	013	0	1	01	01	H1993_013_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1993	013	0	1	01	01	H1993_013_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1993	015	0	1	01	01	H1993_015_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H1993	015	0	1	01	01	H1993_015_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	3	2	0.00	
H1993	015	0	1	01	01	H1993_015_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H1993	015	0	1	01	01	H1993_015_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H1993	015	0	1	01	01	H1993_015_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H1993	015	0	1	01	01	H1993_015_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H1994	001	0	1	01	01	H1994_001_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1994	001	0	1	01	01	H1994_001_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1994	001	0	1	01	01	H1994_001_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1994	001	0	1	01	01	H1994_001_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1994	001	0	1	01	01	H1994_001_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1994	012	0	1	01	01	H1994_012_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1994	012	0	1	01	01	H1994_012_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1994	012	0	1	01	01	H1994_012_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1994	012	0	1	01	01	H1994_012_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1994	012	0	1	01	01	H1994_012_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1994	017	0	1	01	01	H1994_017_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1994	017	0	1	01	01	H1994_017_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1994	017	0	1	01	01	H1994_017_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1994	017	0	1	01	01	H1994_017_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1994	017	0	1	01	01	H1994_017_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1994	021	0	1	01	01	H1994_021_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1994	021	0	1	01	01	H1994_021_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1994	021	0	1	01	01	H1994_021_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1994	021	0	1	01	01	H1994_021_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1994	021	0	1	01	01	H1994_021_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1994	022	0	1	01	01	H1994_022_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1994	022	0	1	01	01	H1994_022_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1994	022	0	1	01	01	H1994_022_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1994	022	0	1	01	01	H1994_022_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1994	022	0	1	01	01	H1994_022_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1994	027	0	1	01	01	H1994_027_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1994	027	0	1	01	01	H1994_027_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1994	027	0	1	01	01	H1994_027_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1994	027	0	1	01	01	H1994_027_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1994	027	0	1	01	01	H1994_027_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1994	029	0	1	01	01	H1994_029_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1994	029	0	1	01	01	H1994_029_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1994	029	0	1	01	01	H1994_029_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1994	029	0	1	01	01	H1994_029_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1994	029	0	1	01	01	H1994_029_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1994	030	0	1	01	01	H1994_030_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1994	030	0	1	01	01	H1994_030_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1994	030	0	1	01	01	H1994_030_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1994	030	0	1	01	01	H1994_030_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1994	030	0	1	01	01	H1994_030_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1994	031	0	1	01	01	H1994_031_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1994	031	0	1	01	01	H1994_031_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1994	031	0	1	01	01	H1994_031_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1994	031	0	1	01	01	H1994_031_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1994	031	0	1	01	01	H1994_031_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1994	034	0	1	01	01	H1994_034_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1994	034	0	1	01	01	H1994_034_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1994	034	0	1	01	01	H1994_034_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1994	034	0	1	01	01	H1994_034_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1994	034	0	1	01	01	H1994_034_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1994	035	0	1	01	01	H1994_035_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1994	035	0	1	01	01	H1994_035_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1994	035	0	1	01	01	H1994_035_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1994	035	0	1	01	01	H1994_035_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1994	035	0	1	01	01	H1994_035_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1994	044	0	1	01	01	H1994_044_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H1994	044	0	1	01	01	H1994_044_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H1994	044	0	1	01	01	H1994_044_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1994	044	0	1	01	01	H1994_044_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1994	044	0	1	01	01	H1994_044_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H1997	013	0	1	01	01	H1997_013_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H1997	013	0	1	01	01	H1997_013_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H1997	013	0	1	01	01	H1997_013_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H1997	013	0	1	01	01	H1997_013_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H1997	013	0	1	01	01	H1997_013_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	010	0	1	04	01	H2001_010_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	010	0	1	04	01	H2001_010_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H2001	010	0	1	04	01	H2001_010_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	010	0	1	04	01	H2001_010_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	010	0	1	04	01	H2001_010_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	017	0	1	04	01	H2001_017_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	017	0	1	04	01	H2001_017_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H2001	017	0	1	04	01	H2001_017_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	017	0	1	04	01	H2001_017_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	017	0	1	04	01	H2001_017_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	019	0	1	04	01	H2001_019_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	019	0	1	04	01	H2001_019_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H2001	019	0	1	04	01	H2001_019_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	019	0	1	04	01	H2001_019_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	019	0	1	04	01	H2001_019_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	023	0	1	04	01	H2001_023_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	023	0	1	04	01	H2001_023_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H2001	023	0	1	04	01	H2001_023_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	023	0	1	04	01	H2001_023_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	023	0	1	04	01	H2001_023_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	030	0	1	04	01	H2001_030_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	030	0	1	04	01	H2001_030_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2001	030	0	1	04	01	H2001_030_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	030	0	1	04	01	H2001_030_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	030	0	1	04	01	H2001_030_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	031	0	1	04	01	H2001_031_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	031	0	1	04	01	H2001_031_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2001	031	0	1	04	01	H2001_031_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	031	0	1	04	01	H2001_031_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	031	0	1	04	01	H2001_031_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	032	0	1	04	01	H2001_032_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	032	0	1	04	01	H2001_032_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2001	032	0	1	04	01	H2001_032_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	032	0	1	04	01	H2001_032_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	032	0	1	04	01	H2001_032_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	034	0	1	04	01	H2001_034_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	034	0	1	04	01	H2001_034_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2001	034	0	1	04	01	H2001_034_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	034	0	1	04	01	H2001_034_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	034	0	1	04	01	H2001_034_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	035	0	1	04	01	H2001_035_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	035	0	1	04	01	H2001_035_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2001	035	0	1	04	01	H2001_035_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	035	0	1	04	01	H2001_035_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	035	0	1	04	01	H2001_035_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	037	0	1	04	01	H2001_037_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	037	0	1	04	01	H2001_037_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2001	037	0	1	04	01	H2001_037_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	037	0	1	04	01	H2001_037_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	037	0	1	04	01	H2001_037_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	038	0	1	04	01	H2001_038_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	038	0	1	04	01	H2001_038_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2001	038	0	1	04	01	H2001_038_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	038	0	1	04	01	H2001_038_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	038	0	1	04	01	H2001_038_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	039	0	1	04	01	H2001_039_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	039	0	1	04	01	H2001_039_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2001	039	0	1	04	01	H2001_039_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	039	0	1	04	01	H2001_039_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	039	0	1	04	01	H2001_039_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	040	0	1	04	01	H2001_040_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	040	0	1	04	01	H2001_040_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2001	040	0	1	04	01	H2001_040_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	040	0	1	04	01	H2001_040_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	040	0	1	04	01	H2001_040_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	041	0	1	04	01	H2001_041_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	041	0	1	04	01	H2001_041_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2001	041	0	1	04	01	H2001_041_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	041	0	1	04	01	H2001_041_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	041	0	1	04	01	H2001_041_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	042	0	1	04	01	H2001_042_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	042	0	1	04	01	H2001_042_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2001	042	0	1	04	01	H2001_042_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	042	0	1	04	01	H2001_042_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	042	0	1	04	01	H2001_042_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	044	0	1	04	01	H2001_044_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	044	0	1	04	01	H2001_044_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2001	044	0	1	04	01	H2001_044_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	044	0	1	04	01	H2001_044_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	044	0	1	04	01	H2001_044_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	046	0	1	04	01	H2001_046_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	046	0	1	04	01	H2001_046_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2001	046	0	1	04	01	H2001_046_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	046	0	1	04	01	H2001_046_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	046	0	1	04	01	H2001_046_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	047	0	1	04	01	H2001_047_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	047	0	1	04	01	H2001_047_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2001	047	0	1	04	01	H2001_047_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	047	0	1	04	01	H2001_047_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	047	0	1	04	01	H2001_047_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	048	0	1	04	01	H2001_048_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	048	0	1	04	01	H2001_048_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2001	048	0	1	04	01	H2001_048_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	048	0	1	04	01	H2001_048_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	048	0	1	04	01	H2001_048_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	049	0	1	04	01	H2001_049_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	049	0	1	04	01	H2001_049_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2001	049	0	1	04	01	H2001_049_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	049	0	1	04	01	H2001_049_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	049	0	1	04	01	H2001_049_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	051	0	1	04	01	H2001_051_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	051	0	1	04	01	H2001_051_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2001	051	0	1	04	01	H2001_051_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	051	0	1	04	01	H2001_051_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	051	0	1	04	01	H2001_051_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	052	0	1	04	01	H2001_052_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	052	0	1	04	01	H2001_052_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2001	052	0	1	04	01	H2001_052_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	052	0	1	04	01	H2001_052_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	052	0	1	04	01	H2001_052_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	053	0	1	04	01	H2001_053_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	053	0	1	04	01	H2001_053_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2001	053	0	1	04	01	H2001_053_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	053	0	1	04	01	H2001_053_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	053	0	1	04	01	H2001_053_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	054	0	1	04	01	H2001_054_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	054	0	1	04	01	H2001_054_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2001	054	0	1	04	01	H2001_054_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	054	0	1	04	01	H2001_054_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	054	0	1	04	01	H2001_054_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	055	0	1	04	01	H2001_055_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	055	0	1	04	01	H2001_055_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H2001	055	0	1	04	01	H2001_055_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	055	0	1	04	01	H2001_055_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	055	0	1	04	01	H2001_055_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	056	0	1	04	01	H2001_056_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	056	0	1	04	01	H2001_056_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2001	056	0	1	04	01	H2001_056_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	056	0	1	04	01	H2001_056_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	056	0	1	04	01	H2001_056_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	058	0	1	04	01	H2001_058_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	0.00	
H2001	058	0	1	04	01	H2001_058_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2001	058	0	1	04	01	H2001_058_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	058	0	1	04	01	H2001_058_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	058	0	1	04	01	H2001_058_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	059	0	1	04	01	H2001_059_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	059	0	1	04	01	H2001_059_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2001	059	0	1	04	01	H2001_059_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	059	0	1	04	01	H2001_059_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	059	0	1	04	01	H2001_059_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	060	0	1	04	01	H2001_060_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	060	0	1	04	01	H2001_060_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H2001	060	0	1	04	01	H2001_060_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	060	0	1	04	01	H2001_060_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	060	0	1	04	01	H2001_060_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	061	0	1	04	01	H2001_061_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	061	0	1	04	01	H2001_061_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2001	061	0	1	04	01	H2001_061_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	061	0	1	04	01	H2001_061_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	061	0	1	04	01	H2001_061_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	062	0	1	04	01	H2001_062_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	062	0	1	04	01	H2001_062_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2001	062	0	1	04	01	H2001_062_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	062	0	1	04	01	H2001_062_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	062	0	1	04	01	H2001_062_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	063	1	1	04	01	H2001_063_1	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	063	1	1	04	01	H2001_063_1	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2001	063	1	1	04	01	H2001_063_1	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	063	1	1	04	01	H2001_063_1	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	063	1	1	04	01	H2001_063_1	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	063	2	1	04	01	H2001_063_2	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	063	2	1	04	01	H2001_063_2	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2001	063	2	1	04	01	H2001_063_2	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	063	2	1	04	01	H2001_063_2	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	063	2	1	04	01	H2001_063_2	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	065	0	1	04	01	H2001_065_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	065	0	1	04	01	H2001_065_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2001	065	0	1	04	01	H2001_065_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	065	0	1	04	01	H2001_065_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	065	0	1	04	01	H2001_065_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	066	0	1	04	01	H2001_066_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	066	0	1	04	01	H2001_066_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2001	066	0	1	04	01	H2001_066_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	066	0	1	04	01	H2001_066_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	066	0	1	04	01	H2001_066_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	068	1	1	04	01	H2001_068_1	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	068	1	1	04	01	H2001_068_1	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2001	068	1	1	04	01	H2001_068_1	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	068	1	1	04	01	H2001_068_1	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	068	1	1	04	01	H2001_068_1	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	068	2	1	04	01	H2001_068_2	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	068	2	1	04	01	H2001_068_2	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2001	068	2	1	04	01	H2001_068_2	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	068	2	1	04	01	H2001_068_2	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	068	2	1	04	01	H2001_068_2	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	069	1	1	04	01	H2001_069_1	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	069	1	1	04	01	H2001_069_1	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2001	069	1	1	04	01	H2001_069_1	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	069	1	1	04	01	H2001_069_1	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	069	1	1	04	01	H2001_069_1	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	069	2	1	04	01	H2001_069_2	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	069	2	1	04	01	H2001_069_2	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2001	069	2	1	04	01	H2001_069_2	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	069	2	1	04	01	H2001_069_2	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	069	2	1	04	01	H2001_069_2	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	070	0	1	04	01	H2001_070_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	070	0	1	04	01	H2001_070_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H2001	070	0	1	04	01	H2001_070_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	070	0	1	04	01	H2001_070_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	070	0	1	04	01	H2001_070_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	075	0	1	04	01	H2001_075_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	075	0	1	04	01	H2001_075_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2001	075	0	1	04	01	H2001_075_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	075	0	1	04	01	H2001_075_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	075	0	1	04	01	H2001_075_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	077	0	1	04	01	H2001_077_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	077	0	1	04	01	H2001_077_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2001	077	0	1	04	01	H2001_077_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	077	0	1	04	01	H2001_077_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	077	0	1	04	01	H2001_077_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	078	0	1	04	01	H2001_078_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	078	0	1	04	01	H2001_078_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2001	078	0	1	04	01	H2001_078_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	078	0	1	04	01	H2001_078_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	078	0	1	04	01	H2001_078_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	079	0	1	04	01	H2001_079_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	079	0	1	04	01	H2001_079_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2001	079	0	1	04	01	H2001_079_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	079	0	1	04	01	H2001_079_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	079	0	1	04	01	H2001_079_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	080	0	1	04	01	H2001_080_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	080	0	1	04	01	H2001_080_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2001	080	0	1	04	01	H2001_080_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	080	0	1	04	01	H2001_080_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	080	0	1	04	01	H2001_080_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	081	0	1	04	01	H2001_081_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	081	0	1	04	01	H2001_081_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2001	081	0	1	04	01	H2001_081_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	081	0	1	04	01	H2001_081_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	081	0	1	04	01	H2001_081_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	082	0	1	04	01	H2001_082_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	082	0	1	04	01	H2001_082_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2001	082	0	1	04	01	H2001_082_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	082	0	1	04	01	H2001_082_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	082	0	1	04	01	H2001_082_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	083	1	1	04	01	H2001_083_1	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	083	1	1	04	01	H2001_083_1	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H2001	083	1	1	04	01	H2001_083_1	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	083	1	1	04	01	H2001_083_1	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	083	1	1	04	01	H2001_083_1	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	083	2	1	04	01	H2001_083_2	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	083	2	1	04	01	H2001_083_2	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H2001	083	2	1	04	01	H2001_083_2	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	083	2	1	04	01	H2001_083_2	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	083	2	1	04	01	H2001_083_2	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	084	0	1	04	01	H2001_084_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	084	0	1	04	01	H2001_084_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H2001	084	0	1	04	01	H2001_084_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	084	0	1	04	01	H2001_084_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	084	0	1	04	01	H2001_084_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	085	0	1	04	01	H2001_085_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	085	0	1	04	01	H2001_085_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2001	085	0	1	04	01	H2001_085_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	085	0	1	04	01	H2001_085_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	085	0	1	04	01	H2001_085_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	087	0	1	04	01	H2001_087_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	087	0	1	04	01	H2001_087_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H2001	087	0	1	04	01	H2001_087_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	087	0	1	04	01	H2001_087_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	087	0	1	04	01	H2001_087_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	090	0	1	04	01	H2001_090_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	090	0	1	04	01	H2001_090_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H2001	090	0	1	04	01	H2001_090_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	090	0	1	04	01	H2001_090_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	090	0	1	04	01	H2001_090_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	094	0	1	04	01	H2001_094_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	094	0	1	04	01	H2001_094_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H2001	094	0	1	04	01	H2001_094_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	094	0	1	04	01	H2001_094_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	094	0	1	04	01	H2001_094_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	095	0	1	04	01	H2001_095_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	095	0	1	04	01	H2001_095_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H2001	095	0	1	04	01	H2001_095_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	095	0	1	04	01	H2001_095_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	095	0	1	04	01	H2001_095_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	096	0	1	04	01	H2001_096_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	096	0	1	04	01	H2001_096_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H2001	096	0	1	04	01	H2001_096_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	096	0	1	04	01	H2001_096_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	096	0	1	04	01	H2001_096_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	097	0	1	04	01	H2001_097_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	097	0	1	04	01	H2001_097_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H2001	097	0	1	04	01	H2001_097_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	097	0	1	04	01	H2001_097_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	097	0	1	04	01	H2001_097_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	098	0	1	04	01	H2001_098_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	098	0	1	04	01	H2001_098_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H2001	098	0	1	04	01	H2001_098_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	098	0	1	04	01	H2001_098_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	098	0	1	04	01	H2001_098_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	102	0	1	04	01	H2001_102_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	102	0	1	04	01	H2001_102_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H2001	102	0	1	04	01	H2001_102_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	102	0	1	04	01	H2001_102_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	102	0	1	04	01	H2001_102_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	104	0	1	04	01	H2001_104_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	104	0	1	04	01	H2001_104_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H2001	104	0	1	04	01	H2001_104_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	104	0	1	04	01	H2001_104_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	104	0	1	04	01	H2001_104_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	108	0	1	04	01	H2001_108_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	108	0	1	04	01	H2001_108_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H2001	108	0	1	04	01	H2001_108_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	108	0	1	04	01	H2001_108_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	108	0	1	04	01	H2001_108_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	109	0	1	04	01	H2001_109_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	109	0	1	04	01	H2001_109_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H2001	109	0	1	04	01	H2001_109_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	109	0	1	04	01	H2001_109_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	109	0	1	04	01	H2001_109_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	110	0	1	04	01	H2001_110_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	110	0	1	04	01	H2001_110_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H2001	110	0	1	04	01	H2001_110_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	110	0	1	04	01	H2001_110_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	110	0	1	04	01	H2001_110_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	115	0	1	04	01	H2001_115_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	115	0	1	04	01	H2001_115_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H2001	115	0	1	04	01	H2001_115_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	115	0	1	04	01	H2001_115_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	115	0	1	04	01	H2001_115_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	116	0	1	04	01	H2001_116_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	116	0	1	04	01	H2001_116_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H2001	116	0	1	04	01	H2001_116_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	116	0	1	04	01	H2001_116_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	116	0	1	04	01	H2001_116_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	117	0	1	04	01	H2001_117_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	117	0	1	04	01	H2001_117_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H2001	117	0	1	04	01	H2001_117_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	117	0	1	04	01	H2001_117_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	117	0	1	04	01	H2001_117_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	119	0	1	04	01	H2001_119_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	119	0	1	04	01	H2001_119_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H2001	119	0	1	04	01	H2001_119_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	119	0	1	04	01	H2001_119_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	119	0	1	04	01	H2001_119_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	120	0	1	04	01	H2001_120_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	120	0	1	04	01	H2001_120_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H2001	120	0	1	04	01	H2001_120_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	120	0	1	04	01	H2001_120_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	120	0	1	04	01	H2001_120_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	123	0	1	04	01	H2001_123_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	123	0	1	04	01	H2001_123_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H2001	123	0	1	04	01	H2001_123_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	123	0	1	04	01	H2001_123_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	123	0	1	04	01	H2001_123_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	125	0	1	04	01	H2001_125_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	125	0	1	04	01	H2001_125_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H2001	125	0	1	04	01	H2001_125_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	125	0	1	04	01	H2001_125_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	125	0	1	04	01	H2001_125_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	127	0	1	04	01	H2001_127_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	127	0	1	04	01	H2001_127_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H2001	127	0	1	04	01	H2001_127_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	127	0	1	04	01	H2001_127_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	127	0	1	04	01	H2001_127_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	128	0	1	04	01	H2001_128_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	128	0	1	04	01	H2001_128_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H2001	128	0	1	04	01	H2001_128_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	128	0	1	04	01	H2001_128_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	128	0	1	04	01	H2001_128_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	131	0	1	04	01	H2001_131_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	131	0	1	04	01	H2001_131_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H2001	131	0	1	04	01	H2001_131_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	131	0	1	04	01	H2001_131_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	131	0	1	04	01	H2001_131_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	132	0	1	04	01	H2001_132_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	132	0	1	04	01	H2001_132_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H2001	132	0	1	04	01	H2001_132_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	132	0	1	04	01	H2001_132_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	132	0	1	04	01	H2001_132_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	133	0	1	04	01	H2001_133_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	133	0	1	04	01	H2001_133_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H2001	133	0	1	04	01	H2001_133_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	133	0	1	04	01	H2001_133_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	133	0	1	04	01	H2001_133_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	136	0	1	04	01	H2001_136_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	136	0	1	04	01	H2001_136_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H2001	136	0	1	04	01	H2001_136_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	136	0	1	04	01	H2001_136_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	136	0	1	04	01	H2001_136_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	137	0	1	04	01	H2001_137_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	137	0	1	04	01	H2001_137_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H2001	137	0	1	04	01	H2001_137_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	137	0	1	04	01	H2001_137_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	137	0	1	04	01	H2001_137_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2001	138	0	1	04	01	H2001_138_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2001	138	0	1	04	01	H2001_138_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H2001	138	0	1	04	01	H2001_138_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2001	138	0	1	04	01	H2001_138_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2001	138	0	1	04	01	H2001_138_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2032	001	0	1	04	01	H2032_001_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2032	001	0	1	04	01	H2032_001_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H2032	001	0	1	04	01	H2032_001_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2032	001	0	1	04	01	H2032_001_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2032	001	0	1	04	01	H2032_001_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2032	002	0	1	04	01	H2032_002_0	10			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2032	002	0	1	04	01	H2032_002_0	10			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H2032	002	0	1	04	01	H2032_002_0	10			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2032	002	0	1	04	01	H2032_002_0	10			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2032	002	0	1	04	01	H2032_002_0	10			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2032	003	0	1	04	01	H2032_003_0	10			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2032	003	0	1	04	01	H2032_003_0	10			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H2032	003	0	1	04	01	H2032_003_0	10			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2032	003	0	1	04	01	H2032_003_0	10			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2032	003	0	1	04	01	H2032_003_0	10			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2032	004	0	1	04	01	H2032_004_0	10			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2032	004	0	1	04	01	H2032_004_0	10			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H2032	004	0	1	04	01	H2032_004_0	10			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2032	004	0	1	04	01	H2032_004_0	10			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2032	004	0	1	04	01	H2032_004_0	10			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2041	001	0	1	01	01	H2041_001_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2041	001	0	1	01	01	H2041_001_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H2041	001	0	1	01	01	H2041_001_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2041	001	0	1	01	01	H2041_001_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2041	001	0	1	01	01	H2041_001_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2041	002	0	1	01	01	H2041_002_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2041	002	0	1	01	01	H2041_002_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H2041	002	0	1	01	01	H2041_002_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2041	002	0	1	01	01	H2041_002_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2041	002	0	1	01	01	H2041_002_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2041	003	0	1	01	01	H2041_003_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2041	003	0	1	01	01	H2041_003_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H2041	003	0	1	01	01	H2041_003_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2041	003	0	1	01	01	H2041_003_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2041	003	0	1	01	01	H2041_003_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2041	004	0	1	01	01	H2041_004_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2041	004	0	1	01	01	H2041_004_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H2041	004	0	1	01	01	H2041_004_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2041	004	0	1	01	01	H2041_004_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2041	004	0	1	01	01	H2041_004_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2041	005	0	1	01	01	H2041_005_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2041	005	0	1	01	01	H2041_005_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H2041	005	0	1	01	01	H2041_005_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2041	005	0	1	01	01	H2041_005_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2041	005	0	1	01	01	H2041_005_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2041	006	0	1	01	01	H2041_006_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2041	006	0	1	01	01	H2041_006_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H2041	006	0	1	01	01	H2041_006_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2041	006	0	1	01	01	H2041_006_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2041	006	0	1	01	01	H2041_006_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2041	007	0	1	01	01	H2041_007_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H2041	007	0	1	01	01	H2041_007_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2041	007	0	1	01	01	H2041_007_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2041	007	0	1	01	01	H2041_007_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2041	007	0	1	01	01	H2041_007_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2041	007	0	1	01	01	H2041_007_0	6		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H2041	008	0	1	01	01	H2041_008_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H2041	008	0	1	01	01	H2041_008_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2041	008	0	1	01	01	H2041_008_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2041	008	0	1	01	01	H2041_008_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2041	008	0	1	01	01	H2041_008_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2041	008	0	1	01	01	H2041_008_0	6		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H2041	009	0	1	01	01	H2041_009_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2041	009	0	1	01	01	H2041_009_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H2041	009	0	1	01	01	H2041_009_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2041	009	0	1	01	01	H2041_009_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2041	009	0	1	01	01	H2041_009_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2041	010	0	1	01	01	H2041_010_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2041	010	0	1	01	01	H2041_010_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H2041	010	0	1	01	01	H2041_010_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2041	010	0	1	01	01	H2041_010_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2041	010	0	1	01	01	H2041_010_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2041	011	0	1	01	01	H2041_011_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H2041	011	0	1	01	01	H2041_011_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2041	011	0	1	01	01	H2041_011_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2041	011	0	1	01	01	H2041_011_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2041	011	0	1	01	01	H2041_011_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2041	011	0	1	01	01	H2041_011_0	7		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H2041	012	0	1	01	01	H2041_012_0	7			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H2041	012	0	1	01	01	H2041_012_0	7			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2041	012	0	1	01	01	H2041_012_0	7			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2041	012	0	1	01	01	H2041_012_0	7			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2041	012	0	1	01	01	H2041_012_0	7			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2041	012	0	1	01	01	H2041_012_0	7			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2041	013	0	1	01	01	H2041_013_0	7			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H2041	013	0	1	01	01	H2041_013_0	7			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2041	013	0	1	01	01	H2041_013_0	7			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2041	013	0	1	01	01	H2041_013_0	7			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2041	013	0	1	01	01	H2041_013_0	7			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2041	013	0	1	01	01	H2041_013_0	7			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2041	014	0	1	01	01	H2041_014_0	7			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H2041	014	0	1	01	01	H2041_014_0	7			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2041	014	0	1	01	01	H2041_014_0	7			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2041	014	0	1	01	01	H2041_014_0	7			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2041	014	0	1	01	01	H2041_014_0	7			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2041	014	0	1	01	01	H2041_014_0	7			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2041	015	0	1	01	01	H2041_015_0	7			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H2041	015	0	1	01	01	H2041_015_0	7			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2041	015	0	1	01	01	H2041_015_0	7			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2041	015	0	1	01	01	H2041_015_0	7			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2041	015	0	1	01	01	H2041_015_0	7			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2041	015	0	1	01	01	H2041_015_0	7			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2041	016	0	1	01	01	H2041_016_0	7			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H2041	016	0	1	01	01	H2041_016_0	7			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2041	016	0	1	01	01	H2041_016_0	7			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2041	016	0	1	01	01	H2041_016_0	7			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2041	016	0	1	01	01	H2041_016_0	7			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2041	016	0	1	01	01	H2041_016_0	7			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2056	003	0	1	02	01	H2056_003_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2056	003	0	1	02	01	H2056_003_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2056	003	0	1	02	01	H2056_003_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2056	003	0	1	02	01	H2056_003_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2056	003	0	1	02	01	H2056_003_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2056	005	0	1	02	01	H2056_005_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2056	005	0	1	02	01	H2056_005_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2056	005	0	1	02	01	H2056_005_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2056	005	0	1	02	01	H2056_005_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2056	005	0	1	02	01	H2056_005_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2108	022	0	1	01	01	H2108_022_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	9.00	
H2108	022	0	1	01	01	H2108_022_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2108	022	0	1	01	01	H2108_022_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2108	022	0	1	01	01	H2108_022_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2108	022	0	1	01	01	H2108_022_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2108	029	0	1	01	01	H2108_029_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	1	2	01	3	2	9.00	
H2108	029	0	1	01	01	H2108_029_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	2	2	01	1	2	0.00	
H2108	029	0	1	01	01	H2108_029_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	3	2	11	1	2	0.00	
H2108	029	0	1	01	01	H2108_029_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	4	2	11	1	2	0.00	
H2108	029	0	1	01	01	H2108_029_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	5	2	11	1	2	0.00	
H2108	029	0	1	01	01	H2108_029_0	6			Select Diabetic Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	6	2	11	1	2	0.00	
H2108	030	0	1	01	01	H2108_030_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	1	2	01	3	2	9.00	
H2108	030	0	1	01	01	H2108_030_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	2	2	01	1	2	0.00	
H2108	030	0	1	01	01	H2108_030_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	3	2	11	1	2	0.00	
H2108	030	0	1	01	01	H2108_030_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	4	2	11	1	2	0.00	
H2108	030	0	1	01	01	H2108_030_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	5	2	11	1	2	0.00	
H2108	030	0	1	01	01	H2108_030_0	6			Select Diabetic Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	6	2	11	1	2	0.00	
H2108	036	0	1	01	01	H2108_036_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	9.00	
H2108	036	0	1	01	01	H2108_036_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2108	036	0	1	01	01	H2108_036_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2108	036	0	1	01	01	H2108_036_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2108	036	0	1	01	01	H2108_036_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2108	041	0	1	01	01	H2108_041_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2108	041	0	1	01	01	H2108_041_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2108	041	0	1	01	01	H2108_041_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2108	041	0	1	01	01	H2108_041_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2108	041	0	1	01	01	H2108_041_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2108	042	1	1	01	01	H2108_042_1	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	9.00	
H2108	042	1	1	01	01	H2108_042_1	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2108	042	1	1	01	01	H2108_042_1	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2108	042	1	1	01	01	H2108_042_1	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2108	042	1	1	01	01	H2108_042_1	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2108	042	2	1	01	01	H2108_042_2	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	9.00	
H2108	042	2	1	01	01	H2108_042_2	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2108	042	2	1	01	01	H2108_042_2	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2108	042	2	1	01	01	H2108_042_2	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2108	042	2	1	01	01	H2108_042_2	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2117	001	0	1	04	01	H2117_001_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H2117	001	0	1	04	01	H2117_001_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2117	001	0	1	04	01	H2117_001_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2117	001	0	1	04	01	H2117_001_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2117	001	0	1	04	01	H2117_001_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2117	001	0	1	04	01	H2117_001_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2117	002	0	1	04	01	H2117_002_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H2117	002	0	1	04	01	H2117_002_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2117	002	0	1	04	01	H2117_002_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2117	002	0	1	04	01	H2117_002_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2117	002	0	1	04	01	H2117_002_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2117	002	0	1	04	01	H2117_002_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2168	001	0	1	01	01	H2168_001_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	3	2	4.00	
H2168	001	0	1	01	01	H2168_001_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H2168	001	0	1	01	01	H2168_001_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2168	001	0	1	01	01	H2168_001_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2168	001	0	1	01	01	H2168_001_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	10	1	2	0.00	
H2168	001	0	1	01	01	H2168_001_0	4		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H2168	002	0	1	01	01	H2168_002_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	3	2	2.00	
H2168	002	0	1	01	01	H2168_002_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H2168	002	0	1	01	01	H2168_002_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2168	002	0	1	01	01	H2168_002_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2168	002	0	1	01	01	H2168_002_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	10	1	2	0.00	
H2168	002	0	1	01	01	H2168_002_0	4		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H2168	004	0	1	01	01	H2168_004_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	3	2	2.00	
H2168	004	0	1	01	01	H2168_004_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H2168	004	0	1	01	01	H2168_004_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2168	004	0	1	01	01	H2168_004_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2168	004	0	1	01	01	H2168_004_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	10	1	2	0.00	
H2168	004	0	1	01	01	H2168_004_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H2172	001	0	1	02	01	H2172_001_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H2172	001	0	1	02	01	H2172_001_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H2172	001	0	1	02	01	H2172_001_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H2172	001	0	1	02	01	H2172_001_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H2172	001	0	1	02	01	H2172_001_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H2172	001	0	1	02	01	H2172_001_0	5			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H2172	002	0	1	02	01	H2172_002_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H2172	002	0	1	02	01	H2172_002_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H2172	002	0	1	02	01	H2172_002_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H2172	002	0	1	02	01	H2172_002_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H2172	002	0	1	02	01	H2172_002_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H2172	002	0	1	02	01	H2172_002_0	4			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H2172	008	0	1	02	01	H2172_008_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H2172	008	0	1	02	01	H2172_008_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H2172	008	0	1	02	01	H2172_008_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H2172	008	0	1	02	01	H2172_008_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H2172	008	0	1	02	01	H2172_008_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H2172	008	0	1	02	01	H2172_008_0	4			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H2172	009	0	1	02	01	H2172_009_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H2172	009	0	1	02	01	H2172_009_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H2172	009	0	1	02	01	H2172_009_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H2172	009	0	1	02	01	H2172_009_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H2172	009	0	1	02	01	H2172_009_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H2172	009	0	1	02	01	H2172_009_0	4			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H2172	010	0	1	02	01	H2172_010_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H2172	010	0	1	02	01	H2172_010_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H2172	010	0	1	02	01	H2172_010_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H2172	010	0	1	02	01	H2172_010_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H2172	010	0	1	02	01	H2172_010_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H2172	010	0	1	02	01	H2172_010_0	4			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H2172	013	0	1	02	01	H2172_013_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H2172	013	0	1	02	01	H2172_013_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H2172	013	0	1	02	01	H2172_013_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H2172	013	0	1	02	01	H2172_013_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H2172	013	0	1	02	01	H2172_013_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H2172	013	0	1	02	01	H2172_013_0	4			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H2172	014	0	1	02	01	H2172_014_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H2172	014	0	1	02	01	H2172_014_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H2172	014	0	1	02	01	H2172_014_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H2172	014	0	1	02	01	H2172_014_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H2172	014	0	1	02	01	H2172_014_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H2172	014	0	1	02	01	H2172_014_0	5			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H2172	016	0	1	01	01	H2172_016_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H2172	016	0	1	01	01	H2172_016_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H2172	016	0	1	01	01	H2172_016_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H2172	016	0	1	01	01	H2172_016_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H2172	016	0	1	01	01	H2172_016_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H2172	016	0	1	01	01	H2172_016_0	4		N	Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H2172	017	0	1	01	01	H2172_017_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H2172	017	0	1	01	01	H2172_017_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H2172	017	0	1	01	01	H2172_017_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H2172	017	0	1	01	01	H2172_017_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H2172	017	0	1	01	01	H2172_017_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H2172	017	0	1	01	01	H2172_017_0	4		N	Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H2172	018	0	1	01	01	H2172_018_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H2172	018	0	1	01	01	H2172_018_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H2172	018	0	1	01	01	H2172_018_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H2172	018	0	1	01	01	H2172_018_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H2172	018	0	1	01	01	H2172_018_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H2172	018	0	1	01	01	H2172_018_0	4		N	Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H2172	019	0	1	01	01	H2172_019_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H2172	019	0	1	01	01	H2172_019_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H2172	019	0	1	01	01	H2172_019_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H2172	019	0	1	01	01	H2172_019_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H2172	019	0	1	01	01	H2172_019_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H2172	019	0	1	01	01	H2172_019_0	4		N	Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H2172	020	0	1	02	01	H2172_020_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H2172	020	0	1	02	01	H2172_020_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H2172	020	0	1	02	01	H2172_020_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H2172	020	0	1	02	01	H2172_020_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H2172	020	0	1	02	01	H2172_020_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H2172	020	0	1	02	01	H2172_020_0	4			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H2172	021	0	1	02	01	H2172_021_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H2172	021	0	1	02	01	H2172_021_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H2172	021	0	1	02	01	H2172_021_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H2172	021	0	1	02	01	H2172_021_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H2172	021	0	1	02	01	H2172_021_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H2172	021	0	1	02	01	H2172_021_0	5			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H2172	022	0	1	02	01	H2172_022_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H2172	022	0	1	02	01	H2172_022_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H2172	022	0	1	02	01	H2172_022_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H2172	022	0	1	02	01	H2172_022_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H2172	022	0	1	02	01	H2172_022_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H2172	022	0	1	02	01	H2172_022_0	5			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H2172	023	0	1	02	01	H2172_023_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H2172	023	0	1	02	01	H2172_023_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H2172	023	0	1	02	01	H2172_023_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H2172	023	0	1	02	01	H2172_023_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H2172	023	0	1	02	01	H2172_023_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H2172	023	0	1	02	01	H2172_023_0	5			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H2172	024	0	1	02	01	H2172_024_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H2172	024	0	1	02	01	H2172_024_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H2172	024	0	1	02	01	H2172_024_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H2172	024	0	1	02	01	H2172_024_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H2172	024	0	1	02	01	H2172_024_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H2172	024	0	1	02	01	H2172_024_0	4			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H2172	025	0	1	01	01	H2172_025_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H2172	025	0	1	01	01	H2172_025_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H2172	025	0	1	01	01	H2172_025_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H2172	025	0	1	01	01	H2172_025_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H2172	025	0	1	01	01	H2172_025_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H2172	025	0	1	01	01	H2172_025_0	5			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H2172	026	0	1	01	01	H2172_026_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H2172	026	0	1	01	01	H2172_026_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H2172	026	0	1	01	01	H2172_026_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H2172	026	0	1	01	01	H2172_026_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H2172	026	0	1	01	01	H2172_026_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H2172	026	0	1	01	01	H2172_026_0	5			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H2172	027	0	1	02	01	H2172_027_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H2172	027	0	1	02	01	H2172_027_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H2172	027	0	1	02	01	H2172_027_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H2172	027	0	1	02	01	H2172_027_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H2172	027	0	1	02	01	H2172_027_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H2172	027	0	1	02	01	H2172_027_0	4			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H2174	001	0	1	02	01	H2174_001_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H2174	001	0	1	02	01	H2174_001_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2174	001	0	1	02	01	H2174_001_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2174	001	0	1	02	01	H2174_001_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2174	001	0	1	02	01	H2174_001_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2174	001	0	1	02	01	H2174_001_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2174	012	0	1	02	01	H2174_012_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H2174	012	0	1	02	01	H2174_012_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2174	012	0	1	02	01	H2174_012_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2174	012	0	1	02	01	H2174_012_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2174	012	0	1	02	01	H2174_012_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2174	012	0	1	02	01	H2174_012_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2174	013	0	1	02	01	H2174_013_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H2174	013	0	1	02	01	H2174_013_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2174	013	0	1	02	01	H2174_013_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2174	013	0	1	02	01	H2174_013_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2174	013	0	1	02	01	H2174_013_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2174	013	0	1	02	01	H2174_013_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2185	003	0	1	02	01	H2185_003_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2185	003	0	1	02	01	H2185_003_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2185	003	0	1	02	01	H2185_003_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H2185	003	0	1	02	01	H2185_003_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	10	1	2	0.00	
H2185	003	0	1	02	01	H2185_003_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2224	001	0	1	01	01	H2224_001_0	11		N	Single Tier	4	Single Tier	1	2	11	1	2	0.00	
H2230	002	0	1	04	01	H2230_002_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2230	002	0	1	04	01	H2230_002_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H2230	002	0	1	04	01	H2230_002_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2230	002	0	1	04	01	H2230_002_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2230	002	0	1	04	01	H2230_002_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2230	018	1	1	04	01	H2230_018_1	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2230	018	1	1	04	01	H2230_018_1	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H2230	018	1	1	04	01	H2230_018_1	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2230	018	1	1	04	01	H2230_018_1	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2230	018	1	1	04	01	H2230_018_1	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2230	018	2	1	04	01	H2230_018_2	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2230	018	2	1	04	01	H2230_018_2	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H2230	018	2	1	04	01	H2230_018_2	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2230	018	2	1	04	01	H2230_018_2	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2230	018	2	1	04	01	H2230_018_2	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2230	019	0	1	04	01	H2230_019_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2230	019	0	1	04	01	H2230_019_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H2230	019	0	1	04	01	H2230_019_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2230	019	0	1	04	01	H2230_019_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2230	019	0	1	04	01	H2230_019_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2235	001	0	1	01	01	H2235_001_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2235	001	0	1	01	01	H2235_001_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H2235	001	0	1	01	01	H2235_001_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H2235	001	0	1	01	01	H2235_001_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2235	001	0	1	01	01	H2235_001_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2235	002	0	1	01	01	H2235_002_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2235	002	0	1	01	01	H2235_002_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H2235	002	0	1	01	01	H2235_002_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H2235	002	0	1	01	01	H2235_002_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2235	002	0	1	01	01	H2235_002_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2235	003	0	1	01	01	H2235_003_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2235	003	0	1	01	01	H2235_003_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H2235	003	0	1	01	01	H2235_003_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H2235	003	0	1	01	01	H2235_003_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2235	003	0	1	01	01	H2235_003_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2247	001	0	1	02	01	H2247_001_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2247	001	0	1	02	01	H2247_001_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2247	001	0	1	02	01	H2247_001_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2247	001	0	1	02	01	H2247_001_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2247	001	0	1	02	01	H2247_001_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2247	003	0	1	02	01	H2247_003_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2247	003	0	1	02	01	H2247_003_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2247	003	0	1	02	01	H2247_003_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2247	003	0	1	02	01	H2247_003_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2247	003	0	1	02	01	H2247_003_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2247	004	0	1	01	01	H2247_004_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2247	004	0	1	01	01	H2247_004_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2247	004	0	1	01	01	H2247_004_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2247	004	0	1	01	01	H2247_004_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2247	004	0	1	01	01	H2247_004_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2247	005	0	1	01	01	H2247_005_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2247	005	0	1	01	01	H2247_005_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2247	005	0	1	01	01	H2247_005_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2247	005	0	1	01	01	H2247_005_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2247	005	0	1	01	01	H2247_005_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2256	001	1	1	01	01	H2256_001_1	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	01	3	2	0.00	
H2256	001	1	1	01	01	H2256_001_1	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	01	3	2	0.00	
H2256	001	1	1	01	01	H2256_001_1	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H2256	001	1	1	01	01	H2256_001_1	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H2256	001	1	1	01	01	H2256_001_1	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H2256	001	1	1	01	01	H2256_001_1	9			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	11	1	2	0.00	
H2256	001	2	1	01	01	H2256_001_2	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	01	3	2	0.00	
H2256	001	2	1	01	01	H2256_001_2	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	01	3	2	0.00	
H2256	001	2	1	01	01	H2256_001_2	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H2256	001	2	1	01	01	H2256_001_2	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H2256	001	2	1	01	01	H2256_001_2	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H2256	001	2	1	01	01	H2256_001_2	8			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	11	1	2	0.00	
H2256	001	6	1	01	01	H2256_001_6	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	01	3	2	0.00	
H2256	001	6	1	01	01	H2256_001_6	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	01	3	2	0.00	
H2256	001	6	1	01	01	H2256_001_6	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H2256	001	6	1	01	01	H2256_001_6	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H2256	001	6	1	01	01	H2256_001_6	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H2256	001	6	1	01	01	H2256_001_6	9			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	11	1	2	0.00	
H2256	015	1	1	01	01	H2256_015_1	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	01	3	2	0.00	
H2256	015	1	1	01	01	H2256_015_1	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	01	3	2	0.00	
H2256	015	1	1	01	01	H2256_015_1	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H2256	015	1	1	01	01	H2256_015_1	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H2256	015	1	1	01	01	H2256_015_1	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H2256	015	1	1	01	01	H2256_015_1	9			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	11	1	2	0.00	
H2256	015	2	1	01	01	H2256_015_2	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	01	3	2	0.00	
H2256	015	2	1	01	01	H2256_015_2	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	01	3	2	0.00	
H2256	015	2	1	01	01	H2256_015_2	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H2256	015	2	1	01	01	H2256_015_2	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H2256	015	2	1	01	01	H2256_015_2	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H2256	015	2	1	01	01	H2256_015_2	9			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	11	1	2	0.00	
H2256	015	6	1	01	01	H2256_015_6	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	01	3	2	0.00	
H2256	015	6	1	01	01	H2256_015_6	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	01	3	2	0.00	
H2256	015	6	1	01	01	H2256_015_6	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H2256	015	6	1	01	01	H2256_015_6	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H2256	015	6	1	01	01	H2256_015_6	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H2256	015	6	1	01	01	H2256_015_6	9			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	11	1	2	0.00	
H2256	018	1	1	01	01	H2256_018_1	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	01	3	2	0.00	
H2256	018	1	1	01	01	H2256_018_1	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	01	3	2	0.00	
H2256	018	1	1	01	01	H2256_018_1	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H2256	018	1	1	01	01	H2256_018_1	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H2256	018	1	1	01	01	H2256_018_1	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H2256	018	1	1	01	01	H2256_018_1	9			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	11	1	2	0.00	
H2256	018	7	1	01	01	H2256_018_7	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	01	3	2	0.00	
H2256	018	7	1	01	01	H2256_018_7	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	01	3	2	0.00	
H2256	018	7	1	01	01	H2256_018_7	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H2256	018	7	1	01	01	H2256_018_7	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H2256	018	7	1	01	01	H2256_018_7	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H2256	018	7	1	01	01	H2256_018_7	8			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	11	1	2	0.00	
H2256	018	8	1	01	01	H2256_018_8	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	01	3	2	0.00	
H2256	018	8	1	01	01	H2256_018_8	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	01	3	2	0.00	
H2256	018	8	1	01	01	H2256_018_8	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H2256	018	8	1	01	01	H2256_018_8	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H2256	018	8	1	01	01	H2256_018_8	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H2256	018	8	1	01	01	H2256_018_8	8			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	11	1	2	0.00	
H2256	026	1	1	01	01	H2256_026_1	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	01	3	2	0.00	
H2256	026	1	1	01	01	H2256_026_1	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	01	3	2	0.00	
H2256	026	1	1	01	01	H2256_026_1	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H2256	026	1	1	01	01	H2256_026_1	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H2256	026	1	1	01	01	H2256_026_1	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H2256	026	1	1	01	01	H2256_026_1	9			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	11	1	2	0.00	
H2256	026	2	1	01	01	H2256_026_2	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	01	3	2	0.00	
H2256	026	2	1	01	01	H2256_026_2	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	01	3	2	0.00	
H2256	026	2	1	01	01	H2256_026_2	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H2256	026	2	1	01	01	H2256_026_2	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H2256	026	2	1	01	01	H2256_026_2	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H2256	026	2	1	01	01	H2256_026_2	9			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	11	1	2	0.00	
H2256	026	3	1	01	01	H2256_026_3	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	01	3	2	0.00	
H2256	026	3	1	01	01	H2256_026_3	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	01	3	2	0.00	
H2256	026	3	1	01	01	H2256_026_3	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H2256	026	3	1	01	01	H2256_026_3	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H2256	026	3	1	01	01	H2256_026_3	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H2256	026	3	1	01	01	H2256_026_3	9			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	11	1	2	0.00	
H2256	033	0	1	01	01	H2256_033_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	01	3	2	0.00	
H2256	033	0	1	01	01	H2256_033_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	01	3	2	0.00	
H2256	033	0	1	01	01	H2256_033_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H2256	033	0	1	01	01	H2256_033_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H2256	033	0	1	01	01	H2256_033_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H2256	033	0	1	01	01	H2256_033_0	9			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	11	1	2	0.00	
H2256	034	0	1	01	01	H2256_034_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	01	3	2	0.00	
H2256	034	0	1	01	01	H2256_034_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	01	3	2	0.00	
H2256	034	0	1	01	01	H2256_034_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H2256	034	0	1	01	01	H2256_034_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H2256	034	0	1	01	01	H2256_034_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H2256	034	0	1	01	01	H2256_034_0	9			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	11	1	2	0.00	
H2256	036	0	1	01	01	H2256_036_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	01	3	2	0.00	
H2256	036	0	1	01	01	H2256_036_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	01	3	2	0.00	
H2256	036	0	1	01	01	H2256_036_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H2256	036	0	1	01	01	H2256_036_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H2256	036	0	1	01	01	H2256_036_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H2256	036	0	1	01	01	H2256_036_0	9			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	11	1	2	0.00	
H2256	046	0	1	01	01	H2256_046_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	01	3	2	0.00	
H2256	046	0	1	01	01	H2256_046_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	01	3	2	0.00	
H2256	046	0	1	01	01	H2256_046_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H2256	046	0	1	01	01	H2256_046_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H2256	046	0	1	01	01	H2256_046_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H2256	046	0	1	01	01	H2256_046_0	9			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	11	1	2	0.00	
H2261	005	0	1	01	01	H2261_005_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2261	005	0	1	01	01	H2261_005_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H2261	005	0	1	01	01	H2261_005_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2261	005	0	1	01	01	H2261_005_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2261	005	0	1	01	01	H2261_005_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2261	022	1	1	01	01	H2261_022_1	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2261	022	1	1	01	01	H2261_022_1	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H2261	022	1	1	01	01	H2261_022_1	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2261	022	1	1	01	01	H2261_022_1	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2261	022	1	1	01	01	H2261_022_1	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2261	022	2	1	01	01	H2261_022_2	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2261	022	2	1	01	01	H2261_022_2	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H2261	022	2	1	01	01	H2261_022_2	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2261	022	2	1	01	01	H2261_022_2	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2261	022	2	1	01	01	H2261_022_2	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2261	023	1	1	02	01	H2261_023_1	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2261	023	1	1	02	01	H2261_023_1	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H2261	023	1	1	02	01	H2261_023_1	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2261	023	1	1	02	01	H2261_023_1	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2261	023	1	1	02	01	H2261_023_1	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2261	023	2	1	02	01	H2261_023_2	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2261	023	2	1	02	01	H2261_023_2	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H2261	023	2	1	02	01	H2261_023_2	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2261	023	2	1	02	01	H2261_023_2	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2261	023	2	1	02	01	H2261_023_2	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2261	024	0	1	02	01	H2261_024_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2261	024	0	1	02	01	H2261_024_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H2261	024	0	1	02	01	H2261_024_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2261	024	0	1	02	01	H2261_024_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2261	024	0	1	02	01	H2261_024_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2272	001	0	1	02	01	H2272_001_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2272	001	0	1	02	01	H2272_001_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2272	001	0	1	02	01	H2272_001_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2272	001	0	1	02	01	H2272_001_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2272	001	0	1	02	01	H2272_001_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2272	003	0	1	02	01	H2272_003_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2272	003	0	1	02	01	H2272_003_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2272	003	0	1	02	01	H2272_003_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2272	003	0	1	02	01	H2272_003_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2272	003	0	1	02	01	H2272_003_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2293	001	0	1	04	01	H2293_001_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2293	001	0	1	04	01	H2293_001_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2293	001	0	1	04	01	H2293_001_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2293	001	0	1	04	01	H2293_001_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2293	001	0	1	04	01	H2293_001_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2293	002	0	1	04	01	H2293_002_0	2		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2293	002	0	1	04	01	H2293_002_0	2		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2293	002	0	1	04	01	H2293_002_0	2		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2293	002	0	1	04	01	H2293_002_0	2		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2293	002	0	1	04	01	H2293_002_0	2		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2293	004	0	1	04	01	H2293_004_0	2		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2293	004	0	1	04	01	H2293_004_0	2		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2293	004	0	1	04	01	H2293_004_0	2		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2293	004	0	1	04	01	H2293_004_0	2		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2293	004	0	1	04	01	H2293_004_0	2		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2293	010	0	1	04	01	H2293_010_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2293	010	0	1	04	01	H2293_010_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2293	010	0	1	04	01	H2293_010_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2293	010	0	1	04	01	H2293_010_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2293	010	0	1	04	01	H2293_010_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2293	014	0	1	04	01	H2293_014_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2293	014	0	1	04	01	H2293_014_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2293	014	0	1	04	01	H2293_014_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2293	014	0	1	04	01	H2293_014_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2293	014	0	1	04	01	H2293_014_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2293	016	0	1	04	01	H2293_016_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2293	016	0	1	04	01	H2293_016_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2293	016	0	1	04	01	H2293_016_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2293	016	0	1	04	01	H2293_016_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2293	016	0	1	04	01	H2293_016_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2293	017	0	1	04	01	H2293_017_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2293	017	0	1	04	01	H2293_017_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2293	017	0	1	04	01	H2293_017_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2293	017	0	1	04	01	H2293_017_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2293	017	0	1	04	01	H2293_017_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2293	019	0	1	04	01	H2293_019_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2293	019	0	1	04	01	H2293_019_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2293	019	0	1	04	01	H2293_019_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2293	019	0	1	04	01	H2293_019_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2293	019	0	1	04	01	H2293_019_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2293	021	0	1	04	01	H2293_021_0	2		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2293	021	0	1	04	01	H2293_021_0	2		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2293	021	0	1	04	01	H2293_021_0	2		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2293	021	0	1	04	01	H2293_021_0	2		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2293	021	0	1	04	01	H2293_021_0	2		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2293	023	0	1	04	01	H2293_023_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2293	023	0	1	04	01	H2293_023_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2293	023	0	1	04	01	H2293_023_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2293	023	0	1	04	01	H2293_023_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2293	023	0	1	04	01	H2293_023_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2293	025	0	1	04	01	H2293_025_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2293	025	0	1	04	01	H2293_025_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2293	025	0	1	04	01	H2293_025_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2293	025	0	1	04	01	H2293_025_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2293	025	0	1	04	01	H2293_025_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2293	026	0	1	04	01	H2293_026_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2293	026	0	1	04	01	H2293_026_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2293	026	0	1	04	01	H2293_026_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2293	026	0	1	04	01	H2293_026_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2293	026	0	1	04	01	H2293_026_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2293	029	0	1	04	01	H2293_029_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2293	029	0	1	04	01	H2293_029_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2293	029	0	1	04	01	H2293_029_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2293	029	0	1	04	01	H2293_029_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2293	029	0	1	04	01	H2293_029_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2293	031	0	1	04	01	H2293_031_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2293	031	0	1	04	01	H2293_031_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2293	031	0	1	04	01	H2293_031_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2293	031	0	1	04	01	H2293_031_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2293	031	0	1	04	01	H2293_031_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2293	033	0	1	04	01	H2293_033_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2293	033	0	1	04	01	H2293_033_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2293	033	0	1	04	01	H2293_033_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2293	033	0	1	04	01	H2293_033_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2293	033	0	1	04	01	H2293_033_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2293	035	0	1	04	01	H2293_035_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2293	035	0	1	04	01	H2293_035_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2293	035	0	1	04	01	H2293_035_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2293	035	0	1	04	01	H2293_035_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2293	035	0	1	04	01	H2293_035_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2320	022	1	1	02	01	H2320_022_1	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2320	022	1	1	02	01	H2320_022_1	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2320	022	1	1	02	01	H2320_022_1	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2320	022	1	1	02	01	H2320_022_1	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2320	022	1	1	02	01	H2320_022_1	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2320	022	2	1	02	01	H2320_022_2	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2320	022	2	1	02	01	H2320_022_2	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2320	022	2	1	02	01	H2320_022_2	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2320	022	2	1	02	01	H2320_022_2	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2320	022	2	1	02	01	H2320_022_2	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2320	022	3	1	02	01	H2320_022_3	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2320	022	3	1	02	01	H2320_022_3	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2320	022	3	1	02	01	H2320_022_3	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2320	022	3	1	02	01	H2320_022_3	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2320	022	3	1	02	01	H2320_022_3	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2320	022	4	1	02	01	H2320_022_4	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2320	022	4	1	02	01	H2320_022_4	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2320	022	4	1	02	01	H2320_022_4	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2320	022	4	1	02	01	H2320_022_4	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2320	022	4	1	02	01	H2320_022_4	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2320	022	5	1	02	01	H2320_022_5	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2320	022	5	1	02	01	H2320_022_5	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2320	022	5	1	02	01	H2320_022_5	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2320	022	5	1	02	01	H2320_022_5	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2320	022	5	1	02	01	H2320_022_5	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2320	028	1	1	02	01	H2320_028_1	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2320	028	1	1	02	01	H2320_028_1	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2320	028	1	1	02	01	H2320_028_1	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2320	028	1	1	02	01	H2320_028_1	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2320	028	1	1	02	01	H2320_028_1	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2320	028	2	1	02	01	H2320_028_2	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2320	028	2	1	02	01	H2320_028_2	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2320	028	2	1	02	01	H2320_028_2	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2320	028	2	1	02	01	H2320_028_2	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2320	028	2	1	02	01	H2320_028_2	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2320	028	3	1	02	01	H2320_028_3	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2320	028	3	1	02	01	H2320_028_3	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2320	028	3	1	02	01	H2320_028_3	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2320	028	3	1	02	01	H2320_028_3	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2320	028	3	1	02	01	H2320_028_3	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2320	028	4	1	02	01	H2320_028_4	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2320	028	4	1	02	01	H2320_028_4	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2320	028	4	1	02	01	H2320_028_4	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2320	028	4	1	02	01	H2320_028_4	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2320	028	4	1	02	01	H2320_028_4	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2320	028	5	1	02	01	H2320_028_5	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2320	028	5	1	02	01	H2320_028_5	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2320	028	5	1	02	01	H2320_028_5	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2320	028	5	1	02	01	H2320_028_5	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2320	028	5	1	02	01	H2320_028_5	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2320	029	1	1	02	01	H2320_029_1	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2320	029	1	1	02	01	H2320_029_1	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2320	029	1	1	02	01	H2320_029_1	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2320	029	1	1	02	01	H2320_029_1	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2320	029	1	1	02	01	H2320_029_1	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2320	029	2	1	02	01	H2320_029_2	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2320	029	2	1	02	01	H2320_029_2	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2320	029	2	1	02	01	H2320_029_2	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2320	029	2	1	02	01	H2320_029_2	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2320	029	2	1	02	01	H2320_029_2	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2320	029	3	1	02	01	H2320_029_3	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2320	029	3	1	02	01	H2320_029_3	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2320	029	3	1	02	01	H2320_029_3	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2320	029	3	1	02	01	H2320_029_3	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2320	029	3	1	02	01	H2320_029_3	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2320	029	4	1	02	01	H2320_029_4	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2320	029	4	1	02	01	H2320_029_4	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2320	029	4	1	02	01	H2320_029_4	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2320	029	4	1	02	01	H2320_029_4	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2320	029	4	1	02	01	H2320_029_4	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2320	029	5	1	02	01	H2320_029_5	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2320	029	5	1	02	01	H2320_029_5	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2320	029	5	1	02	01	H2320_029_5	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2320	029	5	1	02	01	H2320_029_5	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2320	029	5	1	02	01	H2320_029_5	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2320	031	0	1	02	01	H2320_031_0	6			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2320	031	0	1	02	01	H2320_031_0	6			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2320	031	0	1	02	01	H2320_031_0	6			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2320	031	0	1	02	01	H2320_031_0	6			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2320	031	0	1	02	01	H2320_031_0	6			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2320	032	1	1	02	01	H2320_032_1	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2320	032	1	1	02	01	H2320_032_1	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2320	032	1	1	02	01	H2320_032_1	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2320	032	1	1	02	01	H2320_032_1	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2320	032	1	1	02	01	H2320_032_1	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2320	032	2	1	02	01	H2320_032_2	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2320	032	2	1	02	01	H2320_032_2	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2320	032	2	1	02	01	H2320_032_2	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2320	032	2	1	02	01	H2320_032_2	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2320	032	2	1	02	01	H2320_032_2	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2320	032	5	1	02	01	H2320_032_5	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2320	032	5	1	02	01	H2320_032_5	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2320	032	5	1	02	01	H2320_032_5	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2320	032	5	1	02	01	H2320_032_5	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2320	032	5	1	02	01	H2320_032_5	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2322	008	0	1	04	01	H2322_008_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	9.00	
H2322	008	0	1	04	01	H2322_008_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	15.00	
H2322	008	0	1	04	01	H2322_008_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2322	008	0	1	04	01	H2322_008_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2322	008	0	1	04	01	H2322_008_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2322	011	0	1	04	01	H2322_011_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	9.00	
H2322	011	0	1	04	01	H2322_011_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	17.00	
H2322	011	0	1	04	01	H2322_011_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2322	011	0	1	04	01	H2322_011_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2322	011	0	1	04	01	H2322_011_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2322	016	0	1	04	01	H2322_016_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	9.00	
H2322	016	0	1	04	01	H2322_016_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	17.00	
H2322	016	0	1	04	01	H2322_016_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2322	016	0	1	04	01	H2322_016_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2322	016	0	1	04	01	H2322_016_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2322	017	0	1	04	01	H2322_017_0	7			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2322	017	0	1	04	01	H2322_017_0	7			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H2322	017	0	1	04	01	H2322_017_0	7			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2322	017	0	1	04	01	H2322_017_0	7			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2322	017	0	1	04	01	H2322_017_0	7			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2354	015	0	1	01	01	H2354_015_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	7.00	
H2354	015	0	1	01	01	H2354_015_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	16.00	
H2354	015	0	1	01	01	H2354_015_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2354	015	0	1	01	01	H2354_015_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2354	015	0	1	01	01	H2354_015_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2354	018	0	1	01	01	H2354_018_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	7.00	
H2354	018	0	1	01	01	H2354_018_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	16.00	
H2354	018	0	1	01	01	H2354_018_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2354	018	0	1	01	01	H2354_018_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2354	018	0	1	01	01	H2354_018_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2354	021	0	1	02	01	H2354_021_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	7.00	
H2354	021	0	1	02	01	H2354_021_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	16.00	
H2354	021	0	1	02	01	H2354_021_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2354	021	0	1	02	01	H2354_021_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2354	021	0	1	02	01	H2354_021_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2354	028	0	1	01	01	H2354_028_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	7.00	
H2354	028	0	1	01	01	H2354_028_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	16.00	
H2354	028	0	1	01	01	H2354_028_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2354	028	0	1	01	01	H2354_028_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2354	028	0	1	01	01	H2354_028_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2354	029	0	1	01	01	H2354_029_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	7.00	
H2354	029	0	1	01	01	H2354_029_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	15.00	
H2354	029	0	1	01	01	H2354_029_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2354	029	0	1	01	01	H2354_029_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2354	029	0	1	01	01	H2354_029_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2385	001	0	1	04	01	H2385_001_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2385	001	0	1	04	01	H2385_001_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2385	001	0	1	04	01	H2385_001_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2385	001	0	1	04	01	H2385_001_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2385	001	0	1	04	01	H2385_001_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2385	002	0	1	04	01	H2385_002_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2385	002	0	1	04	01	H2385_002_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2385	002	0	1	04	01	H2385_002_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2385	002	0	1	04	01	H2385_002_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2385	002	0	1	04	01	H2385_002_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2385	003	0	1	04	01	H2385_003_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2385	003	0	1	04	01	H2385_003_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2385	003	0	1	04	01	H2385_003_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2385	003	0	1	04	01	H2385_003_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2385	003	0	1	04	01	H2385_003_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2385	004	0	1	04	01	H2385_004_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2385	004	0	1	04	01	H2385_004_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2385	004	0	1	04	01	H2385_004_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2385	004	0	1	04	01	H2385_004_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2385	004	0	1	04	01	H2385_004_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	008	0	1	04	01	H2406_008_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	008	0	1	04	01	H2406_008_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H2406	008	0	1	04	01	H2406_008_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	008	0	1	04	01	H2406_008_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	008	0	1	04	01	H2406_008_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	009	0	1	04	01	H2406_009_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	009	0	1	04	01	H2406_009_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H2406	009	0	1	04	01	H2406_009_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	009	0	1	04	01	H2406_009_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	009	0	1	04	01	H2406_009_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	010	0	1	04	01	H2406_010_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	010	0	1	04	01	H2406_010_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H2406	010	0	1	04	01	H2406_010_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	010	0	1	04	01	H2406_010_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	010	0	1	04	01	H2406_010_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	011	0	1	04	01	H2406_011_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	011	0	1	04	01	H2406_011_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H2406	011	0	1	04	01	H2406_011_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	011	0	1	04	01	H2406_011_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	011	0	1	04	01	H2406_011_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	013	0	1	04	01	H2406_013_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	013	0	1	04	01	H2406_013_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	5.00	
H2406	013	0	1	04	01	H2406_013_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	013	0	1	04	01	H2406_013_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	013	0	1	04	01	H2406_013_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	015	0	1	04	01	H2406_015_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	015	0	1	04	01	H2406_015_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H2406	015	0	1	04	01	H2406_015_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	015	0	1	04	01	H2406_015_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	015	0	1	04	01	H2406_015_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	016	0	1	04	01	H2406_016_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	016	0	1	04	01	H2406_016_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	5.00	
H2406	016	0	1	04	01	H2406_016_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	016	0	1	04	01	H2406_016_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	016	0	1	04	01	H2406_016_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	017	0	1	04	01	H2406_017_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	017	0	1	04	01	H2406_017_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	15.00	
H2406	017	0	1	04	01	H2406_017_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	017	0	1	04	01	H2406_017_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	017	0	1	04	01	H2406_017_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	018	0	1	04	01	H2406_018_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	018	0	1	04	01	H2406_018_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H2406	018	0	1	04	01	H2406_018_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	018	0	1	04	01	H2406_018_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	018	0	1	04	01	H2406_018_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	019	0	1	04	01	H2406_019_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	019	0	1	04	01	H2406_019_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H2406	019	0	1	04	01	H2406_019_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	019	0	1	04	01	H2406_019_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	019	0	1	04	01	H2406_019_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	034	0	1	04	01	H2406_034_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	034	0	1	04	01	H2406_034_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H2406	034	0	1	04	01	H2406_034_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	034	0	1	04	01	H2406_034_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	034	0	1	04	01	H2406_034_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	035	0	1	04	01	H2406_035_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	035	0	1	04	01	H2406_035_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H2406	035	0	1	04	01	H2406_035_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	035	0	1	04	01	H2406_035_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	035	0	1	04	01	H2406_035_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	036	0	1	04	01	H2406_036_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	036	0	1	04	01	H2406_036_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H2406	036	0	1	04	01	H2406_036_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	036	0	1	04	01	H2406_036_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	036	0	1	04	01	H2406_036_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	037	0	1	04	01	H2406_037_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	037	0	1	04	01	H2406_037_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H2406	037	0	1	04	01	H2406_037_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	037	0	1	04	01	H2406_037_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	037	0	1	04	01	H2406_037_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	038	0	1	04	01	H2406_038_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	038	0	1	04	01	H2406_038_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H2406	038	0	1	04	01	H2406_038_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	038	0	1	04	01	H2406_038_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	038	0	1	04	01	H2406_038_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	039	0	1	04	01	H2406_039_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	039	0	1	04	01	H2406_039_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H2406	039	0	1	04	01	H2406_039_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	039	0	1	04	01	H2406_039_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	039	0	1	04	01	H2406_039_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	040	0	1	04	01	H2406_040_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	040	0	1	04	01	H2406_040_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H2406	040	0	1	04	01	H2406_040_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	040	0	1	04	01	H2406_040_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	040	0	1	04	01	H2406_040_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	042	0	1	04	01	H2406_042_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	042	0	1	04	01	H2406_042_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H2406	042	0	1	04	01	H2406_042_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	042	0	1	04	01	H2406_042_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	042	0	1	04	01	H2406_042_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	043	0	1	04	01	H2406_043_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	043	0	1	04	01	H2406_043_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	5.00	
H2406	043	0	1	04	01	H2406_043_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	043	0	1	04	01	H2406_043_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	043	0	1	04	01	H2406_043_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	044	0	1	04	01	H2406_044_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	044	0	1	04	01	H2406_044_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H2406	044	0	1	04	01	H2406_044_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	044	0	1	04	01	H2406_044_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	044	0	1	04	01	H2406_044_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	046	0	1	04	01	H2406_046_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	046	0	1	04	01	H2406_046_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H2406	046	0	1	04	01	H2406_046_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	046	0	1	04	01	H2406_046_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	046	0	1	04	01	H2406_046_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	047	0	1	04	01	H2406_047_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	047	0	1	04	01	H2406_047_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H2406	047	0	1	04	01	H2406_047_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	047	0	1	04	01	H2406_047_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	047	0	1	04	01	H2406_047_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	048	0	1	04	01	H2406_048_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	048	0	1	04	01	H2406_048_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H2406	048	0	1	04	01	H2406_048_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	048	0	1	04	01	H2406_048_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	048	0	1	04	01	H2406_048_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	050	0	1	04	01	H2406_050_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	050	0	1	04	01	H2406_050_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2406	050	0	1	04	01	H2406_050_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	050	0	1	04	01	H2406_050_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	050	0	1	04	01	H2406_050_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	052	0	1	04	01	H2406_052_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	052	0	1	04	01	H2406_052_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2406	052	0	1	04	01	H2406_052_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	052	0	1	04	01	H2406_052_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	052	0	1	04	01	H2406_052_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	053	0	1	04	01	H2406_053_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	053	0	1	04	01	H2406_053_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2406	053	0	1	04	01	H2406_053_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	053	0	1	04	01	H2406_053_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	053	0	1	04	01	H2406_053_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	054	0	1	04	01	H2406_054_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	054	0	1	04	01	H2406_054_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H2406	054	0	1	04	01	H2406_054_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	054	0	1	04	01	H2406_054_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	054	0	1	04	01	H2406_054_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	055	0	1	04	01	H2406_055_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	055	0	1	04	01	H2406_055_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H2406	055	0	1	04	01	H2406_055_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	055	0	1	04	01	H2406_055_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	055	0	1	04	01	H2406_055_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	056	0	1	04	01	H2406_056_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	056	0	1	04	01	H2406_056_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H2406	056	0	1	04	01	H2406_056_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	056	0	1	04	01	H2406_056_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	056	0	1	04	01	H2406_056_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	058	0	1	04	01	H2406_058_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	058	0	1	04	01	H2406_058_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H2406	058	0	1	04	01	H2406_058_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	058	0	1	04	01	H2406_058_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	058	0	1	04	01	H2406_058_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	059	0	1	04	01	H2406_059_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	059	0	1	04	01	H2406_059_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H2406	059	0	1	04	01	H2406_059_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	059	0	1	04	01	H2406_059_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	059	0	1	04	01	H2406_059_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	062	0	1	04	01	H2406_062_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	062	0	1	04	01	H2406_062_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H2406	062	0	1	04	01	H2406_062_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	062	0	1	04	01	H2406_062_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	062	0	1	04	01	H2406_062_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	063	0	1	04	01	H2406_063_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	063	0	1	04	01	H2406_063_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H2406	063	0	1	04	01	H2406_063_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	063	0	1	04	01	H2406_063_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	063	0	1	04	01	H2406_063_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	065	0	1	04	01	H2406_065_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	065	0	1	04	01	H2406_065_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H2406	065	0	1	04	01	H2406_065_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	065	0	1	04	01	H2406_065_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	065	0	1	04	01	H2406_065_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	066	0	1	04	01	H2406_066_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	066	0	1	04	01	H2406_066_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H2406	066	0	1	04	01	H2406_066_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	066	0	1	04	01	H2406_066_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	066	0	1	04	01	H2406_066_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	067	0	1	04	01	H2406_067_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	067	0	1	04	01	H2406_067_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H2406	067	0	1	04	01	H2406_067_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	067	0	1	04	01	H2406_067_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	067	0	1	04	01	H2406_067_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	068	0	1	04	01	H2406_068_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	068	0	1	04	01	H2406_068_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H2406	068	0	1	04	01	H2406_068_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	068	0	1	04	01	H2406_068_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	068	0	1	04	01	H2406_068_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	069	0	1	04	01	H2406_069_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	069	0	1	04	01	H2406_069_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H2406	069	0	1	04	01	H2406_069_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	069	0	1	04	01	H2406_069_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	069	0	1	04	01	H2406_069_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	070	0	1	04	01	H2406_070_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	070	0	1	04	01	H2406_070_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H2406	070	0	1	04	01	H2406_070_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	070	0	1	04	01	H2406_070_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	070	0	1	04	01	H2406_070_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	071	0	1	04	01	H2406_071_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	071	0	1	04	01	H2406_071_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H2406	071	0	1	04	01	H2406_071_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	071	0	1	04	01	H2406_071_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	071	0	1	04	01	H2406_071_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	072	0	1	04	01	H2406_072_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	072	0	1	04	01	H2406_072_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H2406	072	0	1	04	01	H2406_072_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	072	0	1	04	01	H2406_072_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	072	0	1	04	01	H2406_072_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	075	0	1	04	01	H2406_075_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	075	0	1	04	01	H2406_075_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H2406	075	0	1	04	01	H2406_075_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	075	0	1	04	01	H2406_075_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	075	0	1	04	01	H2406_075_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	076	0	1	04	01	H2406_076_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	076	0	1	04	01	H2406_076_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H2406	076	0	1	04	01	H2406_076_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	076	0	1	04	01	H2406_076_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	076	0	1	04	01	H2406_076_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	078	0	1	04	01	H2406_078_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	078	0	1	04	01	H2406_078_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	5.00	
H2406	078	0	1	04	01	H2406_078_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	078	0	1	04	01	H2406_078_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	078	0	1	04	01	H2406_078_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	082	0	1	04	01	H2406_082_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	082	0	1	04	01	H2406_082_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H2406	082	0	1	04	01	H2406_082_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	082	0	1	04	01	H2406_082_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	082	0	1	04	01	H2406_082_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	087	0	1	04	01	H2406_087_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	087	0	1	04	01	H2406_087_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H2406	087	0	1	04	01	H2406_087_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	087	0	1	04	01	H2406_087_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	087	0	1	04	01	H2406_087_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	088	0	1	04	01	H2406_088_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	088	0	1	04	01	H2406_088_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H2406	088	0	1	04	01	H2406_088_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	088	0	1	04	01	H2406_088_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	088	0	1	04	01	H2406_088_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	089	0	1	04	01	H2406_089_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	089	0	1	04	01	H2406_089_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	2.00	
H2406	089	0	1	04	01	H2406_089_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	089	0	1	04	01	H2406_089_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	089	0	1	04	01	H2406_089_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	090	0	1	04	01	H2406_090_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	090	0	1	04	01	H2406_090_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H2406	090	0	1	04	01	H2406_090_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	090	0	1	04	01	H2406_090_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	090	0	1	04	01	H2406_090_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	091	0	1	04	01	H2406_091_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	091	0	1	04	01	H2406_091_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H2406	091	0	1	04	01	H2406_091_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	091	0	1	04	01	H2406_091_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	091	0	1	04	01	H2406_091_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	093	0	1	04	01	H2406_093_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	093	0	1	04	01	H2406_093_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H2406	093	0	1	04	01	H2406_093_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	093	0	1	04	01	H2406_093_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	093	0	1	04	01	H2406_093_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	096	0	1	04	01	H2406_096_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	096	0	1	04	01	H2406_096_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H2406	096	0	1	04	01	H2406_096_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	096	0	1	04	01	H2406_096_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	096	0	1	04	01	H2406_096_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	097	0	1	04	01	H2406_097_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	097	0	1	04	01	H2406_097_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H2406	097	0	1	04	01	H2406_097_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	097	0	1	04	01	H2406_097_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	097	0	1	04	01	H2406_097_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	098	0	1	04	01	H2406_098_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	098	0	1	04	01	H2406_098_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H2406	098	0	1	04	01	H2406_098_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	098	0	1	04	01	H2406_098_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	098	0	1	04	01	H2406_098_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	099	0	1	04	01	H2406_099_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	099	0	1	04	01	H2406_099_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2406	099	0	1	04	01	H2406_099_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	099	0	1	04	01	H2406_099_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	099	0	1	04	01	H2406_099_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	100	0	1	04	01	H2406_100_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	100	0	1	04	01	H2406_100_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H2406	100	0	1	04	01	H2406_100_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	100	0	1	04	01	H2406_100_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	100	0	1	04	01	H2406_100_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	101	0	1	04	01	H2406_101_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	101	0	1	04	01	H2406_101_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H2406	101	0	1	04	01	H2406_101_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	101	0	1	04	01	H2406_101_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	101	0	1	04	01	H2406_101_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	104	0	1	04	01	H2406_104_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	104	0	1	04	01	H2406_104_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H2406	104	0	1	04	01	H2406_104_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	104	0	1	04	01	H2406_104_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	104	0	1	04	01	H2406_104_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	110	0	1	04	01	H2406_110_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	110	0	1	04	01	H2406_110_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H2406	110	0	1	04	01	H2406_110_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	110	0	1	04	01	H2406_110_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	110	0	1	04	01	H2406_110_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	112	0	1	04	01	H2406_112_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	112	0	1	04	01	H2406_112_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H2406	112	0	1	04	01	H2406_112_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	112	0	1	04	01	H2406_112_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	112	0	1	04	01	H2406_112_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	113	0	1	04	01	H2406_113_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	113	0	1	04	01	H2406_113_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H2406	113	0	1	04	01	H2406_113_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	113	0	1	04	01	H2406_113_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	113	0	1	04	01	H2406_113_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	115	0	1	04	01	H2406_115_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	115	0	1	04	01	H2406_115_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H2406	115	0	1	04	01	H2406_115_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	115	0	1	04	01	H2406_115_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	115	0	1	04	01	H2406_115_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	119	0	1	04	01	H2406_119_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	119	0	1	04	01	H2406_119_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H2406	119	0	1	04	01	H2406_119_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	119	0	1	04	01	H2406_119_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	119	0	1	04	01	H2406_119_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	121	0	1	04	01	H2406_121_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	121	0	1	04	01	H2406_121_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H2406	121	0	1	04	01	H2406_121_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	121	0	1	04	01	H2406_121_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	121	0	1	04	01	H2406_121_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	125	0	1	04	01	H2406_125_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	125	0	1	04	01	H2406_125_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H2406	125	0	1	04	01	H2406_125_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	125	0	1	04	01	H2406_125_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	125	0	1	04	01	H2406_125_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	129	0	1	04	01	H2406_129_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	129	0	1	04	01	H2406_129_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H2406	129	0	1	04	01	H2406_129_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	129	0	1	04	01	H2406_129_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	129	0	1	04	01	H2406_129_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2406	135	0	1	04	01	H2406_135_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2406	135	0	1	04	01	H2406_135_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H2406	135	0	1	04	01	H2406_135_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2406	135	0	1	04	01	H2406_135_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2406	135	0	1	04	01	H2406_135_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2441	001	0	1	04	01	H2441_001_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H2441	001	0	1	04	01	H2441_001_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2441	001	0	1	04	01	H2441_001_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2441	001	0	1	04	01	H2441_001_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2441	001	0	1	04	01	H2441_001_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2441	001	0	1	04	01	H2441_001_0	6		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2445	001	0	1	02	01	H2445_001_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2445	001	0	1	02	01	H2445_001_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2445	001	0	1	02	01	H2445_001_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2445	001	0	1	02	01	H2445_001_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2445	001	0	1	02	01	H2445_001_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2445	002	0	1	02	01	H2445_002_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2445	002	0	1	02	01	H2445_002_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2445	002	0	1	02	01	H2445_002_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2445	002	0	1	02	01	H2445_002_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2445	002	0	1	02	01	H2445_002_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2445	003	0	1	02	01	H2445_003_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2445	003	0	1	02	01	H2445_003_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2445	003	0	1	02	01	H2445_003_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2445	003	0	1	02	01	H2445_003_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2445	003	0	1	02	01	H2445_003_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2445	004	0	1	02	01	H2445_004_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2445	004	0	1	02	01	H2445_004_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2445	004	0	1	02	01	H2445_004_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2445	004	0	1	02	01	H2445_004_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2445	004	0	1	02	01	H2445_004_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2445	005	0	1	02	01	H2445_005_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2445	005	0	1	02	01	H2445_005_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2445	005	0	1	02	01	H2445_005_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2445	005	0	1	02	01	H2445_005_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2445	005	0	1	02	01	H2445_005_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2450	002	0	1	18	06	H2450_002_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2450	002	0	1	18	06	H2450_002_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2450	002	0	1	18	06	H2450_002_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2450	002	0	1	18	06	H2450_002_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2450	002	0	1	18	06	H2450_002_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2450	007	0	1	18	06	H2450_007_0	4			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2450	007	0	1	18	06	H2450_007_0	4			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2450	007	0	1	18	06	H2450_007_0	4			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2450	007	0	1	18	06	H2450_007_0	4			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2450	007	0	1	18	06	H2450_007_0	4			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2450	016	0	1	18	06	H2450_016_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2450	016	0	1	18	06	H2450_016_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2450	016	0	1	18	06	H2450_016_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2450	016	0	1	18	06	H2450_016_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2450	016	0	1	18	06	H2450_016_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2450	035	0	1	18	06	H2450_035_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2450	035	0	1	18	06	H2450_035_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2450	035	0	1	18	06	H2450_035_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2450	035	0	1	18	06	H2450_035_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2450	035	0	1	18	06	H2450_035_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2450	037	0	1	18	06	H2450_037_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2450	037	0	1	18	06	H2450_037_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2450	037	0	1	18	06	H2450_037_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2450	037	0	1	18	06	H2450_037_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2450	037	0	1	18	06	H2450_037_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2450	039	0	1	18	06	H2450_039_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2450	039	0	1	18	06	H2450_039_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2450	039	0	1	18	06	H2450_039_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2450	039	0	1	18	06	H2450_039_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2450	039	0	1	18	06	H2450_039_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2450	049	0	1	18	06	H2450_049_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2450	049	0	1	18	06	H2450_049_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2450	049	0	1	18	06	H2450_049_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2450	049	0	1	18	06	H2450_049_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2450	049	0	1	18	06	H2450_049_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2458	002	0	1	01	01	H2458_002_0	8		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H2458	002	0	1	01	01	H2458_002_0	8		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H2458	002	0	1	01	01	H2458_002_0	8		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H2458	002	0	1	01	01	H2458_002_0	8		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2458	002	0	1	01	01	H2458_002_0	8		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2458	002	0	1	01	01	H2458_002_0	8		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H2461	008	0	1	18	06	H2461_008_0	2			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2461	008	0	1	18	06	H2461_008_0	2			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H2461	008	0	1	18	06	H2461_008_0	2			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2461	008	0	1	18	06	H2461_008_0	2			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2461	008	0	1	18	06	H2461_008_0	2			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2461	009	0	1	18	06	H2461_009_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2461	009	0	1	18	06	H2461_009_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H2461	009	0	1	18	06	H2461_009_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2461	009	0	1	18	06	H2461_009_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2461	009	0	1	18	06	H2461_009_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2461	010	0	1	18	06	H2461_010_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2461	010	0	1	18	06	H2461_010_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2461	010	0	1	18	06	H2461_010_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2461	010	0	1	18	06	H2461_010_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2461	010	0	1	18	06	H2461_010_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2463	001	0	1	01	01	H2463_001_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H2463	001	0	1	01	01	H2463_001_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H2463	001	0	1	01	01	H2463_001_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2463	001	0	1	01	01	H2463_001_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2463	001	0	1	01	01	H2463_001_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2478	001	0	1	01	01	H2478_001_0	9		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H2478	001	0	1	01	01	H2478_001_0	9		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2478	001	0	1	01	01	H2478_001_0	9		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2478	001	0	1	01	01	H2478_001_0	9		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2478	001	0	1	01	01	H2478_001_0	9		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2478	001	0	1	01	01	H2478_001_0	9		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H2486	003	0	1	01	01	H2486_003_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2486	003	0	1	01	01	H2486_003_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H2486	003	0	1	01	01	H2486_003_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2486	003	0	1	01	01	H2486_003_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2486	003	0	1	01	01	H2486_003_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2486	005	0	1	01	01	H2486_005_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2486	005	0	1	01	01	H2486_005_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H2486	005	0	1	01	01	H2486_005_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2486	005	0	1	01	01	H2486_005_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2486	005	0	1	01	01	H2486_005_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2486	007	0	1	01	01	H2486_007_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2486	007	0	1	01	01	H2486_007_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H2486	007	0	1	01	01	H2486_007_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2486	007	0	1	01	01	H2486_007_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2486	007	0	1	01	01	H2486_007_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2491	010	0	1	02	01	H2491_010_0	8			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H2491	010	0	1	02	01	H2491_010_0	8			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2491	010	0	1	02	01	H2491_010_0	8			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2491	010	0	1	02	01	H2491_010_0	8			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2491	010	0	1	02	01	H2491_010_0	8			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2491	010	0	1	02	01	H2491_010_0	8			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2491	017	0	1	02	01	H2491_017_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H2491	017	0	1	02	01	H2491_017_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2491	017	0	1	02	01	H2491_017_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2491	017	0	1	02	01	H2491_017_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2491	017	0	1	02	01	H2491_017_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2491	017	0	1	02	01	H2491_017_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2491	025	0	1	02	01	H2491_025_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H2491	025	0	1	02	01	H2491_025_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2491	025	0	1	02	01	H2491_025_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2491	025	0	1	02	01	H2491_025_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2491	025	0	1	02	01	H2491_025_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2491	025	0	1	02	01	H2491_025_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2491	028	0	1	02	01	H2491_028_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H2491	028	0	1	02	01	H2491_028_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2491	028	0	1	02	01	H2491_028_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2491	028	0	1	02	01	H2491_028_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2491	028	0	1	02	01	H2491_028_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2491	028	0	1	02	01	H2491_028_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2491	029	0	1	02	01	H2491_029_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H2491	029	0	1	02	01	H2491_029_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2491	029	0	1	02	01	H2491_029_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2491	029	0	1	02	01	H2491_029_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2491	029	0	1	02	01	H2491_029_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2491	029	0	1	02	01	H2491_029_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2491	031	0	1	02	01	H2491_031_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H2491	031	0	1	02	01	H2491_031_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2491	031	0	1	02	01	H2491_031_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2491	031	0	1	02	01	H2491_031_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2491	031	0	1	02	01	H2491_031_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2491	031	0	1	02	01	H2491_031_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2491	032	1	1	02	01	H2491_032_1	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H2491	032	1	1	02	01	H2491_032_1	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2491	032	1	1	02	01	H2491_032_1	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2491	032	1	1	02	01	H2491_032_1	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2491	032	1	1	02	01	H2491_032_1	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2491	032	1	1	02	01	H2491_032_1	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2491	032	2	1	02	01	H2491_032_2	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H2491	032	2	1	02	01	H2491_032_2	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2491	032	2	1	02	01	H2491_032_2	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2491	032	2	1	02	01	H2491_032_2	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2491	032	2	1	02	01	H2491_032_2	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2491	032	2	1	02	01	H2491_032_2	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2491	033	1	1	02	01	H2491_033_1	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H2491	033	1	1	02	01	H2491_033_1	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2491	033	1	1	02	01	H2491_033_1	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2491	033	1	1	02	01	H2491_033_1	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2491	033	1	1	02	01	H2491_033_1	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2491	033	1	1	02	01	H2491_033_1	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2491	033	2	1	02	01	H2491_033_2	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H2491	033	2	1	02	01	H2491_033_2	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2491	033	2	1	02	01	H2491_033_2	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2491	033	2	1	02	01	H2491_033_2	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2491	033	2	1	02	01	H2491_033_2	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2491	033	2	1	02	01	H2491_033_2	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2509	001	0	1	02	01	H2509_001_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2509	001	0	1	02	01	H2509_001_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2509	001	0	1	02	01	H2509_001_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2509	001	0	1	02	01	H2509_001_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2509	001	0	1	02	01	H2509_001_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2509	002	0	1	02	01	H2509_002_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2509	002	0	1	02	01	H2509_002_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2509	002	0	1	02	01	H2509_002_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2509	002	0	1	02	01	H2509_002_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2509	002	0	1	02	01	H2509_002_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2509	003	0	1	02	01	H2509_003_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2509	003	0	1	02	01	H2509_003_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2509	003	0	1	02	01	H2509_003_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2509	003	0	1	02	01	H2509_003_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2509	003	0	1	02	01	H2509_003_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2526	001	0	1	04	01	H2526_001_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2526	001	0	1	04	01	H2526_001_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	5.00	
H2526	001	0	1	04	01	H2526_001_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2526	001	0	1	04	01	H2526_001_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2526	001	0	1	04	01	H2526_001_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2526	003	0	1	04	01	H2526_003_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2526	003	0	1	04	01	H2526_003_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H2526	003	0	1	04	01	H2526_003_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2526	003	0	1	04	01	H2526_003_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2526	003	0	1	04	01	H2526_003_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2564	001	0	1	01	01	H2564_001_0	10		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H2564	001	0	1	01	01	H2564_001_0	10		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H2564	001	0	1	01	01	H2564_001_0	10		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H2564	001	0	1	01	01	H2564_001_0	10		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2564	001	0	1	01	01	H2564_001_0	10		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2564	001	0	1	01	01	H2564_001_0	10		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H2593	001	0	1	02	01	H2593_001_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H2593	001	0	1	02	01	H2593_001_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2593	001	0	1	02	01	H2593_001_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2593	001	0	1	02	01	H2593_001_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2593	001	0	1	02	01	H2593_001_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2593	001	0	1	02	01	H2593_001_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2593	003	0	1	01	01	H2593_003_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H2593	003	0	1	01	01	H2593_003_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2593	003	0	1	01	01	H2593_003_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2593	003	0	1	01	01	H2593_003_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2593	003	0	1	01	01	H2593_003_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2593	003	0	1	01	01	H2593_003_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2593	005	0	1	02	01	H2593_005_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H2593	005	0	1	02	01	H2593_005_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2593	005	0	1	02	01	H2593_005_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2593	005	0	1	02	01	H2593_005_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2593	005	0	1	02	01	H2593_005_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2593	005	0	1	02	01	H2593_005_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2593	006	0	1	02	01	H2593_006_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H2593	006	0	1	02	01	H2593_006_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2593	006	0	1	02	01	H2593_006_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2593	006	0	1	02	01	H2593_006_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2593	006	0	1	02	01	H2593_006_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2593	006	0	1	02	01	H2593_006_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2593	029	0	1	02	01	H2593_029_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H2593	029	0	1	02	01	H2593_029_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2593	029	0	1	02	01	H2593_029_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2593	029	0	1	02	01	H2593_029_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2593	029	0	1	02	01	H2593_029_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2593	029	0	1	02	01	H2593_029_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2593	031	0	1	02	01	H2593_031_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H2593	031	0	1	02	01	H2593_031_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2593	031	0	1	02	01	H2593_031_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2593	031	0	1	02	01	H2593_031_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2593	031	0	1	02	01	H2593_031_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2593	031	0	1	02	01	H2593_031_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2593	032	0	1	01	01	H2593_032_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H2593	032	0	1	01	01	H2593_032_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2593	032	0	1	01	01	H2593_032_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2593	032	0	1	01	01	H2593_032_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2593	032	0	1	01	01	H2593_032_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2593	032	0	1	01	01	H2593_032_0	5		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2593	040	0	1	02	01	H2593_040_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H2593	040	0	1	02	01	H2593_040_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2593	040	0	1	02	01	H2593_040_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2593	040	0	1	02	01	H2593_040_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2593	040	0	1	02	01	H2593_040_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2593	040	0	1	02	01	H2593_040_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2593	043	0	1	02	01	H2593_043_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H2593	043	0	1	02	01	H2593_043_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2593	043	0	1	02	01	H2593_043_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2593	043	0	1	02	01	H2593_043_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2593	043	0	1	02	01	H2593_043_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2593	043	0	1	02	01	H2593_043_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2593	044	0	1	01	01	H2593_044_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H2593	044	0	1	01	01	H2593_044_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2593	044	0	1	01	01	H2593_044_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2593	044	0	1	01	01	H2593_044_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2593	044	0	1	01	01	H2593_044_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2593	044	0	1	01	01	H2593_044_0	6		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2593	045	0	1	01	01	H2593_045_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H2593	045	0	1	01	01	H2593_045_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2593	045	0	1	01	01	H2593_045_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2593	045	0	1	01	01	H2593_045_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2593	045	0	1	01	01	H2593_045_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2593	045	0	1	01	01	H2593_045_0	5		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2593	046	0	1	01	01	H2593_046_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H2593	046	0	1	01	01	H2593_046_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2593	046	0	1	01	01	H2593_046_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2593	046	0	1	01	01	H2593_046_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2593	046	0	1	01	01	H2593_046_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2593	046	0	1	01	01	H2593_046_0	5		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2593	047	0	1	01	01	H2593_047_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H2593	047	0	1	01	01	H2593_047_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2593	047	0	1	01	01	H2593_047_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2593	047	0	1	01	01	H2593_047_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2593	047	0	1	01	01	H2593_047_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2593	047	0	1	01	01	H2593_047_0	6		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2593	048	0	1	01	01	H2593_048_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H2593	048	0	1	01	01	H2593_048_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2593	048	0	1	01	01	H2593_048_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2593	048	0	1	01	01	H2593_048_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2593	048	0	1	01	01	H2593_048_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2593	048	0	1	01	01	H2593_048_0	6		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2593	051	0	1	01	01	H2593_051_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H2593	051	0	1	01	01	H2593_051_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2593	051	0	1	01	01	H2593_051_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2593	051	0	1	01	01	H2593_051_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2593	051	0	1	01	01	H2593_051_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2593	051	0	1	01	01	H2593_051_0	6		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2593	053	0	1	01	01	H2593_053_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H2593	053	0	1	01	01	H2593_053_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2593	053	0	1	01	01	H2593_053_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2593	053	0	1	01	01	H2593_053_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2593	053	0	1	01	01	H2593_053_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2593	053	0	1	01	01	H2593_053_0	5		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2610	005	0	1	01	01	H2610_005_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H2610	005	0	1	01	01	H2610_005_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	3	2	12.00	
H2610	005	0	1	01	01	H2610_005_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H2610	005	0	1	01	01	H2610_005_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2610	005	0	1	01	01	H2610_005_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2610	005	0	1	01	01	H2610_005_0	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2610	006	0	1	01	01	H2610_006_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H2610	006	0	1	01	01	H2610_006_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	3	2	12.00	
H2610	006	0	1	01	01	H2610_006_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H2610	006	0	1	01	01	H2610_006_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2610	006	0	1	01	01	H2610_006_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2610	006	0	1	01	01	H2610_006_0	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2610	015	0	1	01	01	H2610_015_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H2610	015	0	1	01	01	H2610_015_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	3	2	10.00	
H2610	015	0	1	01	01	H2610_015_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H2610	015	0	1	01	01	H2610_015_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2610	015	0	1	01	01	H2610_015_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2610	015	0	1	01	01	H2610_015_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2610	016	0	1	01	01	H2610_016_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H2610	016	0	1	01	01	H2610_016_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	3	2	12.00	
H2610	016	0	1	01	01	H2610_016_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H2610	016	0	1	01	01	H2610_016_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2610	016	0	1	01	01	H2610_016_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2610	016	0	1	01	01	H2610_016_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2610	021	0	1	01	01	H2610_021_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H2610	021	0	1	01	01	H2610_021_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	3	2	10.00	
H2610	021	0	1	01	01	H2610_021_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H2610	021	0	1	01	01	H2610_021_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2610	021	0	1	01	01	H2610_021_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2610	021	0	1	01	01	H2610_021_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2610	027	0	1	01	01	H2610_027_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H2610	027	0	1	01	01	H2610_027_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	3	2	12.00	
H2610	027	0	1	01	01	H2610_027_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H2610	027	0	1	01	01	H2610_027_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2610	027	0	1	01	01	H2610_027_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2610	027	0	1	01	01	H2610_027_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2624	001	0	1	01	01	H2624_001_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H2624	001	0	1	01	01	H2624_001_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H2624	001	0	1	01	01	H2624_001_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2624	001	0	1	01	01	H2624_001_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2624	001	0	1	01	01	H2624_001_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2624	001	0	1	01	01	H2624_001_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2628	001	0	1	01	01	H2628_001_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H2628	001	0	1	01	01	H2628_001_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2628	001	0	1	01	01	H2628_001_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2628	001	0	1	01	01	H2628_001_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2628	001	0	1	01	01	H2628_001_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2628	001	0	1	01	01	H2628_001_0	5		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2628	003	0	1	01	01	H2628_003_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H2628	003	0	1	01	01	H2628_003_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2628	003	0	1	01	01	H2628_003_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2628	003	0	1	01	01	H2628_003_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2628	003	0	1	01	01	H2628_003_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2628	003	0	1	01	01	H2628_003_0	5		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2628	004	0	1	01	01	H2628_004_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H2628	004	0	1	01	01	H2628_004_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2628	004	0	1	01	01	H2628_004_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2628	004	0	1	01	01	H2628_004_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2628	004	0	1	01	01	H2628_004_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2628	004	0	1	01	01	H2628_004_0	5		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2628	005	0	1	01	01	H2628_005_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H2628	005	0	1	01	01	H2628_005_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2628	005	0	1	01	01	H2628_005_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2628	005	0	1	01	01	H2628_005_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2628	005	0	1	01	01	H2628_005_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2628	005	0	1	01	01	H2628_005_0	5		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2630	001	0	1	01	01	H2630_001_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H2630	001	0	1	01	01	H2630_001_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	3	2	0.00	
H2630	001	0	1	01	01	H2630_001_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2630	001	0	1	01	01	H2630_001_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2630	001	0	1	01	01	H2630_001_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2630	001	0	1	01	01	H2630_001_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2630	002	0	1	01	01	H2630_002_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H2630	002	0	1	01	01	H2630_002_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	3	2	0.00	
H2630	002	0	1	01	01	H2630_002_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2630	002	0	1	01	01	H2630_002_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2630	002	0	1	01	01	H2630_002_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2630	002	0	1	01	01	H2630_002_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2663	005	0	1	02	01	H2663_005_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2663	005	0	1	02	01	H2663_005_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2663	005	0	1	02	01	H2663_005_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2663	005	0	1	02	01	H2663_005_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2663	005	0	1	02	01	H2663_005_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2663	006	0	1	02	01	H2663_006_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2663	006	0	1	02	01	H2663_006_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2663	006	0	1	02	01	H2663_006_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2663	006	0	1	02	01	H2663_006_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2663	006	0	1	02	01	H2663_006_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2663	017	0	1	02	01	H2663_017_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2663	017	0	1	02	01	H2663_017_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2663	017	0	1	02	01	H2663_017_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2663	017	0	1	02	01	H2663_017_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2663	017	0	1	02	01	H2663_017_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2663	021	0	1	02	01	H2663_021_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2663	021	0	1	02	01	H2663_021_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2663	021	0	1	02	01	H2663_021_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2663	021	0	1	02	01	H2663_021_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2663	021	0	1	02	01	H2663_021_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2663	023	0	1	02	01	H2663_023_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2663	023	0	1	02	01	H2663_023_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2663	023	0	1	02	01	H2663_023_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2663	023	0	1	02	01	H2663_023_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2663	023	0	1	02	01	H2663_023_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2663	026	0	1	02	01	H2663_026_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2663	026	0	1	02	01	H2663_026_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2663	026	0	1	02	01	H2663_026_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2663	026	0	1	02	01	H2663_026_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2663	026	0	1	02	01	H2663_026_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2663	028	0	1	02	01	H2663_028_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2663	028	0	1	02	01	H2663_028_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2663	028	0	1	02	01	H2663_028_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2663	028	0	1	02	01	H2663_028_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2663	028	0	1	02	01	H2663_028_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2663	029	0	1	02	01	H2663_029_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2663	029	0	1	02	01	H2663_029_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2663	029	0	1	02	01	H2663_029_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2663	029	0	1	02	01	H2663_029_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2663	029	0	1	02	01	H2663_029_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2663	034	0	1	01	01	H2663_034_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2663	034	0	1	01	01	H2663_034_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2663	034	0	1	01	01	H2663_034_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2663	034	0	1	01	01	H2663_034_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2663	034	0	1	01	01	H2663_034_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2663	038	0	1	02	01	H2663_038_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2663	038	0	1	02	01	H2663_038_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2663	038	0	1	02	01	H2663_038_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2663	038	0	1	02	01	H2663_038_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2663	038	0	1	02	01	H2663_038_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2663	039	0	1	01	01	H2663_039_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2663	039	0	1	01	01	H2663_039_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2663	039	0	1	01	01	H2663_039_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2663	039	0	1	01	01	H2663_039_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2663	039	0	1	01	01	H2663_039_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2663	040	0	1	02	01	H2663_040_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2663	040	0	1	02	01	H2663_040_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2663	040	0	1	02	01	H2663_040_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2663	040	0	1	02	01	H2663_040_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2663	040	0	1	02	01	H2663_040_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2663	041	0	1	02	01	H2663_041_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2663	041	0	1	02	01	H2663_041_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2663	041	0	1	02	01	H2663_041_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2663	041	0	1	02	01	H2663_041_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2663	041	0	1	02	01	H2663_041_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2663	042	0	1	01	01	H2663_042_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2663	042	0	1	01	01	H2663_042_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2663	042	0	1	01	01	H2663_042_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2663	042	0	1	01	01	H2663_042_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2663	042	0	1	01	01	H2663_042_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2663	043	0	1	02	01	H2663_043_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2663	043	0	1	02	01	H2663_043_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2663	043	0	1	02	01	H2663_043_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2663	043	0	1	02	01	H2663_043_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2663	043	0	1	02	01	H2663_043_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2663	052	0	1	01	01	H2663_052_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2663	052	0	1	01	01	H2663_052_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2663	052	0	1	01	01	H2663_052_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2663	052	0	1	01	01	H2663_052_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2663	052	0	1	01	01	H2663_052_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2663	053	0	1	01	01	H2663_053_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2663	053	0	1	01	01	H2663_053_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2663	053	0	1	01	01	H2663_053_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2663	053	0	1	01	01	H2663_053_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2663	053	0	1	01	01	H2663_053_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2663	056	0	1	01	01	H2663_056_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2663	056	0	1	01	01	H2663_056_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2663	056	0	1	01	01	H2663_056_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2663	056	0	1	01	01	H2663_056_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2663	056	0	1	01	01	H2663_056_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2663	057	0	1	02	01	H2663_057_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2663	057	0	1	02	01	H2663_057_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2663	057	0	1	02	01	H2663_057_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2663	057	0	1	02	01	H2663_057_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2663	057	0	1	02	01	H2663_057_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2663	061	0	1	02	01	H2663_061_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2663	061	0	1	02	01	H2663_061_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2663	061	0	1	02	01	H2663_061_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2663	061	0	1	02	01	H2663_061_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2663	061	0	1	02	01	H2663_061_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2663	063	0	1	02	01	H2663_063_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2663	063	0	1	02	01	H2663_063_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2663	063	0	1	02	01	H2663_063_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2663	063	0	1	02	01	H2663_063_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2663	063	0	1	02	01	H2663_063_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2663	064	0	1	01	01	H2663_064_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2663	064	0	1	01	01	H2663_064_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2663	064	0	1	01	01	H2663_064_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2663	064	0	1	01	01	H2663_064_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2663	064	0	1	01	01	H2663_064_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2663	067	0	1	01	01	H2663_067_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2663	067	0	1	01	01	H2663_067_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2663	067	0	1	01	01	H2663_067_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2663	067	0	1	01	01	H2663_067_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2663	067	0	1	01	01	H2663_067_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2663	097	0	1	01	01	H2663_097_0	2		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2663	097	0	1	01	01	H2663_097_0	2		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2663	097	0	1	01	01	H2663_097_0	2		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2663	097	0	1	01	01	H2663_097_0	2		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2663	097	0	1	01	01	H2663_097_0	2		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2663	098	0	1	01	01	H2663_098_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2663	098	0	1	01	01	H2663_098_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2663	098	0	1	01	01	H2663_098_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2663	098	0	1	01	01	H2663_098_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2663	098	0	1	01	01	H2663_098_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2663	099	0	1	01	01	H2663_099_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2663	099	0	1	01	01	H2663_099_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2663	099	0	1	01	01	H2663_099_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2663	099	0	1	01	01	H2663_099_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2663	099	0	1	01	01	H2663_099_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2663	100	0	1	01	01	H2663_100_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2663	100	0	1	01	01	H2663_100_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2663	100	0	1	01	01	H2663_100_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2663	100	0	1	01	01	H2663_100_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2663	100	0	1	01	01	H2663_100_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2663	102	0	1	01	01	H2663_102_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2663	102	0	1	01	01	H2663_102_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2663	102	0	1	01	01	H2663_102_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2663	102	0	1	01	01	H2663_102_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2663	102	0	1	01	01	H2663_102_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2663	103	0	1	02	01	H2663_103_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2663	103	0	1	02	01	H2663_103_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2663	103	0	1	02	01	H2663_103_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2663	103	0	1	02	01	H2663_103_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2663	103	0	1	02	01	H2663_103_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2686	004	1	1	04	01	H2686_004_1	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2686	004	1	1	04	01	H2686_004_1	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	1.00	
H2686	004	1	1	04	01	H2686_004_1	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2686	004	1	1	04	01	H2686_004_1	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2686	004	1	1	04	01	H2686_004_1	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2686	004	3	1	04	01	H2686_004_3	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2686	004	3	1	04	01	H2686_004_3	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	1.00	
H2686	004	3	1	04	01	H2686_004_3	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2686	004	3	1	04	01	H2686_004_3	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2686	004	3	1	04	01	H2686_004_3	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2686	005	1	1	04	01	H2686_005_1	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2686	005	1	1	04	01	H2686_005_1	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	1.00	
H2686	005	1	1	04	01	H2686_005_1	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2686	005	1	1	04	01	H2686_005_1	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2686	005	1	1	04	01	H2686_005_1	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2686	005	2	1	04	01	H2686_005_2	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2686	005	2	1	04	01	H2686_005_2	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	1.00	
H2686	005	2	1	04	01	H2686_005_2	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2686	005	2	1	04	01	H2686_005_2	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2686	005	2	1	04	01	H2686_005_2	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2686	006	1	1	04	01	H2686_006_1	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2686	006	1	1	04	01	H2686_006_1	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H2686	006	1	1	04	01	H2686_006_1	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2686	006	1	1	04	01	H2686_006_1	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2686	006	1	1	04	01	H2686_006_1	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2686	006	2	1	04	01	H2686_006_2	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2686	006	2	1	04	01	H2686_006_2	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H2686	006	2	1	04	01	H2686_006_2	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2686	006	2	1	04	01	H2686_006_2	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2686	006	2	1	04	01	H2686_006_2	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2686	008	0	1	04	01	H2686_008_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2686	008	0	1	04	01	H2686_008_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H2686	008	0	1	04	01	H2686_008_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2686	008	0	1	04	01	H2686_008_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2686	008	0	1	04	01	H2686_008_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2686	009	0	1	04	01	H2686_009_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2686	009	0	1	04	01	H2686_009_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H2686	009	0	1	04	01	H2686_009_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2686	009	0	1	04	01	H2686_009_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2686	009	0	1	04	01	H2686_009_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2686	010	0	1	04	01	H2686_010_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2686	010	0	1	04	01	H2686_010_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H2686	010	0	1	04	01	H2686_010_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2686	010	0	1	04	01	H2686_010_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2686	010	0	1	04	01	H2686_010_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2687	001	0	1	01	01	H2687_001_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2687	001	0	1	01	01	H2687_001_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H2687	001	0	1	01	01	H2687_001_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2687	001	0	1	01	01	H2687_001_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2687	001	0	1	01	01	H2687_001_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2694	001	0	1	04	01	H2694_001_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2694	001	0	1	04	01	H2694_001_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2694	001	0	1	04	01	H2694_001_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2694	001	0	1	04	01	H2694_001_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2694	001	0	1	04	01	H2694_001_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2694	002	0	1	04	01	H2694_002_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2694	002	0	1	04	01	H2694_002_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2694	002	0	1	04	01	H2694_002_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2694	002	0	1	04	01	H2694_002_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2694	002	0	1	04	01	H2694_002_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2697	001	0	1	01	01	H2697_001_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2697	001	0	1	01	01	H2697_001_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H2697	001	0	1	01	01	H2697_001_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2697	001	0	1	01	01	H2697_001_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2697	001	0	1	01	01	H2697_001_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2697	002	0	1	01	01	H2697_002_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2697	002	0	1	01	01	H2697_002_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H2697	002	0	1	01	01	H2697_002_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2697	002	0	1	01	01	H2697_002_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2697	002	0	1	01	01	H2697_002_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2697	003	0	1	01	01	H2697_003_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2697	003	0	1	01	01	H2697_003_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H2697	003	0	1	01	01	H2697_003_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2697	003	0	1	01	01	H2697_003_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2697	003	0	1	01	01	H2697_003_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2697	004	0	1	01	01	H2697_004_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2697	004	0	1	01	01	H2697_004_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	5.00	
H2697	004	0	1	01	01	H2697_004_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2697	004	0	1	01	01	H2697_004_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2697	004	0	1	01	01	H2697_004_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2697	006	0	1	01	01	H2697_006_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2697	006	0	1	01	01	H2697_006_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H2697	006	0	1	01	01	H2697_006_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2697	006	0	1	01	01	H2697_006_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2697	006	0	1	01	01	H2697_006_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2697	007	0	1	01	01	H2697_007_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2697	007	0	1	01	01	H2697_007_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	5.00	
H2697	007	0	1	01	01	H2697_007_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2697	007	0	1	01	01	H2697_007_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2697	007	0	1	01	01	H2697_007_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2697	009	0	1	01	01	H2697_009_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2697	009	0	1	01	01	H2697_009_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H2697	009	0	1	01	01	H2697_009_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2697	009	0	1	01	01	H2697_009_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2697	009	0	1	01	01	H2697_009_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2697	010	0	1	01	01	H2697_010_0	9		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H2697	010	0	1	01	01	H2697_010_0	9		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2697	010	0	1	01	01	H2697_010_0	9		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2697	010	0	1	01	01	H2697_010_0	9		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2697	010	0	1	01	01	H2697_010_0	9		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2697	010	0	1	01	01	H2697_010_0	9		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H2697	011	0	1	01	01	H2697_011_0	9		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H2697	011	0	1	01	01	H2697_011_0	9		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2697	011	0	1	01	01	H2697_011_0	9		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2697	011	0	1	01	01	H2697_011_0	9		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2697	011	0	1	01	01	H2697_011_0	9		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2697	011	0	1	01	01	H2697_011_0	9		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H2697	015	0	1	01	01	H2697_015_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2697	015	0	1	01	01	H2697_015_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H2697	015	0	1	01	01	H2697_015_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2697	015	0	1	01	01	H2697_015_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2697	015	0	1	01	01	H2697_015_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2697	016	0	1	01	01	H2697_016_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H2697	016	0	1	01	01	H2697_016_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2697	016	0	1	01	01	H2697_016_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2697	016	0	1	01	01	H2697_016_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2697	016	0	1	01	01	H2697_016_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2697	016	0	1	01	01	H2697_016_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2697	017	0	1	01	01	H2697_017_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H2697	017	0	1	01	01	H2697_017_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2697	017	0	1	01	01	H2697_017_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2697	017	0	1	01	01	H2697_017_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2697	017	0	1	01	01	H2697_017_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2697	017	0	1	01	01	H2697_017_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2697	018	0	1	01	01	H2697_018_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H2697	018	0	1	01	01	H2697_018_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2697	018	0	1	01	01	H2697_018_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2697	018	0	1	01	01	H2697_018_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2697	018	0	1	01	01	H2697_018_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2697	018	0	1	01	01	H2697_018_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2697	019	0	1	01	01	H2697_019_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2697	019	0	1	01	01	H2697_019_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H2697	019	0	1	01	01	H2697_019_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2697	019	0	1	01	01	H2697_019_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2697	019	0	1	01	01	H2697_019_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2697	020	0	1	01	01	H2697_020_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H2697	020	0	1	01	01	H2697_020_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2697	020	0	1	01	01	H2697_020_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2697	020	0	1	01	01	H2697_020_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2697	020	0	1	01	01	H2697_020_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2697	020	0	1	01	01	H2697_020_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2697	022	0	1	01	01	H2697_022_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2697	022	0	1	01	01	H2697_022_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H2697	022	0	1	01	01	H2697_022_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2697	022	0	1	01	01	H2697_022_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2697	022	0	1	01	01	H2697_022_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2704	015	0	1	01	01	H2704_015_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H2704	015	0	1	01	01	H2704_015_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H2704	015	0	1	01	01	H2704_015_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H2704	015	0	1	01	01	H2704_015_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H2704	015	0	1	01	01	H2704_015_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H2704	015	0	1	01	01	H2704_015_0	4		N	Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H2704	016	0	1	01	01	H2704_016_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H2704	016	0	1	01	01	H2704_016_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H2704	016	0	1	01	01	H2704_016_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H2704	016	0	1	01	01	H2704_016_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H2704	016	0	1	01	01	H2704_016_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H2704	016	0	1	01	01	H2704_016_0	4		N	Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H2715	003	0	1	01	01	H2715_003_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H2715	003	0	1	01	01	H2715_003_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2715	003	0	1	01	01	H2715_003_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2715	003	0	1	01	01	H2715_003_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2715	003	0	1	01	01	H2715_003_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2715	003	0	1	01	01	H2715_003_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H2715	006	1	1	01	01	H2715_006_1	9		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H2715	006	1	1	01	01	H2715_006_1	9		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2715	006	1	1	01	01	H2715_006_1	9		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2715	006	1	1	01	01	H2715_006_1	9		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2715	006	1	1	01	01	H2715_006_1	9		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2715	006	1	1	01	01	H2715_006_1	9		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H2715	006	2	1	01	01	H2715_006_2	9		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H2715	006	2	1	01	01	H2715_006_2	9		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2715	006	2	1	01	01	H2715_006_2	9		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2715	006	2	1	01	01	H2715_006_2	9		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2715	006	2	1	01	01	H2715_006_2	9		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2715	006	2	1	01	01	H2715_006_2	9		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H2737	001	0	1	04	01	H2737_001_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2737	001	0	1	04	01	H2737_001_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H2737	001	0	1	04	01	H2737_001_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2737	001	0	1	04	01	H2737_001_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2737	001	0	1	04	01	H2737_001_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2752	003	0	1	01	01	H2752_003_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2752	003	0	1	01	01	H2752_003_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2752	003	0	1	01	01	H2752_003_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2752	003	0	1	01	01	H2752_003_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2752	003	0	1	01	01	H2752_003_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2775	106	0	1	04	01	H2775_106_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H2775	106	0	1	04	01	H2775_106_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2775	106	0	1	04	01	H2775_106_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2775	106	0	1	04	01	H2775_106_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2775	106	0	1	04	01	H2775_106_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2775	106	0	1	04	01	H2775_106_0	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2775	109	0	1	04	01	H2775_109_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H2775	109	0	1	04	01	H2775_109_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2775	109	0	1	04	01	H2775_109_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2775	109	0	1	04	01	H2775_109_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2775	109	0	1	04	01	H2775_109_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2775	109	0	1	04	01	H2775_109_0	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2775	111	0	1	04	01	H2775_111_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H2775	111	0	1	04	01	H2775_111_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2775	111	0	1	04	01	H2775_111_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2775	111	0	1	04	01	H2775_111_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2775	111	0	1	04	01	H2775_111_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2775	111	0	1	04	01	H2775_111_0	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2775	112	0	1	04	01	H2775_112_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H2775	112	0	1	04	01	H2775_112_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2775	112	0	1	04	01	H2775_112_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2775	112	0	1	04	01	H2775_112_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2775	112	0	1	04	01	H2775_112_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2775	112	0	1	04	01	H2775_112_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2775	113	0	1	04	01	H2775_113_0	8			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H2775	113	0	1	04	01	H2775_113_0	8			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2775	113	0	1	04	01	H2775_113_0	8			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2775	113	0	1	04	01	H2775_113_0	8			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2775	113	0	1	04	01	H2775_113_0	8			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2775	113	0	1	04	01	H2775_113_0	8			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2775	115	0	1	04	01	H2775_115_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H2775	115	0	1	04	01	H2775_115_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2775	115	0	1	04	01	H2775_115_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2775	115	0	1	04	01	H2775_115_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2775	115	0	1	04	01	H2775_115_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2775	115	0	1	04	01	H2775_115_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2802	001	0	1	02	01	H2802_001_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2802	001	0	1	02	01	H2802_001_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H2802	001	0	1	02	01	H2802_001_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2802	001	0	1	02	01	H2802_001_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2802	001	0	1	02	01	H2802_001_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2802	007	0	1	02	01	H2802_007_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2802	007	0	1	02	01	H2802_007_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H2802	007	0	1	02	01	H2802_007_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2802	007	0	1	02	01	H2802_007_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2802	007	0	1	02	01	H2802_007_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2802	008	0	1	02	01	H2802_008_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2802	008	0	1	02	01	H2802_008_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H2802	008	0	1	02	01	H2802_008_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2802	008	0	1	02	01	H2802_008_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2802	008	0	1	02	01	H2802_008_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2802	010	0	1	02	01	H2802_010_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2802	010	0	1	02	01	H2802_010_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H2802	010	0	1	02	01	H2802_010_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2802	010	0	1	02	01	H2802_010_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2802	010	0	1	02	01	H2802_010_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2802	012	0	1	02	01	H2802_012_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2802	012	0	1	02	01	H2802_012_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H2802	012	0	1	02	01	H2802_012_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2802	012	0	1	02	01	H2802_012_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2802	012	0	1	02	01	H2802_012_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2802	024	0	1	02	01	H2802_024_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2802	024	0	1	02	01	H2802_024_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H2802	024	0	1	02	01	H2802_024_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2802	024	0	1	02	01	H2802_024_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2802	024	0	1	02	01	H2802_024_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2802	025	0	1	02	01	H2802_025_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2802	025	0	1	02	01	H2802_025_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H2802	025	0	1	02	01	H2802_025_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2802	025	0	1	02	01	H2802_025_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2802	025	0	1	02	01	H2802_025_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2802	028	0	1	02	01	H2802_028_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2802	028	0	1	02	01	H2802_028_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	5.00	
H2802	028	0	1	02	01	H2802_028_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2802	028	0	1	02	01	H2802_028_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2802	028	0	1	02	01	H2802_028_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2802	029	0	1	02	01	H2802_029_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2802	029	0	1	02	01	H2802_029_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H2802	029	0	1	02	01	H2802_029_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2802	029	0	1	02	01	H2802_029_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2802	029	0	1	02	01	H2802_029_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2802	030	0	1	02	01	H2802_030_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2802	030	0	1	02	01	H2802_030_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H2802	030	0	1	02	01	H2802_030_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2802	030	0	1	02	01	H2802_030_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2802	030	0	1	02	01	H2802_030_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2802	031	0	1	02	01	H2802_031_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2802	031	0	1	02	01	H2802_031_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H2802	031	0	1	02	01	H2802_031_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2802	031	0	1	02	01	H2802_031_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2802	031	0	1	02	01	H2802_031_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2802	032	0	1	02	01	H2802_032_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2802	032	0	1	02	01	H2802_032_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H2802	032	0	1	02	01	H2802_032_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2802	032	0	1	02	01	H2802_032_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2802	032	0	1	02	01	H2802_032_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2802	033	0	1	02	01	H2802_033_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2802	033	0	1	02	01	H2802_033_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H2802	033	0	1	02	01	H2802_033_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2802	033	0	1	02	01	H2802_033_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2802	033	0	1	02	01	H2802_033_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2802	034	0	1	02	01	H2802_034_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2802	034	0	1	02	01	H2802_034_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H2802	034	0	1	02	01	H2802_034_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2802	034	0	1	02	01	H2802_034_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2802	034	0	1	02	01	H2802_034_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2802	035	0	1	02	01	H2802_035_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2802	035	0	1	02	01	H2802_035_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H2802	035	0	1	02	01	H2802_035_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2802	035	0	1	02	01	H2802_035_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2802	035	0	1	02	01	H2802_035_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2802	041	0	1	02	01	H2802_041_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2802	041	0	1	02	01	H2802_041_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H2802	041	0	1	02	01	H2802_041_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2802	041	0	1	02	01	H2802_041_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2802	041	0	1	02	01	H2802_041_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2802	044	0	1	02	01	H2802_044_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2802	044	0	1	02	01	H2802_044_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2802	044	0	1	02	01	H2802_044_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2802	044	0	1	02	01	H2802_044_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2802	044	0	1	02	01	H2802_044_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2802	048	0	1	02	01	H2802_048_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2802	048	0	1	02	01	H2802_048_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H2802	048	0	1	02	01	H2802_048_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2802	048	0	1	02	01	H2802_048_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2802	048	0	1	02	01	H2802_048_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2802	049	0	1	02	01	H2802_049_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2802	049	0	1	02	01	H2802_049_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H2802	049	0	1	02	01	H2802_049_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2802	049	0	1	02	01	H2802_049_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2802	049	0	1	02	01	H2802_049_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2802	052	0	1	02	01	H2802_052_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2802	052	0	1	02	01	H2802_052_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	5.00	
H2802	052	0	1	02	01	H2802_052_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2802	052	0	1	02	01	H2802_052_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2802	052	0	1	02	01	H2802_052_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2802	053	0	1	02	01	H2802_053_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2802	053	0	1	02	01	H2802_053_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2802	053	0	1	02	01	H2802_053_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2802	053	0	1	02	01	H2802_053_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2802	053	0	1	02	01	H2802_053_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2802	054	0	1	02	01	H2802_054_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2802	054	0	1	02	01	H2802_054_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H2802	054	0	1	02	01	H2802_054_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2802	054	0	1	02	01	H2802_054_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2802	054	0	1	02	01	H2802_054_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2802	055	0	1	02	01	H2802_055_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2802	055	0	1	02	01	H2802_055_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	5.00	
H2802	055	0	1	02	01	H2802_055_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2802	055	0	1	02	01	H2802_055_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2802	055	0	1	02	01	H2802_055_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2802	056	0	1	02	01	H2802_056_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2802	056	0	1	02	01	H2802_056_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H2802	056	0	1	02	01	H2802_056_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2802	056	0	1	02	01	H2802_056_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2802	056	0	1	02	01	H2802_056_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2802	058	0	1	02	01	H2802_058_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2802	058	0	1	02	01	H2802_058_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H2802	058	0	1	02	01	H2802_058_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2802	058	0	1	02	01	H2802_058_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2802	058	0	1	02	01	H2802_058_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2802	059	0	1	02	01	H2802_059_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2802	059	0	1	02	01	H2802_059_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H2802	059	0	1	02	01	H2802_059_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2802	059	0	1	02	01	H2802_059_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2802	059	0	1	02	01	H2802_059_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2802	060	0	1	02	01	H2802_060_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2802	060	0	1	02	01	H2802_060_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H2802	060	0	1	02	01	H2802_060_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2802	060	0	1	02	01	H2802_060_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2802	060	0	1	02	01	H2802_060_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2802	061	0	1	02	01	H2802_061_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2802	061	0	1	02	01	H2802_061_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H2802	061	0	1	02	01	H2802_061_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2802	061	0	1	02	01	H2802_061_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2802	061	0	1	02	01	H2802_061_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2802	063	0	1	02	01	H2802_063_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2802	063	0	1	02	01	H2802_063_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	4.00	
H2802	063	0	1	02	01	H2802_063_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2802	063	0	1	02	01	H2802_063_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2802	063	0	1	02	01	H2802_063_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2802	064	0	1	02	01	H2802_064_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2802	064	0	1	02	01	H2802_064_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2802	064	0	1	02	01	H2802_064_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2802	064	0	1	02	01	H2802_064_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2802	064	0	1	02	01	H2802_064_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2802	068	0	1	02	01	H2802_068_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2802	068	0	1	02	01	H2802_068_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H2802	068	0	1	02	01	H2802_068_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2802	068	0	1	02	01	H2802_068_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2802	068	0	1	02	01	H2802_068_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2802	070	0	1	02	01	H2802_070_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2802	070	0	1	02	01	H2802_070_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H2802	070	0	1	02	01	H2802_070_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2802	070	0	1	02	01	H2802_070_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2802	070	0	1	02	01	H2802_070_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2802	071	0	1	02	01	H2802_071_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2802	071	0	1	02	01	H2802_071_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	5.00	
H2802	071	0	1	02	01	H2802_071_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2802	071	0	1	02	01	H2802_071_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2802	071	0	1	02	01	H2802_071_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2802	072	0	1	02	01	H2802_072_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2802	072	0	1	02	01	H2802_072_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H2802	072	0	1	02	01	H2802_072_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2802	072	0	1	02	01	H2802_072_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2802	072	0	1	02	01	H2802_072_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2802	073	0	1	02	01	H2802_073_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2802	073	0	1	02	01	H2802_073_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	5.00	
H2802	073	0	1	02	01	H2802_073_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2802	073	0	1	02	01	H2802_073_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2802	073	0	1	02	01	H2802_073_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2802	074	0	1	02	01	H2802_074_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2802	074	0	1	02	01	H2802_074_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H2802	074	0	1	02	01	H2802_074_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2802	074	0	1	02	01	H2802_074_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2802	074	0	1	02	01	H2802_074_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2802	075	0	1	02	01	H2802_075_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2802	075	0	1	02	01	H2802_075_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H2802	075	0	1	02	01	H2802_075_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2802	075	0	1	02	01	H2802_075_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2802	075	0	1	02	01	H2802_075_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2802	076	0	1	02	01	H2802_076_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2802	076	0	1	02	01	H2802_076_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H2802	076	0	1	02	01	H2802_076_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2802	076	0	1	02	01	H2802_076_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2802	076	0	1	02	01	H2802_076_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2802	078	0	1	02	01	H2802_078_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2802	078	0	1	02	01	H2802_078_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H2802	078	0	1	02	01	H2802_078_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2802	078	0	1	02	01	H2802_078_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2802	078	0	1	02	01	H2802_078_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2802	079	0	1	02	01	H2802_079_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2802	079	0	1	02	01	H2802_079_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H2802	079	0	1	02	01	H2802_079_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2802	079	0	1	02	01	H2802_079_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2802	079	0	1	02	01	H2802_079_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2816	013	0	1	09	04	H2816_013_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H2816	013	0	1	09	04	H2816_013_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2816	013	0	1	09	04	H2816_013_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2816	013	0	1	09	04	H2816_013_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2816	013	0	1	09	04	H2816_013_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2816	013	0	1	09	04	H2816_013_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2816	019	0	1	09	04	H2816_019_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H2816	019	0	1	09	04	H2816_019_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2816	019	0	1	09	04	H2816_019_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2816	019	0	1	09	04	H2816_019_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2816	019	0	1	09	04	H2816_019_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2816	019	0	1	09	04	H2816_019_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2819	001	0	1	01	01	H2819_001_0	8		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H2819	001	0	1	01	01	H2819_001_0	8		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H2819	001	0	1	01	01	H2819_001_0	8		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2819	001	0	1	01	01	H2819_001_0	8		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2819	001	0	1	01	01	H2819_001_0	8		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2836	006	0	1	04	01	H2836_006_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H2836	006	0	1	04	01	H2836_006_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2836	006	0	1	04	01	H2836_006_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2836	006	0	1	04	01	H2836_006_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2836	006	0	1	04	01	H2836_006_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2836	006	0	1	04	01	H2836_006_0	6		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2836	007	0	1	04	01	H2836_007_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H2836	007	0	1	04	01	H2836_007_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2836	007	0	1	04	01	H2836_007_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2836	007	0	1	04	01	H2836_007_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2836	007	0	1	04	01	H2836_007_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2836	007	0	1	04	01	H2836_007_0	6		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2845	001	0	1	04	01	H2845_001_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2845	001	0	1	04	01	H2845_001_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H2845	001	0	1	04	01	H2845_001_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2845	001	0	1	04	01	H2845_001_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2845	001	0	1	04	01	H2845_001_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2845	002	0	1	04	01	H2845_002_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2845	002	0	1	04	01	H2845_002_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H2845	002	0	1	04	01	H2845_002_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2845	002	0	1	04	01	H2845_002_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2845	002	0	1	04	01	H2845_002_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2845	003	0	1	04	01	H2845_003_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H2845	003	0	1	04	01	H2845_003_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2845	003	0	1	04	01	H2845_003_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2845	003	0	1	04	01	H2845_003_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2845	003	0	1	04	01	H2845_003_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2845	003	0	1	04	01	H2845_003_0	6		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H2845	005	0	1	04	01	H2845_005_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2845	005	0	1	04	01	H2845_005_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H2845	005	0	1	04	01	H2845_005_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2845	005	0	1	04	01	H2845_005_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2845	005	0	1	04	01	H2845_005_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2845	006	0	1	04	01	H2845_006_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2845	006	0	1	04	01	H2845_006_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H2845	006	0	1	04	01	H2845_006_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2845	006	0	1	04	01	H2845_006_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2845	006	0	1	04	01	H2845_006_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2845	008	0	1	04	01	H2845_008_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H2845	008	0	1	04	01	H2845_008_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2845	008	0	1	04	01	H2845_008_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2845	008	0	1	04	01	H2845_008_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2845	008	0	1	04	01	H2845_008_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2845	008	0	1	04	01	H2845_008_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2845	009	0	1	04	01	H2845_009_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H2845	009	0	1	04	01	H2845_009_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2845	009	0	1	04	01	H2845_009_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2845	009	0	1	04	01	H2845_009_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2845	009	0	1	04	01	H2845_009_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2845	009	0	1	04	01	H2845_009_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2845	010	0	1	04	01	H2845_010_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H2845	010	0	1	04	01	H2845_010_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2845	010	0	1	04	01	H2845_010_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2845	010	0	1	04	01	H2845_010_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2845	010	0	1	04	01	H2845_010_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2845	010	0	1	04	01	H2845_010_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2875	001	0	1	02	01	H2875_001_0	3		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2875	001	0	1	02	01	H2875_001_0	3		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H2875	001	0	1	02	01	H2875_001_0	3		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2875	001	0	1	02	01	H2875_001_0	3		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2875	001	0	1	02	01	H2875_001_0	3		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2875	002	0	1	02	01	H2875_002_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2875	002	0	1	02	01	H2875_002_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H2875	002	0	1	02	01	H2875_002_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2875	002	0	1	02	01	H2875_002_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2875	002	0	1	02	01	H2875_002_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2875	003	0	1	01	01	H2875_003_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2875	003	0	1	01	01	H2875_003_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H2875	003	0	1	01	01	H2875_003_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2875	003	0	1	01	01	H2875_003_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2875	003	0	1	01	01	H2875_003_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2875	004	0	1	01	01	H2875_004_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2875	004	0	1	01	01	H2875_004_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H2875	004	0	1	01	01	H2875_004_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2875	004	0	1	01	01	H2875_004_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2875	004	0	1	01	01	H2875_004_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2875	005	0	1	01	01	H2875_005_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2875	005	0	1	01	01	H2875_005_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H2875	005	0	1	01	01	H2875_005_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2875	005	0	1	01	01	H2875_005_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2875	005	0	1	01	01	H2875_005_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2875	006	0	1	02	01	H2875_006_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2875	006	0	1	02	01	H2875_006_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H2875	006	0	1	02	01	H2875_006_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2875	006	0	1	02	01	H2875_006_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2875	006	0	1	02	01	H2875_006_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2915	002	0	1	02	01	H2915_002_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H2915	002	0	1	02	01	H2915_002_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2915	002	0	1	02	01	H2915_002_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2915	002	0	1	02	01	H2915_002_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2915	002	0	1	02	01	H2915_002_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2915	002	0	1	02	01	H2915_002_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2915	003	0	1	02	01	H2915_003_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H2915	003	0	1	02	01	H2915_003_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2915	003	0	1	02	01	H2915_003_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2915	003	0	1	02	01	H2915_003_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2915	003	0	1	02	01	H2915_003_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2915	003	0	1	02	01	H2915_003_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2915	011	0	1	02	01	H2915_011_0	8			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H2915	011	0	1	02	01	H2915_011_0	8			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2915	011	0	1	02	01	H2915_011_0	8			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2915	011	0	1	02	01	H2915_011_0	8			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2915	011	0	1	02	01	H2915_011_0	8			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2915	011	0	1	02	01	H2915_011_0	8			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2915	018	0	1	02	01	H2915_018_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H2915	018	0	1	02	01	H2915_018_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2915	018	0	1	02	01	H2915_018_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2915	018	0	1	02	01	H2915_018_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2915	018	0	1	02	01	H2915_018_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2915	018	0	1	02	01	H2915_018_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2923	001	0	1	01	01	H2923_001_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2923	001	0	1	01	01	H2923_001_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	5.00	
H2923	001	0	1	01	01	H2923_001_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2923	001	0	1	01	01	H2923_001_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2923	001	0	1	01	01	H2923_001_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2923	003	0	1	01	01	H2923_003_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2923	003	0	1	01	01	H2923_003_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H2923	003	0	1	01	01	H2923_003_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2923	003	0	1	01	01	H2923_003_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2923	003	0	1	01	01	H2923_003_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2923	004	0	1	01	01	H2923_004_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2923	004	0	1	01	01	H2923_004_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H2923	004	0	1	01	01	H2923_004_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2923	004	0	1	01	01	H2923_004_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2923	004	0	1	01	01	H2923_004_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2923	005	0	1	01	01	H2923_005_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2923	005	0	1	01	01	H2923_005_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H2923	005	0	1	01	01	H2923_005_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2923	005	0	1	01	01	H2923_005_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2923	005	0	1	01	01	H2923_005_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2923	006	0	1	01	01	H2923_006_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H2923	006	0	1	01	01	H2923_006_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H2923	006	0	1	01	01	H2923_006_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2923	006	0	1	01	01	H2923_006_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2923	006	0	1	01	01	H2923_006_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2923	009	0	1	01	01	H2923_009_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H2923	009	0	1	01	01	H2923_009_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2923	009	0	1	01	01	H2923_009_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2923	009	0	1	01	01	H2923_009_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2923	009	0	1	01	01	H2923_009_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2923	009	0	1	01	01	H2923_009_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2942	001	0	1	01	01	H2942_001_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	1	2	01	1	2	0.00	
H2942	001	0	1	01	01	H2942_001_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	2	2	01	3	2	0.00	
H2942	001	0	1	01	01	H2942_001_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	3	2	10	1	2	0.00	
H2942	001	0	1	01	01	H2942_001_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	4	2	11	1	2	0.00	
H2942	001	0	1	01	01	H2942_001_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	5	2	11	1	2	0.00	
H2942	001	0	1	01	01	H2942_001_0	5			Select Diabetic Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	6	2	11	1	2	0.00	
H2942	002	0	1	01	01	H2942_002_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	1	2	01	1	2	0.00	
H2942	002	0	1	01	01	H2942_002_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	2	2	01	3	2	0.00	
H2942	002	0	1	01	01	H2942_002_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	3	2	10	1	2	0.00	
H2942	002	0	1	01	01	H2942_002_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	4	2	11	1	2	0.00	
H2942	002	0	1	01	01	H2942_002_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	5	2	11	1	2	0.00	
H2942	002	0	1	01	01	H2942_002_0	5			Select Diabetic Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	6	2	11	1	2	0.00	
H2942	003	0	1	01	01	H2942_003_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	1	2	01	1	2	0.00	
H2942	003	0	1	01	01	H2942_003_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	2	2	01	3	2	0.00	
H2942	003	0	1	01	01	H2942_003_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	3	2	10	1	2	0.00	
H2942	003	0	1	01	01	H2942_003_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	4	2	11	1	2	0.00	
H2942	003	0	1	01	01	H2942_003_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	5	2	11	1	2	0.00	
H2942	003	0	1	01	01	H2942_003_0	5			Select Diabetic Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	6	2	11	1	2	0.00	
H2960	012	0	1	01	01	H2960_012_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H2960	012	0	1	01	01	H2960_012_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H2960	012	0	1	01	01	H2960_012_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H2960	012	0	1	01	01	H2960_012_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	10	1	2	0.00	
H2960	012	0	1	01	01	H2960_012_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2960	012	0	1	01	01	H2960_012_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H2960	018	0	1	01	01	H2960_018_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H2960	018	0	1	01	01	H2960_018_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H2960	018	0	1	01	01	H2960_018_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H2960	018	0	1	01	01	H2960_018_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	10	1	2	0.00	
H2960	018	0	1	01	01	H2960_018_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2960	018	0	1	01	01	H2960_018_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2960	019	0	1	01	01	H2960_019_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H2960	019	0	1	01	01	H2960_019_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H2960	019	0	1	01	01	H2960_019_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H2960	019	0	1	01	01	H2960_019_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	10	1	2	0.00	
H2960	019	0	1	01	01	H2960_019_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2960	019	0	1	01	01	H2960_019_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2960	023	0	1	01	01	H2960_023_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H2960	023	0	1	01	01	H2960_023_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H2960	023	0	1	01	01	H2960_023_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H2960	023	0	1	01	01	H2960_023_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	10	1	2	0.00	
H2960	023	0	1	01	01	H2960_023_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2960	023	0	1	01	01	H2960_023_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H2962	001	0	1	01	01	H2962_001_0	13			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	0.00	
H2962	001	0	1	01	01	H2962_001_0	13			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H2962	001	0	1	01	01	H2962_001_0	13			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2962	001	0	1	01	01	H2962_001_0	13			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2962	001	0	1	01	01	H2962_001_0	13			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2962	021	0	1	01	01	H2962_021_0	16			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H2962	021	0	1	01	01	H2962_021_0	16			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2962	021	0	1	01	01	H2962_021_0	16			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2962	021	0	1	01	01	H2962_021_0	16			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2962	021	0	1	01	01	H2962_021_0	16			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2962	021	0	1	01	01	H2962_021_0	16			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2962	023	0	1	01	01	H2962_023_0	14			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H2962	023	0	1	01	01	H2962_023_0	14			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2962	023	0	1	01	01	H2962_023_0	14			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2962	023	0	1	01	01	H2962_023_0	14			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2962	023	0	1	01	01	H2962_023_0	14			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2962	023	0	1	01	01	H2962_023_0	14			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2962	025	0	1	01	01	H2962_025_0	16			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H2962	025	0	1	01	01	H2962_025_0	16			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2962	025	0	1	01	01	H2962_025_0	16			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2962	025	0	1	01	01	H2962_025_0	16			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2962	025	0	1	01	01	H2962_025_0	16			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2962	025	0	1	01	01	H2962_025_0	16			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2962	026	0	1	01	01	H2962_026_0	14			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H2962	026	0	1	01	01	H2962_026_0	14			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2962	026	0	1	01	01	H2962_026_0	14			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2962	026	0	1	01	01	H2962_026_0	14			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2962	026	0	1	01	01	H2962_026_0	14			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2962	026	0	1	01	01	H2962_026_0	14			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2962	028	0	1	01	01	H2962_028_0	13			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	0.00	
H2962	028	0	1	01	01	H2962_028_0	13			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H2962	028	0	1	01	01	H2962_028_0	13			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2962	028	0	1	01	01	H2962_028_0	13			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2962	028	0	1	01	01	H2962_028_0	13			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2962	029	0	1	01	01	H2962_029_0	14			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H2962	029	0	1	01	01	H2962_029_0	14			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2962	029	0	1	01	01	H2962_029_0	14			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2962	029	0	1	01	01	H2962_029_0	14			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2962	029	0	1	01	01	H2962_029_0	14			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2962	029	0	1	01	01	H2962_029_0	14			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2962	033	0	1	01	01	H2962_033_0	14			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H2962	033	0	1	01	01	H2962_033_0	14			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2962	033	0	1	01	01	H2962_033_0	14			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2962	033	0	1	01	01	H2962_033_0	14			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2962	033	0	1	01	01	H2962_033_0	14			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2962	033	0	1	01	01	H2962_033_0	14			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2962	035	0	1	01	01	H2962_035_0	11		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	01	1	2	0.00	
H2962	035	0	1	01	01	H2962_035_0	11		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H2962	035	0	1	01	01	H2962_035_0	11		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H2962	035	0	1	01	01	H2962_035_0	11		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H2962	035	0	1	01	01	H2962_035_0	11		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H2962	035	0	1	01	01	H2962_035_0	11		N	Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H2962	036	0	1	01	01	H2962_036_0	11		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	01	1	2	0.00	
H2962	036	0	1	01	01	H2962_036_0	11		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H2962	036	0	1	01	01	H2962_036_0	11		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H2962	036	0	1	01	01	H2962_036_0	11		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H2962	036	0	1	01	01	H2962_036_0	11		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H2962	036	0	1	01	01	H2962_036_0	11		N	Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H2962	045	0	1	01	01	H2962_045_0	13			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	0.00	
H2962	045	0	1	01	01	H2962_045_0	13			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H2962	045	0	1	01	01	H2962_045_0	13			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2962	045	0	1	01	01	H2962_045_0	13			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2962	045	0	1	01	01	H2962_045_0	13			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2962	046	0	1	01	01	H2962_046_0	13			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	0.00	
H2962	046	0	1	01	01	H2962_046_0	13			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H2962	046	0	1	01	01	H2962_046_0	13			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2962	046	0	1	01	01	H2962_046_0	13			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2962	046	0	1	01	01	H2962_046_0	13			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2962	047	0	1	01	01	H2962_047_0	14			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	0.00	
H2962	047	0	1	01	01	H2962_047_0	14			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H2962	047	0	1	01	01	H2962_047_0	14			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H2962	047	0	1	01	01	H2962_047_0	14			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H2962	047	0	1	01	01	H2962_047_0	14			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H2962	050	0	1	01	01	H2962_050_0	14			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H2962	050	0	1	01	01	H2962_050_0	14			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2962	050	0	1	01	01	H2962_050_0	14			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2962	050	0	1	01	01	H2962_050_0	14			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2962	050	0	1	01	01	H2962_050_0	14			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2962	050	0	1	01	01	H2962_050_0	14			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2962	051	0	1	01	01	H2962_051_0	14			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H2962	051	0	1	01	01	H2962_051_0	14			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2962	051	0	1	01	01	H2962_051_0	14			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2962	051	0	1	01	01	H2962_051_0	14			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2962	051	0	1	01	01	H2962_051_0	14			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2962	051	0	1	01	01	H2962_051_0	14			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H2962	052	0	1	01	01	H2962_052_0	14			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H2962	052	0	1	01	01	H2962_052_0	14			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H2962	052	0	1	01	01	H2962_052_0	14			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H2962	052	0	1	01	01	H2962_052_0	14			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H2962	052	0	1	01	01	H2962_052_0	14			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H2962	052	0	1	01	01	H2962_052_0	14			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3038	002	0	1	01	01	H3038_002_0	8		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3038	002	0	1	01	01	H3038_002_0	8		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3038	002	0	1	01	01	H3038_002_0	8		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3038	002	0	1	01	01	H3038_002_0	8		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3038	002	0	1	01	01	H3038_002_0	8		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3038	002	0	1	01	01	H3038_002_0	8		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H3038	004	1	1	01	01	H3038_004_1	8		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3038	004	1	1	01	01	H3038_004_1	8		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3038	004	1	1	01	01	H3038_004_1	8		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3038	004	1	1	01	01	H3038_004_1	8		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3038	004	1	1	01	01	H3038_004_1	8		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3038	004	1	1	01	01	H3038_004_1	8		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H3038	004	2	1	01	01	H3038_004_2	8		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3038	004	2	1	01	01	H3038_004_2	8		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3038	004	2	1	01	01	H3038_004_2	8		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3038	004	2	1	01	01	H3038_004_2	8		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3038	004	2	1	01	01	H3038_004_2	8		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3038	004	2	1	01	01	H3038_004_2	8		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H3038	004	3	1	01	01	H3038_004_3	8		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3038	004	3	1	01	01	H3038_004_3	8		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3038	004	3	1	01	01	H3038_004_3	8		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3038	004	3	1	01	01	H3038_004_3	8		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3038	004	3	1	01	01	H3038_004_3	8		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3038	004	3	1	01	01	H3038_004_3	8		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H3038	004	4	1	01	01	H3038_004_4	8		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3038	004	4	1	01	01	H3038_004_4	8		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3038	004	4	1	01	01	H3038_004_4	8		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3038	004	4	1	01	01	H3038_004_4	8		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3038	004	4	1	01	01	H3038_004_4	8		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3038	004	4	1	01	01	H3038_004_4	8		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H3041	001	0	1	01	01	H3041_001_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3041	001	0	1	01	01	H3041_001_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H3041	001	0	1	01	01	H3041_001_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3041	001	0	1	01	01	H3041_001_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3041	001	0	1	01	01	H3041_001_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3041	003	0	1	01	01	H3041_003_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3041	003	0	1	01	01	H3041_003_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H3041	003	0	1	01	01	H3041_003_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3041	003	0	1	01	01	H3041_003_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3041	003	0	1	01	01	H3041_003_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3048	003	0	1	01	01	H3048_003_0	12			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3048	003	0	1	01	01	H3048_003_0	12			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3048	003	0	1	01	01	H3048_003_0	12			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H3048	003	0	1	01	01	H3048_003_0	12			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	10	1	2	0.00	
H3048	003	0	1	01	01	H3048_003_0	12			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3071	002	0	1	01	01	H3071_002_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3071	002	0	1	01	01	H3071_002_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H3071	002	0	1	01	01	H3071_002_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3071	002	0	1	01	01	H3071_002_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3071	002	0	1	01	01	H3071_002_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3071	002	0	1	01	01	H3071_002_0	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H3080	001	0	1	01	01	H3080_001_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3080	001	0	1	01	01	H3080_001_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H3080	001	0	1	01	01	H3080_001_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3080	001	0	1	01	01	H3080_001_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3080	001	0	1	01	01	H3080_001_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3080	002	0	1	01	01	H3080_002_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3080	002	0	1	01	01	H3080_002_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H3080	002	0	1	01	01	H3080_002_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3080	002	0	1	01	01	H3080_002_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3080	002	0	1	01	01	H3080_002_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3080	003	0	1	01	01	H3080_003_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3080	003	0	1	01	01	H3080_003_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3080	003	0	1	01	01	H3080_003_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3080	003	0	1	01	01	H3080_003_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3080	003	0	1	01	01	H3080_003_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3080	003	0	1	01	01	H3080_003_0	6		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H3080	004	0	1	01	01	H3080_004_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3080	004	0	1	01	01	H3080_004_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3080	004	0	1	01	01	H3080_004_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3080	004	0	1	01	01	H3080_004_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3080	004	0	1	01	01	H3080_004_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3080	004	0	1	01	01	H3080_004_0	6		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H3080	006	0	1	01	01	H3080_006_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3080	006	0	1	01	01	H3080_006_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3080	006	0	1	01	01	H3080_006_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3080	006	0	1	01	01	H3080_006_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3080	006	0	1	01	01	H3080_006_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3080	006	0	1	01	01	H3080_006_0	6		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H3080	007	0	1	01	01	H3080_007_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3080	007	0	1	01	01	H3080_007_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3080	007	0	1	01	01	H3080_007_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3080	007	0	1	01	01	H3080_007_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3080	007	0	1	01	01	H3080_007_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3080	007	0	1	01	01	H3080_007_0	5		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H3093	001	0	1	01	01	H3093_001_0	9		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3093	001	0	1	01	01	H3093_001_0	9		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3093	001	0	1	01	01	H3093_001_0	9		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3093	001	0	1	01	01	H3093_001_0	9		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3093	001	0	1	01	01	H3093_001_0	9		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3093	001	0	1	01	01	H3093_001_0	9		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H3093	002	0	1	01	01	H3093_002_0	9		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3093	002	0	1	01	01	H3093_002_0	9		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3093	002	0	1	01	01	H3093_002_0	9		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3093	002	0	1	01	01	H3093_002_0	9		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3093	002	0	1	01	01	H3093_002_0	9		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3093	002	0	1	01	01	H3093_002_0	9		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H3093	003	0	1	01	01	H3093_003_0	9		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3093	003	0	1	01	01	H3093_003_0	9		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3093	003	0	1	01	01	H3093_003_0	9		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3093	003	0	1	01	01	H3093_003_0	9		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3093	003	0	1	01	01	H3093_003_0	9		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3093	003	0	1	01	01	H3093_003_0	9		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H3093	004	0	1	01	01	H3093_004_0	9		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3093	004	0	1	01	01	H3093_004_0	9		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3093	004	0	1	01	01	H3093_004_0	9		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3093	004	0	1	01	01	H3093_004_0	9		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3093	004	0	1	01	01	H3093_004_0	9		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3093	004	0	1	01	01	H3093_004_0	9		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H3093	005	0	1	01	01	H3093_005_0	9		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3093	005	0	1	01	01	H3093_005_0	9		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3093	005	0	1	01	01	H3093_005_0	9		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3093	005	0	1	01	01	H3093_005_0	9		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3093	005	0	1	01	01	H3093_005_0	9		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3093	005	0	1	01	01	H3093_005_0	9		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H3113	009	0	1	02	01	H3113_009_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3113	009	0	1	02	01	H3113_009_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3113	009	0	1	02	01	H3113_009_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3113	009	0	1	02	01	H3113_009_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3113	009	0	1	02	01	H3113_009_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3113	010	0	1	02	01	H3113_010_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3113	010	0	1	02	01	H3113_010_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3113	010	0	1	02	01	H3113_010_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3113	010	0	1	02	01	H3113_010_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3113	010	0	1	02	01	H3113_010_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3113	014	0	1	02	01	H3113_014_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3113	014	0	1	02	01	H3113_014_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3113	014	0	1	02	01	H3113_014_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3113	014	0	1	02	01	H3113_014_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3113	014	0	1	02	01	H3113_014_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3113	016	0	1	02	01	H3113_016_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3113	016	0	1	02	01	H3113_016_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3113	016	0	1	02	01	H3113_016_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3113	016	0	1	02	01	H3113_016_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3113	016	0	1	02	01	H3113_016_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3124	001	0	1	04	01	H3124_001_0	19			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3124	001	0	1	04	01	H3124_001_0	19			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3124	001	0	1	04	01	H3124_001_0	19			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3124	001	0	1	04	01	H3124_001_0	19			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3124	001	0	1	04	01	H3124_001_0	19			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3124	002	0	1	04	01	H3124_002_0	19			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3124	002	0	1	04	01	H3124_002_0	19			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3124	002	0	1	04	01	H3124_002_0	19			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3124	002	0	1	04	01	H3124_002_0	19			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3124	002	0	1	04	01	H3124_002_0	19			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3138	001	0	1	04	01	H3138_001_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H3138	001	0	1	04	01	H3138_001_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H3138	001	0	1	04	01	H3138_001_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H3138	001	0	1	04	01	H3138_001_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H3138	001	0	1	04	01	H3138_001_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H3138	001	0	1	04	01	H3138_001_0	6			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H3138	002	0	1	04	01	H3138_002_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H3138	002	0	1	04	01	H3138_002_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H3138	002	0	1	04	01	H3138_002_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H3138	002	0	1	04	01	H3138_002_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H3138	002	0	1	04	01	H3138_002_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H3138	002	0	1	04	01	H3138_002_0	6			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H3138	003	0	1	04	01	H3138_003_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H3138	003	0	1	04	01	H3138_003_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H3138	003	0	1	04	01	H3138_003_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H3138	003	0	1	04	01	H3138_003_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H3138	003	0	1	04	01	H3138_003_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H3138	003	0	1	04	01	H3138_003_0	6			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H3146	001	0	1	01	01	H3146_001_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3146	001	0	1	01	01	H3146_001_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3146	001	0	1	01	01	H3146_001_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3146	001	0	1	01	01	H3146_001_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3146	001	0	1	01	01	H3146_001_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3146	002	0	1	01	01	H3146_002_0	2		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3146	002	0	1	01	01	H3146_002_0	2		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3146	002	0	1	01	01	H3146_002_0	2		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3146	002	0	1	01	01	H3146_002_0	2		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3146	002	0	1	01	01	H3146_002_0	2		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3146	004	0	1	01	01	H3146_004_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3146	004	0	1	01	01	H3146_004_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3146	004	0	1	01	01	H3146_004_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3146	004	0	1	01	01	H3146_004_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3146	004	0	1	01	01	H3146_004_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3146	006	0	1	01	01	H3146_006_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3146	006	0	1	01	01	H3146_006_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3146	006	0	1	01	01	H3146_006_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3146	006	0	1	01	01	H3146_006_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3146	006	0	1	01	01	H3146_006_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3146	007	0	1	01	01	H3146_007_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3146	007	0	1	01	01	H3146_007_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3146	007	0	1	01	01	H3146_007_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3146	007	0	1	01	01	H3146_007_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3146	007	0	1	01	01	H3146_007_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3146	011	0	1	01	01	H3146_011_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3146	011	0	1	01	01	H3146_011_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3146	011	0	1	01	01	H3146_011_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3146	011	0	1	01	01	H3146_011_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3146	011	0	1	01	01	H3146_011_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3146	012	0	1	01	01	H3146_012_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3146	012	0	1	01	01	H3146_012_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3146	012	0	1	01	01	H3146_012_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3146	012	0	1	01	01	H3146_012_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3146	012	0	1	01	01	H3146_012_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3146	014	0	1	01	01	H3146_014_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3146	014	0	1	01	01	H3146_014_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3146	014	0	1	01	01	H3146_014_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3146	014	0	1	01	01	H3146_014_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3146	014	0	1	01	01	H3146_014_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3146	016	0	1	01	01	H3146_016_0	2		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3146	016	0	1	01	01	H3146_016_0	2		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3146	016	0	1	01	01	H3146_016_0	2		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3146	016	0	1	01	01	H3146_016_0	2		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3146	016	0	1	01	01	H3146_016_0	2		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3146	021	0	1	01	01	H3146_021_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3146	021	0	1	01	01	H3146_021_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3146	021	0	1	01	01	H3146_021_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3146	021	0	1	01	01	H3146_021_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3146	021	0	1	01	01	H3146_021_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3146	022	0	1	01	01	H3146_022_0	2		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3146	022	0	1	01	01	H3146_022_0	2		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3146	022	0	1	01	01	H3146_022_0	2		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3146	022	0	1	01	01	H3146_022_0	2		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3146	022	0	1	01	01	H3146_022_0	2		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3146	023	0	1	01	01	H3146_023_0	2		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3146	023	0	1	01	01	H3146_023_0	2		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3146	023	0	1	01	01	H3146_023_0	2		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3146	023	0	1	01	01	H3146_023_0	2		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3146	023	0	1	01	01	H3146_023_0	2		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3146	036	0	1	01	01	H3146_036_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3146	036	0	1	01	01	H3146_036_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3146	036	0	1	01	01	H3146_036_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3146	036	0	1	01	01	H3146_036_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3146	036	0	1	01	01	H3146_036_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3146	037	0	1	01	01	H3146_037_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3146	037	0	1	01	01	H3146_037_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3146	037	0	1	01	01	H3146_037_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3146	037	0	1	01	01	H3146_037_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3146	037	0	1	01	01	H3146_037_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3146	038	0	1	01	01	H3146_038_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3146	038	0	1	01	01	H3146_038_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3146	038	0	1	01	01	H3146_038_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3146	038	0	1	01	01	H3146_038_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3146	038	0	1	01	01	H3146_038_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3146	039	0	1	01	01	H3146_039_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3146	039	0	1	01	01	H3146_039_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3146	039	0	1	01	01	H3146_039_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3146	039	0	1	01	01	H3146_039_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3146	039	0	1	01	01	H3146_039_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3146	040	0	1	01	01	H3146_040_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3146	040	0	1	01	01	H3146_040_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3146	040	0	1	01	01	H3146_040_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3146	040	0	1	01	01	H3146_040_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3146	040	0	1	01	01	H3146_040_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3146	041	0	1	01	01	H3146_041_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3146	041	0	1	01	01	H3146_041_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3146	041	0	1	01	01	H3146_041_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3146	041	0	1	01	01	H3146_041_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3146	041	0	1	01	01	H3146_041_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3146	044	0	1	01	01	H3146_044_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3146	044	0	1	01	01	H3146_044_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3146	044	0	1	01	01	H3146_044_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3146	044	0	1	01	01	H3146_044_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3146	044	0	1	01	01	H3146_044_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3146	046	0	1	01	01	H3146_046_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3146	046	0	1	01	01	H3146_046_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3146	046	0	1	01	01	H3146_046_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3146	046	0	1	01	01	H3146_046_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3146	046	0	1	01	01	H3146_046_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3146	047	0	1	01	01	H3146_047_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3146	047	0	1	01	01	H3146_047_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3146	047	0	1	01	01	H3146_047_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3146	047	0	1	01	01	H3146_047_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3146	047	0	1	01	01	H3146_047_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3152	022	0	1	02	01	H3152_022_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3152	022	0	1	02	01	H3152_022_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3152	022	0	1	02	01	H3152_022_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3152	022	0	1	02	01	H3152_022_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3152	022	0	1	02	01	H3152_022_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3152	048	0	1	01	01	H3152_048_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3152	048	0	1	01	01	H3152_048_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3152	048	0	1	01	01	H3152_048_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3152	048	0	1	01	01	H3152_048_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3152	048	0	1	01	01	H3152_048_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3152	080	0	1	02	01	H3152_080_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3152	080	0	1	02	01	H3152_080_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3152	080	0	1	02	01	H3152_080_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3152	080	0	1	02	01	H3152_080_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3152	080	0	1	02	01	H3152_080_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3152	082	0	1	01	01	H3152_082_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3152	082	0	1	01	01	H3152_082_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3152	082	0	1	01	01	H3152_082_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3152	082	0	1	01	01	H3152_082_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3152	082	0	1	01	01	H3152_082_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3152	098	0	1	01	01	H3152_098_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3152	098	0	1	01	01	H3152_098_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3152	098	0	1	01	01	H3152_098_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3152	098	0	1	01	01	H3152_098_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3152	098	0	1	01	01	H3152_098_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3170	003	1	1	01	01	H3170_003_1	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	0.00	
H3170	003	1	1	01	01	H3170_003_1	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3170	003	1	1	01	01	H3170_003_1	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3170	003	1	1	01	01	H3170_003_1	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3170	003	1	1	01	01	H3170_003_1	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3170	003	2	1	01	01	H3170_003_2	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	0.00	
H3170	003	2	1	01	01	H3170_003_2	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3170	003	2	1	01	01	H3170_003_2	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3170	003	2	1	01	01	H3170_003_2	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3170	003	2	1	01	01	H3170_003_2	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3186	001	0	1	04	01	H3186_001_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3186	001	0	1	04	01	H3186_001_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H3186	001	0	1	04	01	H3186_001_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H3186	001	0	1	04	01	H3186_001_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	10	1	2	0.00	
H3186	001	0	1	04	01	H3186_001_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3186	001	0	1	04	01	H3186_001_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3186	002	0	1	04	01	H3186_002_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3186	002	0	1	04	01	H3186_002_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H3186	002	0	1	04	01	H3186_002_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H3186	002	0	1	04	01	H3186_002_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	10	1	2	0.00	
H3186	002	0	1	04	01	H3186_002_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3186	002	0	1	04	01	H3186_002_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3192	001	0	1	02	01	H3192_001_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3192	001	0	1	02	01	H3192_001_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3192	001	0	1	02	01	H3192_001_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3192	001	0	1	02	01	H3192_001_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3192	001	0	1	02	01	H3192_001_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3192	003	0	1	02	01	H3192_003_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3192	003	0	1	02	01	H3192_003_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3192	003	0	1	02	01	H3192_003_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3192	003	0	1	02	01	H3192_003_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3192	003	0	1	02	01	H3192_003_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3192	005	0	1	02	01	H3192_005_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3192	005	0	1	02	01	H3192_005_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3192	005	0	1	02	01	H3192_005_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3192	005	0	1	02	01	H3192_005_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3192	005	0	1	02	01	H3192_005_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3192	007	0	1	01	01	H3192_007_0	2		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3192	007	0	1	01	01	H3192_007_0	2		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3192	007	0	1	01	01	H3192_007_0	2		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3192	007	0	1	01	01	H3192_007_0	2		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3192	007	0	1	01	01	H3192_007_0	2		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3192	010	0	1	02	01	H3192_010_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3192	010	0	1	02	01	H3192_010_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3192	010	0	1	02	01	H3192_010_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3192	010	0	1	02	01	H3192_010_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3192	010	0	1	02	01	H3192_010_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3192	013	0	1	02	01	H3192_013_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3192	013	0	1	02	01	H3192_013_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3192	013	0	1	02	01	H3192_013_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3192	013	0	1	02	01	H3192_013_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3192	013	0	1	02	01	H3192_013_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3192	020	0	1	02	01	H3192_020_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3192	020	0	1	02	01	H3192_020_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3192	020	0	1	02	01	H3192_020_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3192	020	0	1	02	01	H3192_020_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3192	020	0	1	02	01	H3192_020_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3192	021	0	1	02	01	H3192_021_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3192	021	0	1	02	01	H3192_021_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3192	021	0	1	02	01	H3192_021_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3192	021	0	1	02	01	H3192_021_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3192	021	0	1	02	01	H3192_021_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3192	028	0	1	01	01	H3192_028_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3192	028	0	1	01	01	H3192_028_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3192	028	0	1	01	01	H3192_028_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3192	028	0	1	01	01	H3192_028_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3192	028	0	1	01	01	H3192_028_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3192	029	0	1	01	01	H3192_029_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3192	029	0	1	01	01	H3192_029_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3192	029	0	1	01	01	H3192_029_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3192	029	0	1	01	01	H3192_029_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3192	029	0	1	01	01	H3192_029_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3192	033	0	1	01	01	H3192_033_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3192	033	0	1	01	01	H3192_033_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3192	033	0	1	01	01	H3192_033_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3192	033	0	1	01	01	H3192_033_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3192	033	0	1	01	01	H3192_033_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3204	001	0	1	01	01	H3204_001_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3204	001	0	1	01	01	H3204_001_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3204	001	0	1	01	01	H3204_001_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3204	001	0	1	01	01	H3204_001_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3204	001	0	1	01	01	H3204_001_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3204	007	0	1	01	01	H3204_007_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3204	007	0	1	01	01	H3204_007_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3204	007	0	1	01	01	H3204_007_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H3204	007	0	1	01	01	H3204_007_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3204	007	0	1	01	01	H3204_007_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3204	013	4	1	01	01	H3204_013_4	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3204	013	4	1	01	01	H3204_013_4	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3204	013	4	1	01	01	H3204_013_4	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3204	013	4	1	01	01	H3204_013_4	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3204	013	4	1	01	01	H3204_013_4	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3204	013	5	1	01	01	H3204_013_5	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3204	013	5	1	01	01	H3204_013_5	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3204	013	5	1	01	01	H3204_013_5	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3204	013	5	1	01	01	H3204_013_5	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3204	013	5	1	01	01	H3204_013_5	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3204	013	6	1	01	01	H3204_013_6	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3204	013	6	1	01	01	H3204_013_6	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3204	013	6	1	01	01	H3204_013_6	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3204	013	6	1	01	01	H3204_013_6	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3204	013	6	1	01	01	H3204_013_6	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3219	001	0	1	04	01	H3219_001_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3219	001	0	1	04	01	H3219_001_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3219	001	0	1	04	01	H3219_001_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3219	001	0	1	04	01	H3219_001_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3219	001	0	1	04	01	H3219_001_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3219	002	0	1	04	01	H3219_002_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3219	002	0	1	04	01	H3219_002_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3219	002	0	1	04	01	H3219_002_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3219	002	0	1	04	01	H3219_002_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3219	002	0	1	04	01	H3219_002_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3219	003	0	1	04	01	H3219_003_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3219	003	0	1	04	01	H3219_003_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3219	003	0	1	04	01	H3219_003_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3219	003	0	1	04	01	H3219_003_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3219	003	0	1	04	01	H3219_003_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3219	004	0	1	04	01	H3219_004_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3219	004	0	1	04	01	H3219_004_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3219	004	0	1	04	01	H3219_004_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3219	004	0	1	04	01	H3219_004_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3219	004	0	1	04	01	H3219_004_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3219	008	0	1	04	01	H3219_008_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3219	008	0	1	04	01	H3219_008_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3219	008	0	1	04	01	H3219_008_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3219	008	0	1	04	01	H3219_008_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3219	008	0	1	04	01	H3219_008_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3219	012	0	1	04	01	H3219_012_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3219	012	0	1	04	01	H3219_012_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3219	012	0	1	04	01	H3219_012_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3219	012	0	1	04	01	H3219_012_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3219	012	0	1	04	01	H3219_012_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3219	014	0	1	04	01	H3219_014_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3219	014	0	1	04	01	H3219_014_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3219	014	0	1	04	01	H3219_014_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3219	014	0	1	04	01	H3219_014_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3219	014	0	1	04	01	H3219_014_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3219	015	0	1	04	01	H3219_015_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3219	015	0	1	04	01	H3219_015_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3219	015	0	1	04	01	H3219_015_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3219	015	0	1	04	01	H3219_015_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3219	015	0	1	04	01	H3219_015_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3219	016	0	1	04	01	H3219_016_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3219	016	0	1	04	01	H3219_016_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3219	016	0	1	04	01	H3219_016_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3219	016	0	1	04	01	H3219_016_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3219	016	0	1	04	01	H3219_016_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3239	001	0	1	01	01	H3239_001_0	2		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3239	001	0	1	01	01	H3239_001_0	2		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3239	001	0	1	01	01	H3239_001_0	2		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3239	001	0	1	01	01	H3239_001_0	2		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3239	001	0	1	01	01	H3239_001_0	2		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3239	002	0	1	01	01	H3239_002_0	2		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3239	002	0	1	01	01	H3239_002_0	2		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3239	002	0	1	01	01	H3239_002_0	2		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3239	002	0	1	01	01	H3239_002_0	2		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3239	002	0	1	01	01	H3239_002_0	2		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3239	005	0	1	01	01	H3239_005_0	2		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3239	005	0	1	01	01	H3239_005_0	2		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3239	005	0	1	01	01	H3239_005_0	2		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3239	005	0	1	01	01	H3239_005_0	2		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3239	005	0	1	01	01	H3239_005_0	2		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3239	007	0	1	01	01	H3239_007_0	2		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3239	007	0	1	01	01	H3239_007_0	2		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3239	007	0	1	01	01	H3239_007_0	2		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3239	007	0	1	01	01	H3239_007_0	2		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3239	007	0	1	01	01	H3239_007_0	2		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3239	010	0	1	01	01	H3239_010_0	2		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3239	010	0	1	01	01	H3239_010_0	2		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3239	010	0	1	01	01	H3239_010_0	2		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3239	010	0	1	01	01	H3239_010_0	2		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3239	010	0	1	01	01	H3239_010_0	2		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3239	012	0	1	01	01	H3239_012_0	2		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3239	012	0	1	01	01	H3239_012_0	2		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3239	012	0	1	01	01	H3239_012_0	2		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3239	012	0	1	01	01	H3239_012_0	2		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3239	012	0	1	01	01	H3239_012_0	2		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3239	014	0	1	01	01	H3239_014_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3239	014	0	1	01	01	H3239_014_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3239	014	0	1	01	01	H3239_014_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3239	014	0	1	01	01	H3239_014_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3239	014	0	1	01	01	H3239_014_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3239	015	0	1	01	01	H3239_015_0	2		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3239	015	0	1	01	01	H3239_015_0	2		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3239	015	0	1	01	01	H3239_015_0	2		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3239	015	0	1	01	01	H3239_015_0	2		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3239	015	0	1	01	01	H3239_015_0	2		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3239	017	0	1	01	01	H3239_017_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3239	017	0	1	01	01	H3239_017_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3239	017	0	1	01	01	H3239_017_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3239	017	0	1	01	01	H3239_017_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3239	017	0	1	01	01	H3239_017_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3239	020	0	1	01	01	H3239_020_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3239	020	0	1	01	01	H3239_020_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3239	020	0	1	01	01	H3239_020_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3239	020	0	1	01	01	H3239_020_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3239	020	0	1	01	01	H3239_020_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3239	022	0	1	01	01	H3239_022_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3239	022	0	1	01	01	H3239_022_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3239	022	0	1	01	01	H3239_022_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3239	022	0	1	01	01	H3239_022_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3239	022	0	1	01	01	H3239_022_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3239	023	0	1	01	01	H3239_023_0	2		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3239	023	0	1	01	01	H3239_023_0	2		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3239	023	0	1	01	01	H3239_023_0	2		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3239	023	0	1	01	01	H3239_023_0	2		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3239	023	0	1	01	01	H3239_023_0	2		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3239	026	0	1	01	01	H3239_026_0	2		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3239	026	0	1	01	01	H3239_026_0	2		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3239	026	0	1	01	01	H3239_026_0	2		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3239	026	0	1	01	01	H3239_026_0	2		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3239	026	0	1	01	01	H3239_026_0	2		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3239	027	0	1	01	01	H3239_027_0	2		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3239	027	0	1	01	01	H3239_027_0	2		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3239	027	0	1	01	01	H3239_027_0	2		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3239	027	0	1	01	01	H3239_027_0	2		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3239	027	0	1	01	01	H3239_027_0	2		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3239	028	0	1	01	01	H3239_028_0	2		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3239	028	0	1	01	01	H3239_028_0	2		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3239	028	0	1	01	01	H3239_028_0	2		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3239	028	0	1	01	01	H3239_028_0	2		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3239	028	0	1	01	01	H3239_028_0	2		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3239	030	0	1	01	01	H3239_030_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3239	030	0	1	01	01	H3239_030_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3239	030	0	1	01	01	H3239_030_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3239	030	0	1	01	01	H3239_030_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3239	030	0	1	01	01	H3239_030_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3240	013	0	1	01	01	H3240_013_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3240	013	0	1	01	01	H3240_013_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3240	013	0	1	01	01	H3240_013_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3240	013	0	1	01	01	H3240_013_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3240	013	0	1	01	01	H3240_013_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3240	013	0	1	01	01	H3240_013_0	5		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3240	017	0	1	02	01	H3240_017_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3240	017	0	1	02	01	H3240_017_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3240	017	0	1	02	01	H3240_017_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3240	017	0	1	02	01	H3240_017_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3240	017	0	1	02	01	H3240_017_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3240	017	0	1	02	01	H3240_017_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3240	024	0	1	02	01	H3240_024_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3240	024	0	1	02	01	H3240_024_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3240	024	0	1	02	01	H3240_024_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3240	024	0	1	02	01	H3240_024_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3240	024	0	1	02	01	H3240_024_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3240	024	0	1	02	01	H3240_024_0	5		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3251	002	0	1	01	01	H3251_002_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3251	002	0	1	01	01	H3251_002_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3251	002	0	1	01	01	H3251_002_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3251	002	0	1	01	01	H3251_002_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3251	002	0	1	01	01	H3251_002_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3256	004	1	1	04	01	H3256_004_1	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3256	004	1	1	04	01	H3256_004_1	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3256	004	1	1	04	01	H3256_004_1	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3256	004	1	1	04	01	H3256_004_1	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3256	004	1	1	04	01	H3256_004_1	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3256	004	2	1	04	01	H3256_004_2	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3256	004	2	1	04	01	H3256_004_2	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3256	004	2	1	04	01	H3256_004_2	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3256	004	2	1	04	01	H3256_004_2	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3256	004	2	1	04	01	H3256_004_2	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3256	005	1	1	04	01	H3256_005_1	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3256	005	1	1	04	01	H3256_005_1	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3256	005	1	1	04	01	H3256_005_1	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3256	005	1	1	04	01	H3256_005_1	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3256	005	1	1	04	01	H3256_005_1	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3256	005	2	1	04	01	H3256_005_2	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3256	005	2	1	04	01	H3256_005_2	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3256	005	2	1	04	01	H3256_005_2	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3256	005	2	1	04	01	H3256_005_2	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3256	005	2	1	04	01	H3256_005_2	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3256	006	1	1	04	01	H3256_006_1	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3256	006	1	1	04	01	H3256_006_1	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3256	006	1	1	04	01	H3256_006_1	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3256	006	1	1	04	01	H3256_006_1	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3256	006	1	1	04	01	H3256_006_1	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3256	006	2	1	04	01	H3256_006_2	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3256	006	2	1	04	01	H3256_006_2	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3256	006	2	1	04	01	H3256_006_2	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3256	006	2	1	04	01	H3256_006_2	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3256	006	2	1	04	01	H3256_006_2	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3259	001	0	1	01	01	H3259_001_0	11		N	Preferred Generic	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3259	001	0	1	01	01	H3259_001_0	11		N	Preferred Brand	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	10	1	2	0.00	
H3259	001	0	1	01	01	H3259_001_0	11		N	Non-Preferred Drug	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3259	001	0	1	01	01	H3259_001_0	11		N	Specialty Tier	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3259	002	0	1	01	01	H3259_002_0	12		N	Preferred Generic	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3259	002	0	1	01	01	H3259_002_0	12		N	Preferred Brand	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	10	1	2	0.00	
H3259	002	0	1	01	01	H3259_002_0	12		N	Non-Preferred Drug	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3259	002	0	1	01	01	H3259_002_0	12		N	Specialty Tier	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3259	003	0	1	01	01	H3259_003_0	11		N	Preferred Generic	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3259	003	0	1	01	01	H3259_003_0	11		N	Preferred Brand	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	10	1	2	0.00	
H3259	003	0	1	01	01	H3259_003_0	11		N	Non-Preferred Drug	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3259	003	0	1	01	01	H3259_003_0	11		N	Specialty Tier	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3274	002	0	1	01	01	H3274_002_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3274	002	0	1	01	01	H3274_002_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3274	002	0	1	01	01	H3274_002_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H3274	002	0	1	01	01	H3274_002_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	10	1	2	0.00	
H3274	002	0	1	01	01	H3274_002_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3274	005	0	1	01	01	H3274_005_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3274	005	0	1	01	01	H3274_005_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3274	005	0	1	01	01	H3274_005_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H3274	005	0	1	01	01	H3274_005_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	10	1	2	0.00	
H3274	005	0	1	01	01	H3274_005_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3276	001	0	1	02	01	H3276_001_0	13		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3276	001	0	1	02	01	H3276_001_0	13		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3276	001	0	1	02	01	H3276_001_0	13		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3276	001	0	1	02	01	H3276_001_0	13		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3276	001	0	1	02	01	H3276_001_0	13		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3276	001	0	1	02	01	H3276_001_0	13		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H3288	001	0	1	04	01	H3288_001_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3288	001	0	1	04	01	H3288_001_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3288	001	0	1	04	01	H3288_001_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3288	001	0	1	04	01	H3288_001_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3288	001	0	1	04	01	H3288_001_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3288	002	0	1	04	01	H3288_002_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3288	002	0	1	04	01	H3288_002_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3288	002	0	1	04	01	H3288_002_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3288	002	0	1	04	01	H3288_002_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3288	002	0	1	04	01	H3288_002_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3288	003	0	1	04	01	H3288_003_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3288	003	0	1	04	01	H3288_003_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3288	003	0	1	04	01	H3288_003_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3288	003	0	1	04	01	H3288_003_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3288	003	0	1	04	01	H3288_003_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3288	004	0	1	04	01	H3288_004_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3288	004	0	1	04	01	H3288_004_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3288	004	0	1	04	01	H3288_004_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3288	004	0	1	04	01	H3288_004_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3288	004	0	1	04	01	H3288_004_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3288	005	0	1	04	01	H3288_005_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3288	005	0	1	04	01	H3288_005_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3288	005	0	1	04	01	H3288_005_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3288	005	0	1	04	01	H3288_005_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3288	005	0	1	04	01	H3288_005_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3288	006	0	1	04	01	H3288_006_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3288	006	0	1	04	01	H3288_006_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3288	006	0	1	04	01	H3288_006_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3288	006	0	1	04	01	H3288_006_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3288	006	0	1	04	01	H3288_006_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3288	007	0	1	04	01	H3288_007_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3288	007	0	1	04	01	H3288_007_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3288	007	0	1	04	01	H3288_007_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3288	007	0	1	04	01	H3288_007_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3288	007	0	1	04	01	H3288_007_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3288	008	0	1	04	01	H3288_008_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3288	008	0	1	04	01	H3288_008_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3288	008	0	1	04	01	H3288_008_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3288	008	0	1	04	01	H3288_008_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3288	008	0	1	04	01	H3288_008_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3288	009	0	1	04	01	H3288_009_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3288	009	0	1	04	01	H3288_009_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3288	009	0	1	04	01	H3288_009_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3288	009	0	1	04	01	H3288_009_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3288	009	0	1	04	01	H3288_009_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3288	011	0	1	04	01	H3288_011_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3288	011	0	1	04	01	H3288_011_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3288	011	0	1	04	01	H3288_011_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3288	011	0	1	04	01	H3288_011_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3288	011	0	1	04	01	H3288_011_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3288	016	0	1	04	01	H3288_016_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3288	016	0	1	04	01	H3288_016_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3288	016	0	1	04	01	H3288_016_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3288	016	0	1	04	01	H3288_016_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3288	016	0	1	04	01	H3288_016_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3288	017	0	1	04	01	H3288_017_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3288	017	0	1	04	01	H3288_017_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3288	017	0	1	04	01	H3288_017_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3288	017	0	1	04	01	H3288_017_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3288	017	0	1	04	01	H3288_017_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3288	018	0	1	04	01	H3288_018_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3288	018	0	1	04	01	H3288_018_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3288	018	0	1	04	01	H3288_018_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3288	018	0	1	04	01	H3288_018_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3288	018	0	1	04	01	H3288_018_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3288	019	0	1	04	01	H3288_019_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3288	019	0	1	04	01	H3288_019_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3288	019	0	1	04	01	H3288_019_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3288	019	0	1	04	01	H3288_019_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3288	019	0	1	04	01	H3288_019_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3288	020	0	1	04	01	H3288_020_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3288	020	0	1	04	01	H3288_020_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3288	020	0	1	04	01	H3288_020_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3288	020	0	1	04	01	H3288_020_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3288	020	0	1	04	01	H3288_020_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3288	021	0	1	04	01	H3288_021_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3288	021	0	1	04	01	H3288_021_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3288	021	0	1	04	01	H3288_021_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3288	021	0	1	04	01	H3288_021_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3288	021	0	1	04	01	H3288_021_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3288	027	0	1	04	01	H3288_027_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3288	027	0	1	04	01	H3288_027_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3288	027	0	1	04	01	H3288_027_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3288	027	0	1	04	01	H3288_027_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3288	027	0	1	04	01	H3288_027_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3288	042	0	1	04	01	H3288_042_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3288	042	0	1	04	01	H3288_042_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3288	042	0	1	04	01	H3288_042_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3288	042	0	1	04	01	H3288_042_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3288	042	0	1	04	01	H3288_042_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3288	046	0	1	04	01	H3288_046_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3288	046	0	1	04	01	H3288_046_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3288	046	0	1	04	01	H3288_046_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3288	046	0	1	04	01	H3288_046_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3288	046	0	1	04	01	H3288_046_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3288	047	0	1	04	01	H3288_047_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3288	047	0	1	04	01	H3288_047_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3288	047	0	1	04	01	H3288_047_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3288	047	0	1	04	01	H3288_047_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3288	047	0	1	04	01	H3288_047_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3288	048	0	1	04	01	H3288_048_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3288	048	0	1	04	01	H3288_048_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3288	048	0	1	04	01	H3288_048_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3288	048	0	1	04	01	H3288_048_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3288	048	0	1	04	01	H3288_048_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3288	053	0	1	04	01	H3288_053_0	3		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3288	053	0	1	04	01	H3288_053_0	3		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3288	053	0	1	04	01	H3288_053_0	3		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3288	053	0	1	04	01	H3288_053_0	3		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3288	053	0	1	04	01	H3288_053_0	3		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3291	003	0	1	01	01	H3291_003_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3291	003	0	1	01	01	H3291_003_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3291	003	0	1	01	01	H3291_003_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H3291	003	0	1	01	01	H3291_003_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	10	1	2	0.00	
H3291	003	0	1	01	01	H3291_003_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3305	015	0	1	02	01	H3305_015_0	17			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3305	015	0	1	02	01	H3305_015_0	17			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3305	015	0	1	02	01	H3305_015_0	17			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3305	015	0	1	02	01	H3305_015_0	17			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3305	015	0	1	02	01	H3305_015_0	17			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3305	022	0	1	02	01	H3305_022_0	16			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3305	022	0	1	02	01	H3305_022_0	16			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3305	022	0	1	02	01	H3305_022_0	16			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3305	022	0	1	02	01	H3305_022_0	16			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3305	022	0	1	02	01	H3305_022_0	16			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3305	033	0	1	01	01	H3305_033_0	9		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3305	033	0	1	01	01	H3305_033_0	9		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H3305	033	0	1	01	01	H3305_033_0	9		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3305	033	0	1	01	01	H3305_033_0	9		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3305	033	0	1	01	01	H3305_033_0	9		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3305	033	0	1	01	01	H3305_033_0	9		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H3305	034	0	1	01	01	H3305_034_0	9		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3305	034	0	1	01	01	H3305_034_0	9		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H3305	034	0	1	01	01	H3305_034_0	9		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3305	034	0	1	01	01	H3305_034_0	9		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3305	034	0	1	01	01	H3305_034_0	9		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3305	034	0	1	01	01	H3305_034_0	9		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H3312	002	0	1	01	01	H3312_002_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3312	002	0	1	01	01	H3312_002_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3312	002	0	1	01	01	H3312_002_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3312	002	0	1	01	01	H3312_002_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3312	002	0	1	01	01	H3312_002_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3312	018	0	1	02	01	H3312_018_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3312	018	0	1	02	01	H3312_018_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3312	018	0	1	02	01	H3312_018_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3312	018	0	1	02	01	H3312_018_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3312	018	0	1	02	01	H3312_018_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3312	048	0	1	01	01	H3312_048_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3312	048	0	1	01	01	H3312_048_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3312	048	0	1	01	01	H3312_048_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3312	048	0	1	01	01	H3312_048_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3312	048	0	1	01	01	H3312_048_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3312	062	0	1	01	01	H3312_062_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3312	062	0	1	01	01	H3312_062_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3312	062	0	1	01	01	H3312_062_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3312	062	0	1	01	01	H3312_062_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3312	062	0	1	01	01	H3312_062_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3312	064	0	1	01	01	H3312_064_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3312	064	0	1	01	01	H3312_064_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3312	064	0	1	01	01	H3312_064_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3312	064	0	1	01	01	H3312_064_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3312	064	0	1	01	01	H3312_064_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3312	065	0	1	02	01	H3312_065_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3312	065	0	1	02	01	H3312_065_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3312	065	0	1	02	01	H3312_065_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3312	065	0	1	02	01	H3312_065_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3312	065	0	1	02	01	H3312_065_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3312	069	0	1	01	01	H3312_069_0	3		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3312	069	0	1	01	01	H3312_069_0	3		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3312	069	0	1	01	01	H3312_069_0	3		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3312	069	0	1	01	01	H3312_069_0	3		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3312	069	0	1	01	01	H3312_069_0	3		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3312	070	0	1	01	01	H3312_070_0	3		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3312	070	0	1	01	01	H3312_070_0	3		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3312	070	0	1	01	01	H3312_070_0	3		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3312	070	0	1	01	01	H3312_070_0	3		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3312	070	0	1	01	01	H3312_070_0	3		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3312	074	0	1	01	01	H3312_074_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3312	074	0	1	01	01	H3312_074_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3312	074	0	1	01	01	H3312_074_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3312	074	0	1	01	01	H3312_074_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3312	074	0	1	01	01	H3312_074_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3312	081	0	1	01	01	H3312_081_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3312	081	0	1	01	01	H3312_081_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3312	081	0	1	01	01	H3312_081_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3312	081	0	1	01	01	H3312_081_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3312	081	0	1	01	01	H3312_081_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3312	082	0	1	01	01	H3312_082_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3312	082	0	1	01	01	H3312_082_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3312	082	0	1	01	01	H3312_082_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3312	082	0	1	01	01	H3312_082_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3312	082	0	1	01	01	H3312_082_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3312	087	0	1	01	01	H3312_087_0	3		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3312	087	0	1	01	01	H3312_087_0	3		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3312	087	0	1	01	01	H3312_087_0	3		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3312	087	0	1	01	01	H3312_087_0	3		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3312	087	0	1	01	01	H3312_087_0	3		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3312	089	0	1	01	01	H3312_089_0	3		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3312	089	0	1	01	01	H3312_089_0	3		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3312	089	0	1	01	01	H3312_089_0	3		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3312	089	0	1	01	01	H3312_089_0	3		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3312	089	0	1	01	01	H3312_089_0	3		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3312	090	0	1	01	01	H3312_090_0	3		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3312	090	0	1	01	01	H3312_090_0	3		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3312	090	0	1	01	01	H3312_090_0	3		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3312	090	0	1	01	01	H3312_090_0	3		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3312	090	0	1	01	01	H3312_090_0	3		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3312	091	0	1	01	01	H3312_091_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3312	091	0	1	01	01	H3312_091_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3312	091	0	1	01	01	H3312_091_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3312	091	0	1	01	01	H3312_091_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3312	091	0	1	01	01	H3312_091_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3312	097	0	1	01	01	H3312_097_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3312	097	0	1	01	01	H3312_097_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3312	097	0	1	01	01	H3312_097_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3312	097	0	1	01	01	H3312_097_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3312	097	0	1	01	01	H3312_097_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3330	021	2	1	01	01	H3330_021_2	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3330	021	2	1	01	01	H3330_021_2	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3330	021	2	1	01	01	H3330_021_2	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3330	021	2	1	01	01	H3330_021_2	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3330	021	2	1	01	01	H3330_021_2	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3330	021	2	1	01	01	H3330_021_2	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3330	021	3	1	01	01	H3330_021_3	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3330	021	3	1	01	01	H3330_021_3	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3330	021	3	1	01	01	H3330_021_3	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3330	021	3	1	01	01	H3330_021_3	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3330	021	3	1	01	01	H3330_021_3	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3330	021	3	1	01	01	H3330_021_3	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3330	021	5	1	01	01	H3330_021_5	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3330	021	5	1	01	01	H3330_021_5	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3330	021	5	1	01	01	H3330_021_5	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3330	021	5	1	01	01	H3330_021_5	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3330	021	5	1	01	01	H3330_021_5	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3330	021	5	1	01	01	H3330_021_5	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3330	038	0	1	01	01	H3330_038_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3330	038	0	1	01	01	H3330_038_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3330	038	0	1	01	01	H3330_038_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3330	038	0	1	01	01	H3330_038_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3330	038	0	1	01	01	H3330_038_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3330	038	0	1	01	01	H3330_038_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3330	048	0	1	02	01	H3330_048_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3330	048	0	1	02	01	H3330_048_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3330	048	0	1	02	01	H3330_048_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3330	048	0	1	02	01	H3330_048_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3330	048	0	1	02	01	H3330_048_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3330	048	0	1	02	01	H3330_048_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3335	015	0	1	04	01	H3335_015_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3335	015	0	1	04	01	H3335_015_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3335	015	0	1	04	01	H3335_015_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3335	015	0	1	04	01	H3335_015_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3335	015	0	1	04	01	H3335_015_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3335	018	0	1	04	01	H3335_018_0	8			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3335	018	0	1	04	01	H3335_018_0	8			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3335	018	0	1	04	01	H3335_018_0	8			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3335	018	0	1	04	01	H3335_018_0	8			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3335	018	0	1	04	01	H3335_018_0	8			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3335	038	0	1	04	01	H3335_038_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3335	038	0	1	04	01	H3335_038_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3335	038	0	1	04	01	H3335_038_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3335	038	0	1	04	01	H3335_038_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3335	038	0	1	04	01	H3335_038_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3335	053	0	1	04	01	H3335_053_0	8			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3335	053	0	1	04	01	H3335_053_0	8			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3335	053	0	1	04	01	H3335_053_0	8			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3335	053	0	1	04	01	H3335_053_0	8			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3335	053	0	1	04	01	H3335_053_0	8			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3335	055	0	1	04	01	H3335_055_0	8			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3335	055	0	1	04	01	H3335_055_0	8			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3335	055	0	1	04	01	H3335_055_0	8			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3335	055	0	1	04	01	H3335_055_0	8			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3335	055	0	1	04	01	H3335_055_0	8			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3335	060	0	1	04	01	H3335_060_0	8			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3335	060	0	1	04	01	H3335_060_0	8			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3335	060	0	1	04	01	H3335_060_0	8			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3335	060	0	1	04	01	H3335_060_0	8			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3335	060	0	1	04	01	H3335_060_0	8			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3335	061	0	1	04	01	H3335_061_0	7			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3335	061	0	1	04	01	H3335_061_0	7			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3335	061	0	1	04	01	H3335_061_0	7			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3335	061	0	1	04	01	H3335_061_0	7			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3335	061	0	1	04	01	H3335_061_0	7			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3335	062	0	1	04	01	H3335_062_0	7			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3335	062	0	1	04	01	H3335_062_0	7			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3335	062	0	1	04	01	H3335_062_0	7			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3335	062	0	1	04	01	H3335_062_0	7			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3335	062	0	1	04	01	H3335_062_0	7			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3347	009	0	1	02	01	H3347_009_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3347	009	0	1	02	01	H3347_009_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3347	009	0	1	02	01	H3347_009_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3347	009	0	1	02	01	H3347_009_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3347	009	0	1	02	01	H3347_009_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3347	016	0	1	02	01	H3347_016_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3347	016	0	1	02	01	H3347_016_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3347	016	0	1	02	01	H3347_016_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3347	016	0	1	02	01	H3347_016_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3347	016	0	1	02	01	H3347_016_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3347	018	0	1	02	01	H3347_018_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3347	018	0	1	02	01	H3347_018_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3347	018	0	1	02	01	H3347_018_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3347	018	0	1	02	01	H3347_018_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3347	018	0	1	02	01	H3347_018_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3351	002	0	1	02	01	H3351_002_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3351	002	0	1	02	01	H3351_002_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3351	002	0	1	02	01	H3351_002_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3351	002	0	1	02	01	H3351_002_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3351	002	0	1	02	01	H3351_002_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3351	006	0	1	02	01	H3351_006_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3351	006	0	1	02	01	H3351_006_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3351	006	0	1	02	01	H3351_006_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3351	006	0	1	02	01	H3351_006_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3351	006	0	1	02	01	H3351_006_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3351	012	0	1	02	01	H3351_012_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3351	012	0	1	02	01	H3351_012_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3351	012	0	1	02	01	H3351_012_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3351	012	0	1	02	01	H3351_012_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3351	012	0	1	02	01	H3351_012_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3351	017	0	1	01	01	H3351_017_0	7			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3351	017	0	1	01	01	H3351_017_0	7			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3351	017	0	1	01	01	H3351_017_0	7			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3351	017	0	1	01	01	H3351_017_0	7			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3351	017	0	1	01	01	H3351_017_0	7			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3351	019	0	1	02	01	H3351_019_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3351	019	0	1	02	01	H3351_019_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3351	019	0	1	02	01	H3351_019_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3351	019	0	1	02	01	H3351_019_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3351	019	0	1	02	01	H3351_019_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3351	020	0	1	01	01	H3351_020_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3351	020	0	1	01	01	H3351_020_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3351	020	0	1	01	01	H3351_020_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3351	020	0	1	01	01	H3351_020_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3351	020	0	1	01	01	H3351_020_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3351	022	0	1	01	01	H3351_022_0	7			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3351	022	0	1	01	01	H3351_022_0	7			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3351	022	0	1	01	01	H3351_022_0	7			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3351	022	0	1	01	01	H3351_022_0	7			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3351	022	0	1	01	01	H3351_022_0	7			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3351	023	0	1	01	01	H3351_023_0	7			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3351	023	0	1	01	01	H3351_023_0	7			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3351	023	0	1	01	01	H3351_023_0	7			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3351	023	0	1	01	01	H3351_023_0	7			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3351	023	0	1	01	01	H3351_023_0	7			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3359	001	0	1	01	01	H3359_001_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H3359	001	0	1	01	01	H3359_001_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3359	001	0	1	01	01	H3359_001_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3359	001	0	1	01	01	H3359_001_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3359	001	0	1	01	01	H3359_001_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3359	019	0	1	01	01	H3359_019_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3359	019	0	1	01	01	H3359_019_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	6.00	
H3359	019	0	1	01	01	H3359_019_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3359	019	0	1	01	01	H3359_019_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3359	019	0	1	01	01	H3359_019_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3359	021	0	1	01	01	H3359_021_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3359	021	0	1	01	01	H3359_021_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3359	021	0	1	01	01	H3359_021_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3359	021	0	1	01	01	H3359_021_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3359	021	0	1	01	01	H3359_021_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3359	038	0	1	01	01	H3359_038_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3359	038	0	1	01	01	H3359_038_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3359	038	0	1	01	01	H3359_038_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3359	038	0	1	01	01	H3359_038_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3359	038	0	1	01	01	H3359_038_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3362	020	0	1	01	01	H3362_020_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3362	020	0	1	01	01	H3362_020_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H3362	020	0	1	01	01	H3362_020_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3362	020	0	1	01	01	H3362_020_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3362	020	0	1	01	01	H3362_020_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3362	040	0	1	01	01	H3362_040_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3362	040	0	1	01	01	H3362_040_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H3362	040	0	1	01	01	H3362_040_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3362	040	0	1	01	01	H3362_040_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3362	040	0	1	01	01	H3362_040_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3362	042	0	1	01	01	H3362_042_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3362	042	0	1	01	01	H3362_042_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3362	042	0	1	01	01	H3362_042_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3362	042	0	1	01	01	H3362_042_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3362	042	0	1	01	01	H3362_042_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3362	043	0	1	01	01	H3362_043_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3362	043	0	1	01	01	H3362_043_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H3362	043	0	1	01	01	H3362_043_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3362	043	0	1	01	01	H3362_043_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3362	043	0	1	01	01	H3362_043_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3362	044	0	1	01	01	H3362_044_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3362	044	0	1	01	01	H3362_044_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3362	044	0	1	01	01	H3362_044_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3362	044	0	1	01	01	H3362_044_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3362	044	0	1	01	01	H3362_044_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3379	001	0	1	02	01	H3379_001_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3379	001	0	1	02	01	H3379_001_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H3379	001	0	1	02	01	H3379_001_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3379	001	0	1	02	01	H3379_001_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3379	001	0	1	02	01	H3379_001_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3379	039	0	1	02	01	H3379_039_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3379	039	0	1	02	01	H3379_039_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H3379	039	0	1	02	01	H3379_039_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3379	039	0	1	02	01	H3379_039_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3379	039	0	1	02	01	H3379_039_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3379	040	0	1	02	01	H3379_040_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3379	040	0	1	02	01	H3379_040_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H3379	040	0	1	02	01	H3379_040_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3379	040	0	1	02	01	H3379_040_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3379	040	0	1	02	01	H3379_040_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3379	043	0	1	02	01	H3379_043_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3379	043	0	1	02	01	H3379_043_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H3379	043	0	1	02	01	H3379_043_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3379	043	0	1	02	01	H3379_043_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3379	043	0	1	02	01	H3379_043_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3379	052	0	1	02	01	H3379_052_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3379	052	0	1	02	01	H3379_052_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H3379	052	0	1	02	01	H3379_052_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3379	052	0	1	02	01	H3379_052_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3379	052	0	1	02	01	H3379_052_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3379	053	0	1	02	01	H3379_053_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3379	053	0	1	02	01	H3379_053_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H3379	053	0	1	02	01	H3379_053_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3379	053	0	1	02	01	H3379_053_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3379	053	0	1	02	01	H3379_053_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3379	054	0	1	02	01	H3379_054_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3379	054	0	1	02	01	H3379_054_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H3379	054	0	1	02	01	H3379_054_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3379	054	0	1	02	01	H3379_054_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3379	054	0	1	02	01	H3379_054_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3379	056	0	1	02	01	H3379_056_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3379	056	0	1	02	01	H3379_056_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H3379	056	0	1	02	01	H3379_056_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3379	056	0	1	02	01	H3379_056_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3379	056	0	1	02	01	H3379_056_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3379	059	0	1	02	01	H3379_059_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3379	059	0	1	02	01	H3379_059_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H3379	059	0	1	02	01	H3379_059_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3379	059	0	1	02	01	H3379_059_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3379	059	0	1	02	01	H3379_059_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3384	013	0	1	01	01	H3384_013_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3384	013	0	1	01	01	H3384_013_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3384	013	0	1	01	01	H3384_013_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3384	013	0	1	01	01	H3384_013_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3384	013	0	1	01	01	H3384_013_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3384	019	0	1	01	01	H3384_019_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3384	019	0	1	01	01	H3384_019_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3384	019	0	1	01	01	H3384_019_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3384	019	0	1	01	01	H3384_019_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3384	019	0	1	01	01	H3384_019_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3384	069	1	1	01	01	H3384_069_1	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3384	069	1	1	01	01	H3384_069_1	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3384	069	1	1	01	01	H3384_069_1	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3384	069	1	1	01	01	H3384_069_1	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3384	069	1	1	01	01	H3384_069_1	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3384	069	2	1	01	01	H3384_069_2	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3384	069	2	1	01	01	H3384_069_2	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3384	069	2	1	01	01	H3384_069_2	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3384	069	2	1	01	01	H3384_069_2	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3384	069	2	1	01	01	H3384_069_2	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3384	069	3	1	01	01	H3384_069_3	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3384	069	3	1	01	01	H3384_069_3	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3384	069	3	1	01	01	H3384_069_3	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3384	069	3	1	01	01	H3384_069_3	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3384	069	3	1	01	01	H3384_069_3	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3384	070	1	1	01	01	H3384_070_1	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3384	070	1	1	01	01	H3384_070_1	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3384	070	1	1	01	01	H3384_070_1	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3384	070	1	1	01	01	H3384_070_1	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3384	070	1	1	01	01	H3384_070_1	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3384	070	2	1	01	01	H3384_070_2	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3384	070	2	1	01	01	H3384_070_2	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3384	070	2	1	01	01	H3384_070_2	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3384	070	2	1	01	01	H3384_070_2	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3384	070	2	1	01	01	H3384_070_2	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3384	070	3	1	01	01	H3384_070_3	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3384	070	3	1	01	01	H3384_070_3	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3384	070	3	1	01	01	H3384_070_3	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3384	070	3	1	01	01	H3384_070_3	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3384	070	3	1	01	01	H3384_070_3	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3384	071	0	1	01	01	H3384_071_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3384	071	0	1	01	01	H3384_071_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3384	071	0	1	01	01	H3384_071_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3384	071	0	1	01	01	H3384_071_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3384	071	0	1	01	01	H3384_071_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3387	013	0	1	02	01	H3387_013_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3387	013	0	1	02	01	H3387_013_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3387	013	0	1	02	01	H3387_013_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3387	013	0	1	02	01	H3387_013_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3387	013	0	1	02	01	H3387_013_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3387	014	1	1	02	01	H3387_014_1	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3387	014	1	1	02	01	H3387_014_1	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3387	014	1	1	02	01	H3387_014_1	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3387	014	1	1	02	01	H3387_014_1	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3387	014	1	1	02	01	H3387_014_1	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3387	014	2	1	02	01	H3387_014_2	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3387	014	2	1	02	01	H3387_014_2	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3387	014	2	1	02	01	H3387_014_2	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3387	014	2	1	02	01	H3387_014_2	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3387	014	2	1	02	01	H3387_014_2	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3387	015	1	1	02	01	H3387_015_1	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3387	015	1	1	02	01	H3387_015_1	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3387	015	1	1	02	01	H3387_015_1	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3387	015	1	1	02	01	H3387_015_1	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3387	015	1	1	02	01	H3387_015_1	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3387	015	2	1	02	01	H3387_015_2	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3387	015	2	1	02	01	H3387_015_2	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3387	015	2	1	02	01	H3387_015_2	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3387	015	2	1	02	01	H3387_015_2	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3387	015	2	1	02	01	H3387_015_2	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3387	017	0	1	02	01	H3387_017_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3387	017	0	1	02	01	H3387_017_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3387	017	0	1	02	01	H3387_017_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3387	017	0	1	02	01	H3387_017_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3387	017	0	1	02	01	H3387_017_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3388	002	0	1	01	01	H3388_002_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3388	002	0	1	01	01	H3388_002_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3388	002	0	1	01	01	H3388_002_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3388	002	0	1	01	01	H3388_002_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3388	002	0	1	01	01	H3388_002_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3388	014	0	1	01	01	H3388_014_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3388	014	0	1	01	01	H3388_014_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3388	014	0	1	01	01	H3388_014_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3388	014	0	1	01	01	H3388_014_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3388	014	0	1	01	01	H3388_014_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3388	020	0	1	01	01	H3388_020_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3388	020	0	1	01	01	H3388_020_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3388	020	0	1	01	01	H3388_020_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3388	020	0	1	01	01	H3388_020_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3388	020	0	1	01	01	H3388_020_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3404	003	1	1	04	01	H3404_003_1	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3404	003	1	1	04	01	H3404_003_1	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	3	2	0.00	
H3404	003	1	1	04	01	H3404_003_1	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3404	003	1	1	04	01	H3404_003_1	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3404	003	1	1	04	01	H3404_003_1	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3404	003	1	1	04	01	H3404_003_1	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3404	003	2	1	04	01	H3404_003_2	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3404	003	2	1	04	01	H3404_003_2	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	3	2	0.00	
H3404	003	2	1	04	01	H3404_003_2	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3404	003	2	1	04	01	H3404_003_2	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3404	003	2	1	04	01	H3404_003_2	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3404	003	2	1	04	01	H3404_003_2	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3407	001	0	1	01	01	H3407_001_0	8		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	01	1	2	0.00	
H3407	001	0	1	01	01	H3407_001_0	8		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	01	1	2	0.00	
H3407	001	0	1	01	01	H3407_001_0	8		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	10	1	2	0.00	
H3407	001	0	1	01	01	H3407_001_0	8		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H3407	001	0	1	01	01	H3407_001_0	8		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H3407	001	0	1	01	01	H3407_001_0	8		N	Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	11	2	2	0.00	
H3407	002	0	1	01	01	H3407_002_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	01	1	2	0.00	
H3407	002	0	1	01	01	H3407_002_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	01	1	2	0.00	
H3407	002	0	1	01	01	H3407_002_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	10	1	2	0.00	
H3407	002	0	1	01	01	H3407_002_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H3407	002	0	1	01	01	H3407_002_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H3407	002	0	1	01	01	H3407_002_0	8			Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	11	2	2	0.00	
H3407	003	0	1	01	01	H3407_003_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	01	1	2	0.00	
H3407	003	0	1	01	01	H3407_003_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	01	1	2	0.00	
H3407	003	0	1	01	01	H3407_003_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	10	1	2	0.00	
H3407	003	0	1	01	01	H3407_003_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	10	1	2	0.00	
H3407	003	0	1	01	01	H3407_003_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H3407	003	0	1	01	01	H3407_003_0	7			Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	11	2	2	0.00	
H3418	001	0	1	04	01	H3418_001_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3418	001	0	1	04	01	H3418_001_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H3418	001	0	1	04	01	H3418_001_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3418	001	0	1	04	01	H3418_001_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3418	001	0	1	04	01	H3418_001_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3418	002	0	1	04	01	H3418_002_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3418	002	0	1	04	01	H3418_002_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H3418	002	0	1	04	01	H3418_002_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3418	002	0	1	04	01	H3418_002_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3418	002	0	1	04	01	H3418_002_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3418	004	0	1	04	01	H3418_004_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3418	004	0	1	04	01	H3418_004_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H3418	004	0	1	04	01	H3418_004_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3418	004	0	1	04	01	H3418_004_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3418	004	0	1	04	01	H3418_004_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3418	008	0	1	04	01	H3418_008_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3418	008	0	1	04	01	H3418_008_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H3418	008	0	1	04	01	H3418_008_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3418	008	0	1	04	01	H3418_008_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3418	008	0	1	04	01	H3418_008_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3419	003	0	1	02	01	H3419_003_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3419	003	0	1	02	01	H3419_003_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3419	003	0	1	02	01	H3419_003_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H3419	003	0	1	02	01	H3419_003_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	10	1	2	0.00	
H3419	003	0	1	02	01	H3419_003_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3419	004	0	1	02	01	H3419_004_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3419	004	0	1	02	01	H3419_004_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3419	004	0	1	02	01	H3419_004_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H3419	004	0	1	02	01	H3419_004_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	10	1	2	0.00	
H3419	004	0	1	02	01	H3419_004_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3419	006	0	1	01	01	H3419_006_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3419	006	0	1	01	01	H3419_006_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3419	006	0	1	01	01	H3419_006_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H3419	006	0	1	01	01	H3419_006_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	10	1	2	0.00	
H3419	006	0	1	01	01	H3419_006_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3419	007	0	1	01	01	H3419_007_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3419	007	0	1	01	01	H3419_007_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3419	007	0	1	01	01	H3419_007_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H3419	007	0	1	01	01	H3419_007_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	10	1	2	0.00	
H3419	007	0	1	01	01	H3419_007_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3443	001	0	1	01	01	H3443_001_0	10			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3443	001	0	1	01	01	H3443_001_0	10			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3443	001	0	1	01	01	H3443_001_0	10			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	3	2	45.00	
H3443	001	0	1	01	01	H3443_001_0	10			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	3	1		40
H3443	001	0	1	01	01	H3443_001_0	10			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3443	001	0	1	01	01	H3443_001_0	10			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H3443	002	0	1	01	01	H3443_002_0	10			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3443	002	0	1	01	01	H3443_002_0	10			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3443	002	0	1	01	01	H3443_002_0	10			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	3	2	40.00	
H3443	002	0	1	01	01	H3443_002_0	10			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	3	1		40
H3443	002	0	1	01	01	H3443_002_0	10			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3443	002	0	1	01	01	H3443_002_0	10			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H3443	003	0	1	01	01	H3443_003_0	10			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3443	003	0	1	01	01	H3443_003_0	10			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3443	003	0	1	01	01	H3443_003_0	10			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	3	2	40.00	
H3443	003	0	1	01	01	H3443_003_0	10			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	3	1		40
H3443	003	0	1	01	01	H3443_003_0	10			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3443	003	0	1	01	01	H3443_003_0	10			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H3443	005	0	1	01	01	H3443_005_0	11			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3443	005	0	1	01	01	H3443_005_0	11			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3443	005	0	1	01	01	H3443_005_0	11			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	3	2	30.00	
H3443	005	0	1	01	01	H3443_005_0	11			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	3	1		40
H3443	005	0	1	01	01	H3443_005_0	11			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3443	005	0	1	01	01	H3443_005_0	11			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H3443	006	0	1	01	01	H3443_006_0	10			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3443	006	0	1	01	01	H3443_006_0	10			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3443	006	0	1	01	01	H3443_006_0	10			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3443	006	0	1	01	01	H3443_006_0	10			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3443	006	0	1	01	01	H3443_006_0	10			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3443	006	0	1	01	01	H3443_006_0	10			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H3443	007	0	1	01	01	H3443_007_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3443	007	0	1	01	01	H3443_007_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3443	007	0	1	01	01	H3443_007_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3443	007	0	1	01	01	H3443_007_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3443	007	0	1	01	01	H3443_007_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3443	007	0	1	01	01	H3443_007_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H3447	013	0	1	02	01	H3447_013_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	3	2	5.00	
H3447	013	0	1	02	01	H3447_013_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3447	013	0	1	02	01	H3447_013_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3447	013	0	1	02	01	H3447_013_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3447	013	0	1	02	01	H3447_013_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3447	013	0	1	02	01	H3447_013_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3447	018	0	1	01	01	H3447_018_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3447	018	0	1	01	01	H3447_018_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3447	018	0	1	01	01	H3447_018_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3447	018	0	1	01	01	H3447_018_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3447	018	0	1	01	01	H3447_018_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3447	018	0	1	01	01	H3447_018_0	5		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3447	024	0	1	02	01	H3447_024_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3447	024	0	1	02	01	H3447_024_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3447	024	0	1	02	01	H3447_024_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3447	024	0	1	02	01	H3447_024_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3447	024	0	1	02	01	H3447_024_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3447	024	0	1	02	01	H3447_024_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3447	025	0	1	02	01	H3447_025_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H3447	025	0	1	02	01	H3447_025_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3447	025	0	1	02	01	H3447_025_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3447	025	0	1	02	01	H3447_025_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3447	025	0	1	02	01	H3447_025_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3447	025	0	1	02	01	H3447_025_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3447	033	0	1	02	01	H3447_033_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H3447	033	0	1	02	01	H3447_033_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3447	033	0	1	02	01	H3447_033_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3447	033	0	1	02	01	H3447_033_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3447	033	0	1	02	01	H3447_033_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3447	033	0	1	02	01	H3447_033_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3447	037	0	1	02	01	H3447_037_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3447	037	0	1	02	01	H3447_037_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3447	037	0	1	02	01	H3447_037_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3447	037	0	1	02	01	H3447_037_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3447	037	0	1	02	01	H3447_037_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3447	037	0	1	02	01	H3447_037_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3447	038	1	1	02	01	H3447_038_1	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3447	038	1	1	02	01	H3447_038_1	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3447	038	1	1	02	01	H3447_038_1	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3447	038	1	1	02	01	H3447_038_1	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3447	038	1	1	02	01	H3447_038_1	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3447	038	1	1	02	01	H3447_038_1	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3447	038	2	1	02	01	H3447_038_2	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3447	038	2	1	02	01	H3447_038_2	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3447	038	2	1	02	01	H3447_038_2	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3447	038	2	1	02	01	H3447_038_2	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3447	038	2	1	02	01	H3447_038_2	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3447	038	2	1	02	01	H3447_038_2	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3447	039	0	1	02	01	H3447_039_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	3	2	5.00	
H3447	039	0	1	02	01	H3447_039_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3447	039	0	1	02	01	H3447_039_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3447	039	0	1	02	01	H3447_039_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3447	039	0	1	02	01	H3447_039_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3447	039	0	1	02	01	H3447_039_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3447	042	1	1	02	01	H3447_042_1	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3447	042	1	1	02	01	H3447_042_1	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3447	042	1	1	02	01	H3447_042_1	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3447	042	1	1	02	01	H3447_042_1	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3447	042	1	1	02	01	H3447_042_1	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3447	042	1	1	02	01	H3447_042_1	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3447	042	2	1	02	01	H3447_042_2	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3447	042	2	1	02	01	H3447_042_2	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3447	042	2	1	02	01	H3447_042_2	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3447	042	2	1	02	01	H3447_042_2	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3447	042	2	1	02	01	H3447_042_2	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3447	042	2	1	02	01	H3447_042_2	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3447	042	3	1	02	01	H3447_042_3	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3447	042	3	1	02	01	H3447_042_3	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3447	042	3	1	02	01	H3447_042_3	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3447	042	3	1	02	01	H3447_042_3	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3447	042	3	1	02	01	H3447_042_3	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3447	042	3	1	02	01	H3447_042_3	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3447	042	4	1	02	01	H3447_042_4	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3447	042	4	1	02	01	H3447_042_4	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3447	042	4	1	02	01	H3447_042_4	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3447	042	4	1	02	01	H3447_042_4	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3447	042	4	1	02	01	H3447_042_4	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3447	042	4	1	02	01	H3447_042_4	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3447	049	0	1	02	01	H3447_049_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3447	049	0	1	02	01	H3447_049_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3447	049	0	1	02	01	H3447_049_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3447	049	0	1	02	01	H3447_049_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3447	049	0	1	02	01	H3447_049_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3447	050	0	1	02	01	H3447_050_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3447	050	0	1	02	01	H3447_050_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3447	050	0	1	02	01	H3447_050_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3447	050	0	1	02	01	H3447_050_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3447	050	0	1	02	01	H3447_050_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3447	051	0	1	02	01	H3447_051_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3447	051	0	1	02	01	H3447_051_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3447	051	0	1	02	01	H3447_051_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3447	051	0	1	02	01	H3447_051_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3447	051	0	1	02	01	H3447_051_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3447	052	0	1	02	01	H3447_052_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3447	052	0	1	02	01	H3447_052_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3447	052	0	1	02	01	H3447_052_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3447	052	0	1	02	01	H3447_052_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3447	052	0	1	02	01	H3447_052_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3447	053	0	1	01	01	H3447_053_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3447	053	0	1	01	01	H3447_053_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3447	053	0	1	01	01	H3447_053_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3447	053	0	1	01	01	H3447_053_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3447	053	0	1	01	01	H3447_053_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3447	053	0	1	01	01	H3447_053_0	5		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3447	056	0	1	02	01	H3447_056_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3447	056	0	1	02	01	H3447_056_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3447	056	0	1	02	01	H3447_056_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3447	056	0	1	02	01	H3447_056_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3447	056	0	1	02	01	H3447_056_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3447	056	0	1	02	01	H3447_056_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3449	023	1	1	02	01	H3449_023_1	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3449	023	1	1	02	01	H3449_023_1	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	3	2	0.00	
H3449	023	1	1	02	01	H3449_023_1	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3449	023	1	1	02	01	H3449_023_1	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3449	023	1	1	02	01	H3449_023_1	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3449	023	1	1	02	01	H3449_023_1	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3449	023	2	1	02	01	H3449_023_2	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3449	023	2	1	02	01	H3449_023_2	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	3	2	0.00	
H3449	023	2	1	02	01	H3449_023_2	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3449	023	2	1	02	01	H3449_023_2	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3449	023	2	1	02	01	H3449_023_2	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3449	023	2	1	02	01	H3449_023_2	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3449	023	4	1	02	01	H3449_023_4	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3449	023	4	1	02	01	H3449_023_4	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	3	2	0.00	
H3449	023	4	1	02	01	H3449_023_4	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3449	023	4	1	02	01	H3449_023_4	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3449	023	4	1	02	01	H3449_023_4	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3449	023	4	1	02	01	H3449_023_4	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3449	023	5	1	02	01	H3449_023_5	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3449	023	5	1	02	01	H3449_023_5	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	3	2	0.00	
H3449	023	5	1	02	01	H3449_023_5	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3449	023	5	1	02	01	H3449_023_5	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3449	023	5	1	02	01	H3449_023_5	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3449	023	5	1	02	01	H3449_023_5	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3449	024	1	1	02	01	H3449_024_1	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3449	024	1	1	02	01	H3449_024_1	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	3	2	0.00	
H3449	024	1	1	02	01	H3449_024_1	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3449	024	1	1	02	01	H3449_024_1	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3449	024	1	1	02	01	H3449_024_1	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3449	024	1	1	02	01	H3449_024_1	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3449	024	2	1	02	01	H3449_024_2	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3449	024	2	1	02	01	H3449_024_2	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	3	2	0.00	
H3449	024	2	1	02	01	H3449_024_2	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3449	024	2	1	02	01	H3449_024_2	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3449	024	2	1	02	01	H3449_024_2	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3449	024	2	1	02	01	H3449_024_2	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3449	024	3	1	02	01	H3449_024_3	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3449	024	3	1	02	01	H3449_024_3	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	3	2	0.00	
H3449	024	3	1	02	01	H3449_024_3	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3449	024	3	1	02	01	H3449_024_3	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3449	024	3	1	02	01	H3449_024_3	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3449	024	3	1	02	01	H3449_024_3	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3449	026	0	1	01	01	H3449_026_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3449	026	0	1	01	01	H3449_026_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	3	2	0.00	
H3449	026	0	1	01	01	H3449_026_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3449	026	0	1	01	01	H3449_026_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3449	026	0	1	01	01	H3449_026_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3449	026	0	1	01	01	H3449_026_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3449	027	1	1	01	01	H3449_027_1	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3449	027	1	1	01	01	H3449_027_1	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	3	2	0.00	
H3449	027	1	1	01	01	H3449_027_1	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3449	027	1	1	01	01	H3449_027_1	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3449	027	1	1	01	01	H3449_027_1	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3449	027	1	1	01	01	H3449_027_1	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3449	027	2	1	01	01	H3449_027_2	10			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3449	027	2	1	01	01	H3449_027_2	10			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	3	2	0.00	
H3449	027	2	1	01	01	H3449_027_2	10			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3449	027	2	1	01	01	H3449_027_2	10			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3449	027	2	1	01	01	H3449_027_2	10			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3449	027	2	1	01	01	H3449_027_2	10			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3467	005	0	1	02	01	H3467_005_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3467	005	0	1	02	01	H3467_005_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3467	005	0	1	02	01	H3467_005_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H3467	005	0	1	02	01	H3467_005_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	10	1	2	0.00	
H3467	005	0	1	02	01	H3467_005_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3499	002	0	1	02	01	H3499_002_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H3499	002	0	1	02	01	H3499_002_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3499	002	0	1	02	01	H3499_002_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3499	002	0	1	02	01	H3499_002_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3499	002	0	1	02	01	H3499_002_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3499	002	0	1	02	01	H3499_002_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3499	008	0	1	02	01	H3499_008_0	8			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3499	008	0	1	02	01	H3499_008_0	8			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3499	008	0	1	02	01	H3499_008_0	8			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3499	008	0	1	02	01	H3499_008_0	8			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3499	008	0	1	02	01	H3499_008_0	8			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3499	008	0	1	02	01	H3499_008_0	8			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3528	010	0	1	02	01	H3528_010_0	13			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3528	010	0	1	02	01	H3528_010_0	13			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3528	010	0	1	02	01	H3528_010_0	13			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3528	010	0	1	02	01	H3528_010_0	13			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3528	010	0	1	02	01	H3528_010_0	13			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3528	010	0	1	02	01	H3528_010_0	13			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H3528	011	1	1	02	01	H3528_011_1	13			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3528	011	1	1	02	01	H3528_011_1	13			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3528	011	1	1	02	01	H3528_011_1	13			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3528	011	1	1	02	01	H3528_011_1	13			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3528	011	1	1	02	01	H3528_011_1	13			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3528	011	1	1	02	01	H3528_011_1	13			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H3528	011	2	1	02	01	H3528_011_2	13			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3528	011	2	1	02	01	H3528_011_2	13			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3528	011	2	1	02	01	H3528_011_2	13			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3528	011	2	1	02	01	H3528_011_2	13			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3528	011	2	1	02	01	H3528_011_2	13			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3528	011	2	1	02	01	H3528_011_2	13			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H3528	014	0	1	02	01	H3528_014_0	13			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3528	014	0	1	02	01	H3528_014_0	13			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3528	014	0	1	02	01	H3528_014_0	13			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3528	014	0	1	02	01	H3528_014_0	13			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3528	014	0	1	02	01	H3528_014_0	13			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3528	014	0	1	02	01	H3528_014_0	13			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H3528	015	0	1	02	01	H3528_015_0	13			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3528	015	0	1	02	01	H3528_015_0	13			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3528	015	0	1	02	01	H3528_015_0	13			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3528	015	0	1	02	01	H3528_015_0	13			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3528	015	0	1	02	01	H3528_015_0	13			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3528	015	0	1	02	01	H3528_015_0	13			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H3528	016	0	1	02	01	H3528_016_0	14			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3528	016	0	1	02	01	H3528_016_0	14			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3528	016	0	1	02	01	H3528_016_0	14			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3528	016	0	1	02	01	H3528_016_0	14			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3528	016	0	1	02	01	H3528_016_0	14			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3528	016	0	1	02	01	H3528_016_0	14			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H3533	002	0	1	01	01	H3533_002_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3533	002	0	1	01	01	H3533_002_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3533	002	0	1	01	01	H3533_002_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3533	002	0	1	01	01	H3533_002_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3533	002	0	1	01	01	H3533_002_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3533	027	0	1	01	01	H3533_027_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3533	027	0	1	01	01	H3533_027_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3533	027	0	1	01	01	H3533_027_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3533	027	0	1	01	01	H3533_027_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3533	027	0	1	01	01	H3533_027_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3533	033	0	1	01	01	H3533_033_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H3533	033	0	1	01	01	H3533_033_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3533	033	0	1	01	01	H3533_033_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3533	033	0	1	01	01	H3533_033_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3533	033	0	1	01	01	H3533_033_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3533	034	1	1	01	01	H3533_034_1	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3533	034	1	1	01	01	H3533_034_1	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3533	034	1	1	01	01	H3533_034_1	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3533	034	1	1	01	01	H3533_034_1	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3533	034	1	1	01	01	H3533_034_1	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3533	034	2	1	01	01	H3533_034_2	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3533	034	2	1	01	01	H3533_034_2	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3533	034	2	1	01	01	H3533_034_2	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3533	034	2	1	01	01	H3533_034_2	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3533	034	2	1	01	01	H3533_034_2	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3533	035	0	1	01	01	H3533_035_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H3533	035	0	1	01	01	H3533_035_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3533	035	0	1	01	01	H3533_035_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3533	035	0	1	01	01	H3533_035_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3533	035	0	1	01	01	H3533_035_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3551	001	0	1	01	01	H3551_001_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3551	001	0	1	01	01	H3551_001_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3551	001	0	1	01	01	H3551_001_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3551	001	0	1	01	01	H3551_001_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3551	001	0	1	01	01	H3551_001_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3551	002	0	1	01	01	H3551_002_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3551	002	0	1	01	01	H3551_002_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3551	002	0	1	01	01	H3551_002_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3551	002	0	1	01	01	H3551_002_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3551	002	0	1	01	01	H3551_002_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3551	004	0	1	01	01	H3551_004_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3551	004	0	1	01	01	H3551_004_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3551	004	0	1	01	01	H3551_004_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3551	004	0	1	01	01	H3551_004_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3551	004	0	1	01	01	H3551_004_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3561	007	0	1	01	01	H3561_007_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3561	007	0	1	01	01	H3561_007_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3561	007	0	1	01	01	H3561_007_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3561	007	0	1	01	01	H3561_007_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3561	007	0	1	01	01	H3561_007_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3561	007	0	1	01	01	H3561_007_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3561	008	0	1	01	01	H3561_008_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3561	008	0	1	01	01	H3561_008_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3561	008	0	1	01	01	H3561_008_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3561	008	0	1	01	01	H3561_008_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3561	008	0	1	01	01	H3561_008_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3561	008	0	1	01	01	H3561_008_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3561	009	0	1	01	01	H3561_009_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3561	009	0	1	01	01	H3561_009_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3561	009	0	1	01	01	H3561_009_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3561	009	0	1	01	01	H3561_009_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3561	009	0	1	01	01	H3561_009_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3561	009	0	1	01	01	H3561_009_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3597	001	0	1	02	01	H3597_001_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3597	001	0	1	02	01	H3597_001_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3597	001	0	1	02	01	H3597_001_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3597	001	0	1	02	01	H3597_001_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3597	001	0	1	02	01	H3597_001_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3597	011	0	1	02	01	H3597_011_0	2		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3597	011	0	1	02	01	H3597_011_0	2		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3597	011	0	1	02	01	H3597_011_0	2		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3597	011	0	1	02	01	H3597_011_0	2		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3597	011	0	1	02	01	H3597_011_0	2		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3597	012	0	1	02	01	H3597_012_0	2		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3597	012	0	1	02	01	H3597_012_0	2		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3597	012	0	1	02	01	H3597_012_0	2		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3597	012	0	1	02	01	H3597_012_0	2		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3597	012	0	1	02	01	H3597_012_0	2		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3597	017	0	1	02	01	H3597_017_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3597	017	0	1	02	01	H3597_017_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3597	017	0	1	02	01	H3597_017_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3597	017	0	1	02	01	H3597_017_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3597	017	0	1	02	01	H3597_017_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3597	018	0	1	02	01	H3597_018_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3597	018	0	1	02	01	H3597_018_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3597	018	0	1	02	01	H3597_018_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3597	018	0	1	02	01	H3597_018_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3597	018	0	1	02	01	H3597_018_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3653	004	0	1	02	01	H3653_004_0	12			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3653	004	0	1	02	01	H3653_004_0	12			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3653	004	0	1	02	01	H3653_004_0	12			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3653	004	0	1	02	01	H3653_004_0	12			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3653	004	0	1	02	01	H3653_004_0	12			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3653	015	0	1	02	01	H3653_015_0	15			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3653	015	0	1	02	01	H3653_015_0	15			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3653	015	0	1	02	01	H3653_015_0	15			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3653	015	0	1	02	01	H3653_015_0	15			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3653	015	0	1	02	01	H3653_015_0	15			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3653	022	0	1	02	01	H3653_022_0	13			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3653	022	0	1	02	01	H3653_022_0	13			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3653	022	0	1	02	01	H3653_022_0	13			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3653	022	0	1	02	01	H3653_022_0	13			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3653	022	0	1	02	01	H3653_022_0	13			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3655	041	0	1	02	01	H3655_041_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3655	041	0	1	02	01	H3655_041_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3655	041	0	1	02	01	H3655_041_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3655	041	0	1	02	01	H3655_041_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3655	041	0	1	02	01	H3655_041_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3655	041	0	1	02	01	H3655_041_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3655	045	1	1	02	01	H3655_045_1	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3655	045	1	1	02	01	H3655_045_1	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3655	045	1	1	02	01	H3655_045_1	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3655	045	1	1	02	01	H3655_045_1	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3655	045	1	1	02	01	H3655_045_1	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3655	045	1	1	02	01	H3655_045_1	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3655	045	2	1	02	01	H3655_045_2	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3655	045	2	1	02	01	H3655_045_2	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3655	045	2	1	02	01	H3655_045_2	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3655	045	2	1	02	01	H3655_045_2	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3655	045	2	1	02	01	H3655_045_2	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3655	045	2	1	02	01	H3655_045_2	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3655	045	3	1	02	01	H3655_045_3	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3655	045	3	1	02	01	H3655_045_3	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3655	045	3	1	02	01	H3655_045_3	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3655	045	3	1	02	01	H3655_045_3	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3655	045	3	1	02	01	H3655_045_3	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3655	045	3	1	02	01	H3655_045_3	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3655	045	4	1	02	01	H3655_045_4	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3655	045	4	1	02	01	H3655_045_4	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3655	045	4	1	02	01	H3655_045_4	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3655	045	4	1	02	01	H3655_045_4	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3655	045	4	1	02	01	H3655_045_4	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3655	045	4	1	02	01	H3655_045_4	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3660	028	0	1	02	01	H3660_028_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3660	028	0	1	02	01	H3660_028_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3660	028	0	1	02	01	H3660_028_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	3	2	0.00	
H3660	028	0	1	02	01	H3660_028_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3660	028	0	1	02	01	H3660_028_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3660	028	0	1	02	01	H3660_028_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3660	029	0	1	02	01	H3660_029_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3660	029	0	1	02	01	H3660_029_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3660	029	0	1	02	01	H3660_029_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	3	2	0.00	
H3660	029	0	1	02	01	H3660_029_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3660	029	0	1	02	01	H3660_029_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3660	029	0	1	02	01	H3660_029_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3660	044	0	1	01	01	H3660_044_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3660	044	0	1	01	01	H3660_044_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3660	044	0	1	01	01	H3660_044_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	3	2	0.00	
H3660	044	0	1	01	01	H3660_044_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3660	044	0	1	01	01	H3660_044_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3660	044	0	1	01	01	H3660_044_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3660	050	0	1	01	01	H3660_050_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3660	050	0	1	01	01	H3660_050_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3660	050	0	1	01	01	H3660_050_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	3	2	0.00	
H3660	050	0	1	01	01	H3660_050_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3660	050	0	1	01	01	H3660_050_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3660	050	0	1	01	01	H3660_050_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3660	053	1	1	01	01	H3660_053_1	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3660	053	1	1	01	01	H3660_053_1	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3660	053	1	1	01	01	H3660_053_1	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	3	2	0.00	
H3660	053	1	1	01	01	H3660_053_1	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3660	053	1	1	01	01	H3660_053_1	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3660	053	1	1	01	01	H3660_053_1	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3660	053	2	1	01	01	H3660_053_2	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3660	053	2	1	01	01	H3660_053_2	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3660	053	2	1	01	01	H3660_053_2	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	3	2	0.00	
H3660	053	2	1	01	01	H3660_053_2	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3660	053	2	1	01	01	H3660_053_2	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3660	053	2	1	01	01	H3660_053_2	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3660	057	0	1	01	01	H3660_057_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3660	057	0	1	01	01	H3660_057_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3660	057	0	1	01	01	H3660_057_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	3	2	0.00	
H3660	057	0	1	01	01	H3660_057_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3660	057	0	1	01	01	H3660_057_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3660	057	0	1	01	01	H3660_057_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3664	017	0	1	02	01	H3664_017_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3664	017	0	1	02	01	H3664_017_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3664	017	0	1	02	01	H3664_017_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3664	017	0	1	02	01	H3664_017_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3664	017	0	1	02	01	H3664_017_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3664	020	0	1	02	01	H3664_020_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3664	020	0	1	02	01	H3664_020_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3664	020	0	1	02	01	H3664_020_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3664	020	0	1	02	01	H3664_020_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3664	020	0	1	02	01	H3664_020_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3664	021	0	1	02	01	H3664_021_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3664	021	0	1	02	01	H3664_021_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3664	021	0	1	02	01	H3664_021_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3664	021	0	1	02	01	H3664_021_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3664	021	0	1	02	01	H3664_021_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3668	018	1	1	01	01	H3668_018_1	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3668	018	1	1	01	01	H3668_018_1	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	5.00	
H3668	018	1	1	01	01	H3668_018_1	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3668	018	1	1	01	01	H3668_018_1	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3668	018	1	1	01	01	H3668_018_1	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3668	018	2	1	01	01	H3668_018_2	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3668	018	2	1	01	01	H3668_018_2	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	5.00	
H3668	018	2	1	01	01	H3668_018_2	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3668	018	2	1	01	01	H3668_018_2	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3668	018	2	1	01	01	H3668_018_2	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3668	019	1	1	01	01	H3668_019_1	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3668	019	1	1	01	01	H3668_019_1	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	5.00	
H3668	019	1	1	01	01	H3668_019_1	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3668	019	1	1	01	01	H3668_019_1	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3668	019	1	1	01	01	H3668_019_1	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3668	019	2	1	01	01	H3668_019_2	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3668	019	2	1	01	01	H3668_019_2	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	5.00	
H3668	019	2	1	01	01	H3668_019_2	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3668	019	2	1	01	01	H3668_019_2	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3668	019	2	1	01	01	H3668_019_2	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3668	020	0	1	01	01	H3668_020_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3668	020	0	1	01	01	H3668_020_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	5.00	
H3668	020	0	1	01	01	H3668_020_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3668	020	0	1	01	01	H3668_020_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3668	020	0	1	01	01	H3668_020_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3668	022	0	1	01	01	H3668_022_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3668	022	0	1	01	01	H3668_022_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	10.00	
H3668	022	0	1	01	01	H3668_022_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3668	022	0	1	01	01	H3668_022_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3668	022	0	1	01	01	H3668_022_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3668	023	0	1	01	01	H3668_023_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3668	023	0	1	01	01	H3668_023_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	10.00	
H3668	023	0	1	01	01	H3668_023_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3668	023	0	1	01	01	H3668_023_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3668	023	0	1	01	01	H3668_023_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3668	025	0	1	01	01	H3668_025_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3668	025	0	1	01	01	H3668_025_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H3668	025	0	1	01	01	H3668_025_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3668	025	0	1	01	01	H3668_025_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3668	025	0	1	01	01	H3668_025_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3668	026	0	1	01	01	H3668_026_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3668	026	0	1	01	01	H3668_026_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H3668	026	0	1	01	01	H3668_026_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3668	026	0	1	01	01	H3668_026_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3668	026	0	1	01	01	H3668_026_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3668	030	0	1	01	01	H3668_030_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3668	030	0	1	01	01	H3668_030_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	5.00	
H3668	030	0	1	01	01	H3668_030_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3668	030	0	1	01	01	H3668_030_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3668	030	0	1	01	01	H3668_030_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3668	031	0	1	01	01	H3668_031_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3668	031	0	1	01	01	H3668_031_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	5.00	
H3668	031	0	1	01	01	H3668_031_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3668	031	0	1	01	01	H3668_031_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3668	031	0	1	01	01	H3668_031_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3672	013	0	1	01	01	H3672_013_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3672	013	0	1	01	01	H3672_013_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3672	013	0	1	01	01	H3672_013_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3672	013	0	1	01	01	H3672_013_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3672	013	0	1	01	01	H3672_013_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3672	019	0	1	01	01	H3672_019_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3672	019	0	1	01	01	H3672_019_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3672	019	0	1	01	01	H3672_019_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3672	019	0	1	01	01	H3672_019_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3672	019	0	1	01	01	H3672_019_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3672	020	0	1	01	01	H3672_020_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3672	020	0	1	01	01	H3672_020_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3672	020	0	1	01	01	H3672_020_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3672	020	0	1	01	01	H3672_020_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3672	020	0	1	01	01	H3672_020_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3672	023	0	1	01	01	H3672_023_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3672	023	0	1	01	01	H3672_023_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3672	023	0	1	01	01	H3672_023_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3672	023	0	1	01	01	H3672_023_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3672	023	0	1	01	01	H3672_023_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3706	001	0	1	01	01	H3706_001_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H3706	001	0	1	01	01	H3706_001_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H3706	001	0	1	01	01	H3706_001_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3706	001	0	1	01	01	H3706_001_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3706	001	0	1	01	01	H3706_001_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3706	023	0	1	01	01	H3706_023_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H3706	023	0	1	01	01	H3706_023_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H3706	023	0	1	01	01	H3706_023_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3706	023	0	1	01	01	H3706_023_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3706	023	0	1	01	01	H3706_023_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3706	024	0	1	01	01	H3706_024_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H3706	024	0	1	01	01	H3706_024_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H3706	024	0	1	01	01	H3706_024_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3706	024	0	1	01	01	H3706_024_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3706	024	0	1	01	01	H3706_024_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3706	025	0	1	01	01	H3706_025_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H3706	025	0	1	01	01	H3706_025_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H3706	025	0	1	01	01	H3706_025_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3706	025	0	1	01	01	H3706_025_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3706	025	0	1	01	01	H3706_025_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3727	001	2	1	01	01	H3727_001_2	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3727	001	2	1	01	01	H3727_001_2	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3727	001	2	1	01	01	H3727_001_2	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3727	001	2	1	01	01	H3727_001_2	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3727	001	2	1	01	01	H3727_001_2	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3727	001	3	1	01	01	H3727_001_3	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3727	001	3	1	01	01	H3727_001_3	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3727	001	3	1	01	01	H3727_001_3	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3727	001	3	1	01	01	H3727_001_3	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3727	001	3	1	01	01	H3727_001_3	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3748	003	0	1	01	01	H3748_003_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3748	003	0	1	01	01	H3748_003_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3748	003	0	1	01	01	H3748_003_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3748	003	0	1	01	01	H3748_003_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3748	003	0	1	01	01	H3748_003_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3755	001	0	1	01	01	H3755_001_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3755	001	0	1	01	01	H3755_001_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3755	001	0	1	01	01	H3755_001_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3755	001	0	1	01	01	H3755_001_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3755	001	0	1	01	01	H3755_001_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3755	004	0	1	01	01	H3755_004_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3755	004	0	1	01	01	H3755_004_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3755	004	0	1	01	01	H3755_004_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3755	004	0	1	01	01	H3755_004_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3755	004	0	1	01	01	H3755_004_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3755	005	0	1	01	01	H3755_005_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3755	005	0	1	01	01	H3755_005_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3755	005	0	1	01	01	H3755_005_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3755	005	0	1	01	01	H3755_005_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3755	005	0	1	01	01	H3755_005_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3755	006	0	1	01	01	H3755_006_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3755	006	0	1	01	01	H3755_006_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3755	006	0	1	01	01	H3755_006_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3755	006	0	1	01	01	H3755_006_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3755	006	0	1	01	01	H3755_006_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3777	002	0	1	01	01	H3777_002_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3777	002	0	1	01	01	H3777_002_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3777	002	0	1	01	01	H3777_002_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3777	002	0	1	01	01	H3777_002_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3777	002	0	1	01	01	H3777_002_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3777	002	0	1	01	01	H3777_002_0	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3794	002	0	1	02	01	H3794_002_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3794	002	0	1	02	01	H3794_002_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3794	002	0	1	02	01	H3794_002_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3794	002	0	1	02	01	H3794_002_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3794	002	0	1	02	01	H3794_002_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3794	004	0	1	02	01	H3794_004_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3794	004	0	1	02	01	H3794_004_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3794	004	0	1	02	01	H3794_004_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3794	004	0	1	02	01	H3794_004_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3794	004	0	1	02	01	H3794_004_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3794	006	0	1	02	01	H3794_006_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3794	006	0	1	02	01	H3794_006_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3794	006	0	1	02	01	H3794_006_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3794	006	0	1	02	01	H3794_006_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3794	006	0	1	02	01	H3794_006_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3805	001	0	1	02	01	H3805_001_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3805	001	0	1	02	01	H3805_001_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	5.00	
H3805	001	0	1	02	01	H3805_001_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3805	001	0	1	02	01	H3805_001_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3805	001	0	1	02	01	H3805_001_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3805	015	0	1	02	01	H3805_015_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3805	015	0	1	02	01	H3805_015_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H3805	015	0	1	02	01	H3805_015_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3805	015	0	1	02	01	H3805_015_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3805	015	0	1	02	01	H3805_015_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3805	017	0	1	02	01	H3805_017_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3805	017	0	1	02	01	H3805_017_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H3805	017	0	1	02	01	H3805_017_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3805	017	0	1	02	01	H3805_017_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3805	017	0	1	02	01	H3805_017_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3805	032	0	1	02	01	H3805_032_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3805	032	0	1	02	01	H3805_032_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H3805	032	0	1	02	01	H3805_032_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3805	032	0	1	02	01	H3805_032_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3805	032	0	1	02	01	H3805_032_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3805	033	0	1	02	01	H3805_033_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3805	033	0	1	02	01	H3805_033_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H3805	033	0	1	02	01	H3805_033_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3805	033	0	1	02	01	H3805_033_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3805	033	0	1	02	01	H3805_033_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3805	034	0	1	02	01	H3805_034_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3805	034	0	1	02	01	H3805_034_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H3805	034	0	1	02	01	H3805_034_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3805	034	0	1	02	01	H3805_034_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3805	034	0	1	02	01	H3805_034_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3805	037	0	1	02	01	H3805_037_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3805	037	0	1	02	01	H3805_037_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H3805	037	0	1	02	01	H3805_037_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3805	037	0	1	02	01	H3805_037_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3805	037	0	1	02	01	H3805_037_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3805	039	1	1	02	01	H3805_039_1	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3805	039	1	1	02	01	H3805_039_1	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	5.00	
H3805	039	1	1	02	01	H3805_039_1	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3805	039	1	1	02	01	H3805_039_1	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3805	039	1	1	02	01	H3805_039_1	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3805	039	2	1	02	01	H3805_039_2	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3805	039	2	1	02	01	H3805_039_2	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	5.00	
H3805	039	2	1	02	01	H3805_039_2	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3805	039	2	1	02	01	H3805_039_2	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3805	039	2	1	02	01	H3805_039_2	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3805	040	0	1	02	01	H3805_040_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3805	040	0	1	02	01	H3805_040_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	5.00	
H3805	040	0	1	02	01	H3805_040_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3805	040	0	1	02	01	H3805_040_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3805	040	0	1	02	01	H3805_040_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3805	041	0	1	02	01	H3805_041_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3805	041	0	1	02	01	H3805_041_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H3805	041	0	1	02	01	H3805_041_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3805	041	0	1	02	01	H3805_041_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3805	041	0	1	02	01	H3805_041_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3805	043	0	1	02	01	H3805_043_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3805	043	0	1	02	01	H3805_043_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H3805	043	0	1	02	01	H3805_043_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3805	043	0	1	02	01	H3805_043_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3805	043	0	1	02	01	H3805_043_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3805	044	0	1	02	01	H3805_044_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3805	044	0	1	02	01	H3805_044_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H3805	044	0	1	02	01	H3805_044_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3805	044	0	1	02	01	H3805_044_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3805	044	0	1	02	01	H3805_044_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3805	045	0	1	02	01	H3805_045_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3805	045	0	1	02	01	H3805_045_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H3805	045	0	1	02	01	H3805_045_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3805	045	0	1	02	01	H3805_045_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3805	045	0	1	02	01	H3805_045_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3811	003	0	1	01	01	H3811_003_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3811	003	0	1	01	01	H3811_003_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3811	003	0	1	01	01	H3811_003_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3811	003	0	1	01	01	H3811_003_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3811	003	0	1	01	01	H3811_003_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3811	003	0	1	01	01	H3811_003_0	5		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3815	001	0	1	01	01	H3815_001_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3815	001	0	1	01	01	H3815_001_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3815	001	0	1	01	01	H3815_001_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	3	2	30.00	
H3815	001	0	1	01	01	H3815_001_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	3	2	100.00	
H3815	001	0	1	01	01	H3815_001_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3815	001	0	1	01	01	H3815_001_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H3815	008	0	1	01	01	H3815_008_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3815	008	0	1	01	01	H3815_008_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3815	008	0	1	01	01	H3815_008_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	3	2	30.00	
H3815	008	0	1	01	01	H3815_008_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	3	2	75.00	
H3815	008	0	1	01	01	H3815_008_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3815	008	0	1	01	01	H3815_008_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H3815	010	0	1	01	01	H3815_010_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3815	010	0	1	01	01	H3815_010_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3815	010	0	1	01	01	H3815_010_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	3	2	30.00	
H3815	010	0	1	01	01	H3815_010_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	3	1		40
H3815	010	0	1	01	01	H3815_010_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3815	010	0	1	01	01	H3815_010_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H3815	011	0	1	01	01	H3815_011_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3815	011	0	1	01	01	H3815_011_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3815	011	0	1	01	01	H3815_011_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	3	2	40.00	
H3815	011	0	1	01	01	H3815_011_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	3	2	93.00	
H3815	011	0	1	01	01	H3815_011_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3815	011	0	1	01	01	H3815_011_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H3815	013	0	1	01	01	H3815_013_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3815	013	0	1	01	01	H3815_013_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3815	013	0	1	01	01	H3815_013_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	3	2	30.00	
H3815	013	0	1	01	01	H3815_013_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	3	2	100.00	
H3815	013	0	1	01	01	H3815_013_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3815	013	0	1	01	01	H3815_013_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H3815	016	0	1	02	01	H3815_016_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3815	016	0	1	02	01	H3815_016_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3815	016	0	1	02	01	H3815_016_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	3	2	30.00	
H3815	016	0	1	02	01	H3815_016_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	3	2	75.00	
H3815	016	0	1	02	01	H3815_016_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3815	016	0	1	02	01	H3815_016_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H3815	019	0	1	01	01	H3815_019_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3815	019	0	1	01	01	H3815_019_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3815	019	0	1	01	01	H3815_019_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	3	2	40.00	
H3815	019	0	1	01	01	H3815_019_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	3	1		32
H3815	019	0	1	01	01	H3815_019_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3815	019	0	1	01	01	H3815_019_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H3815	020	0	1	01	01	H3815_020_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3815	020	0	1	01	01	H3815_020_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3815	020	0	1	01	01	H3815_020_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	3	2	40.00	
H3815	020	0	1	01	01	H3815_020_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	3	1		32
H3815	020	0	1	01	01	H3815_020_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3815	020	0	1	01	01	H3815_020_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H3815	021	0	1	01	01	H3815_021_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3815	021	0	1	01	01	H3815_021_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3815	021	0	1	01	01	H3815_021_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	3	2	40.00	
H3815	021	0	1	01	01	H3815_021_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	3	1		32
H3815	021	0	1	01	01	H3815_021_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3815	021	0	1	01	01	H3815_021_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H3815	023	0	1	01	01	H3815_023_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3815	023	0	1	01	01	H3815_023_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3815	023	0	1	01	01	H3815_023_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	3	2	40.00	
H3815	023	0	1	01	01	H3815_023_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	3	1		32
H3815	023	0	1	01	01	H3815_023_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3815	023	0	1	01	01	H3815_023_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H3815	028	0	1	01	01	H3815_028_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3815	028	0	1	01	01	H3815_028_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3815	028	0	1	01	01	H3815_028_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	3	2	40.00	
H3815	028	0	1	01	01	H3815_028_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	3	1		32
H3815	028	0	1	01	01	H3815_028_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3815	028	0	1	01	01	H3815_028_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H3815	030	0	1	01	01	H3815_030_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3815	030	0	1	01	01	H3815_030_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3815	030	0	1	01	01	H3815_030_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3815	030	0	1	01	01	H3815_030_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3815	030	0	1	01	01	H3815_030_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3815	030	0	1	01	01	H3815_030_0	6		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H3815	031	0	1	01	01	H3815_031_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3815	031	0	1	01	01	H3815_031_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3815	031	0	1	01	01	H3815_031_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	3	2	40.00	
H3815	031	0	1	01	01	H3815_031_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	3	2	100.00	
H3815	031	0	1	01	01	H3815_031_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3815	031	0	1	01	01	H3815_031_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H3815	033	0	1	01	01	H3815_033_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3815	033	0	1	01	01	H3815_033_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3815	033	0	1	01	01	H3815_033_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	3	2	40.00	
H3815	033	0	1	01	01	H3815_033_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	3	2	100.00	
H3815	033	0	1	01	01	H3815_033_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3815	033	0	1	01	01	H3815_033_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H3815	034	0	1	01	01	H3815_034_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3815	034	0	1	01	01	H3815_034_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3815	034	0	1	01	01	H3815_034_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	3	2	40.00	
H3815	034	0	1	01	01	H3815_034_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	3	2	100.00	
H3815	034	0	1	01	01	H3815_034_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3815	034	0	1	01	01	H3815_034_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H3815	035	0	1	01	01	H3815_035_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3815	035	0	1	01	01	H3815_035_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3815	035	0	1	01	01	H3815_035_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	3	2	45.00	
H3815	035	0	1	01	01	H3815_035_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	3	2	100.00	
H3815	035	0	1	01	01	H3815_035_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3815	035	0	1	01	01	H3815_035_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H3815	038	0	1	01	01	H3815_038_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3815	038	0	1	01	01	H3815_038_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3815	038	0	1	01	01	H3815_038_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	3	2	47.00	
H3815	038	0	1	01	01	H3815_038_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	3	2	100.00	
H3815	038	0	1	01	01	H3815_038_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3815	038	0	1	01	01	H3815_038_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H3815	039	0	1	01	01	H3815_039_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3815	039	0	1	01	01	H3815_039_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3815	039	0	1	01	01	H3815_039_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3815	039	0	1	01	01	H3815_039_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3815	039	0	1	01	01	H3815_039_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3815	039	0	1	01	01	H3815_039_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H3815	040	0	1	01	01	H3815_040_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3815	040	0	1	01	01	H3815_040_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3815	040	0	1	01	01	H3815_040_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	3	2	45.00	
H3815	040	0	1	01	01	H3815_040_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	3	2	100.00	
H3815	040	0	1	01	01	H3815_040_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3815	040	0	1	01	01	H3815_040_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H3815	041	0	1	01	01	H3815_041_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3815	041	0	1	01	01	H3815_041_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3815	041	0	1	01	01	H3815_041_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3815	041	0	1	01	01	H3815_041_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3815	041	0	1	01	01	H3815_041_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3815	041	0	1	01	01	H3815_041_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H3815	042	0	1	01	01	H3815_042_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3815	042	0	1	01	01	H3815_042_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3815	042	0	1	01	01	H3815_042_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3815	042	0	1	01	01	H3815_042_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3815	042	0	1	01	01	H3815_042_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3815	042	0	1	01	01	H3815_042_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H3815	044	0	1	01	01	H3815_044_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3815	044	0	1	01	01	H3815_044_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3815	044	0	1	01	01	H3815_044_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3815	044	0	1	01	01	H3815_044_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3815	044	0	1	01	01	H3815_044_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3815	044	0	1	01	01	H3815_044_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H3815	045	0	1	01	01	H3815_045_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3815	045	0	1	01	01	H3815_045_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3815	045	0	1	01	01	H3815_045_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3815	045	0	1	01	01	H3815_045_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3815	045	0	1	01	01	H3815_045_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3815	045	0	1	01	01	H3815_045_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H3815	046	0	1	01	01	H3815_046_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3815	046	0	1	01	01	H3815_046_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3815	046	0	1	01	01	H3815_046_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	3	2	40.00	
H3815	046	0	1	01	01	H3815_046_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	3	2	100.00	
H3815	046	0	1	01	01	H3815_046_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3815	046	0	1	01	01	H3815_046_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H3815	047	0	1	01	01	H3815_047_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3815	047	0	1	01	01	H3815_047_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3815	047	0	1	01	01	H3815_047_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	3	2	30.00	
H3815	047	0	1	01	01	H3815_047_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	3	2	100.00	
H3815	047	0	1	01	01	H3815_047_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3815	047	0	1	01	01	H3815_047_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H3815	048	0	1	01	01	H3815_048_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3815	048	0	1	01	01	H3815_048_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3815	048	0	1	01	01	H3815_048_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	3	2	30.00	
H3815	048	0	1	01	01	H3815_048_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	3	1		50
H3815	048	0	1	01	01	H3815_048_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3815	048	0	1	01	01	H3815_048_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H3815	049	0	1	01	01	H3815_049_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3815	049	0	1	01	01	H3815_049_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3815	049	0	1	01	01	H3815_049_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	3	2	30.00	
H3815	049	0	1	01	01	H3815_049_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	3	2	100.00	
H3815	049	0	1	01	01	H3815_049_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3815	049	0	1	01	01	H3815_049_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H3815	050	0	1	01	01	H3815_050_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3815	050	0	1	01	01	H3815_050_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3815	050	0	1	01	01	H3815_050_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	3	2	40.00	
H3815	050	0	1	01	01	H3815_050_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	3	2	100.00	
H3815	050	0	1	01	01	H3815_050_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3815	050	0	1	01	01	H3815_050_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H3815	051	0	1	01	01	H3815_051_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3815	051	0	1	01	01	H3815_051_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3815	051	0	1	01	01	H3815_051_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3815	051	0	1	01	01	H3815_051_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3815	051	0	1	01	01	H3815_051_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3815	051	0	1	01	01	H3815_051_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H3815	052	0	1	01	01	H3815_052_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3815	052	0	1	01	01	H3815_052_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3815	052	0	1	01	01	H3815_052_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3815	052	0	1	01	01	H3815_052_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3815	052	0	1	01	01	H3815_052_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3815	052	0	1	01	01	H3815_052_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H3815	053	0	1	01	01	H3815_053_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3815	053	0	1	01	01	H3815_053_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3815	053	0	1	01	01	H3815_053_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	3	2	30.00	
H3815	053	0	1	01	01	H3815_053_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	3	2	100.00	
H3815	053	0	1	01	01	H3815_053_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3815	053	0	1	01	01	H3815_053_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H3815	054	0	1	01	01	H3815_054_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3815	054	0	1	01	01	H3815_054_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3815	054	0	1	01	01	H3815_054_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	3	2	30.00	
H3815	054	0	1	01	01	H3815_054_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	3	1		40
H3815	054	0	1	01	01	H3815_054_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3815	054	0	1	01	01	H3815_054_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H3815	055	0	1	01	01	H3815_055_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3815	055	0	1	01	01	H3815_055_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3815	055	0	1	01	01	H3815_055_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	3	2	42.00	
H3815	055	0	1	01	01	H3815_055_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	3	1		45
H3815	055	0	1	01	01	H3815_055_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3815	055	0	1	01	01	H3815_055_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H3815	056	0	1	01	01	H3815_056_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3815	056	0	1	01	01	H3815_056_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3815	056	0	1	01	01	H3815_056_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	3	2	47.00	
H3815	056	0	1	01	01	H3815_056_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	3	1		45
H3815	056	0	1	01	01	H3815_056_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3815	056	0	1	01	01	H3815_056_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H3817	008	1	1	04	01	H3817_008_1	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3817	008	1	1	04	01	H3817_008_1	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3817	008	1	1	04	01	H3817_008_1	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3817	008	1	1	04	01	H3817_008_1	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3817	008	1	1	04	01	H3817_008_1	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3817	008	2	1	04	01	H3817_008_2	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3817	008	2	1	04	01	H3817_008_2	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3817	008	2	1	04	01	H3817_008_2	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3817	008	2	1	04	01	H3817_008_2	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3817	008	2	1	04	01	H3817_008_2	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3817	008	4	1	04	01	H3817_008_4	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3817	008	4	1	04	01	H3817_008_4	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3817	008	4	1	04	01	H3817_008_4	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3817	008	4	1	04	01	H3817_008_4	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3817	008	4	1	04	01	H3817_008_4	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3817	009	1	1	04	01	H3817_009_1	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3817	009	1	1	04	01	H3817_009_1	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3817	009	1	1	04	01	H3817_009_1	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3817	009	1	1	04	01	H3817_009_1	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3817	009	1	1	04	01	H3817_009_1	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3817	009	2	1	04	01	H3817_009_2	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3817	009	2	1	04	01	H3817_009_2	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3817	009	2	1	04	01	H3817_009_2	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3817	009	2	1	04	01	H3817_009_2	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3817	009	2	1	04	01	H3817_009_2	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3817	011	1	1	04	01	H3817_011_1	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3817	011	1	1	04	01	H3817_011_1	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3817	011	1	1	04	01	H3817_011_1	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3817	011	1	1	04	01	H3817_011_1	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3817	011	1	1	04	01	H3817_011_1	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3817	011	2	1	04	01	H3817_011_2	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3817	011	2	1	04	01	H3817_011_2	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3817	011	2	1	04	01	H3817_011_2	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3817	011	2	1	04	01	H3817_011_2	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3817	011	2	1	04	01	H3817_011_2	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3817	011	3	1	04	01	H3817_011_3	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3817	011	3	1	04	01	H3817_011_3	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3817	011	3	1	04	01	H3817_011_3	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3817	011	3	1	04	01	H3817_011_3	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3817	011	3	1	04	01	H3817_011_3	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3822	001	0	1	01	01	H3822_001_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3822	001	0	1	01	01	H3822_001_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3822	001	0	1	01	01	H3822_001_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3822	001	0	1	01	01	H3822_001_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3822	001	0	1	01	01	H3822_001_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3822	002	0	1	01	01	H3822_002_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3822	002	0	1	01	01	H3822_002_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3822	002	0	1	01	01	H3822_002_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3822	002	0	1	01	01	H3822_002_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3822	002	0	1	01	01	H3822_002_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3822	007	0	1	02	01	H3822_007_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3822	007	0	1	02	01	H3822_007_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3822	007	0	1	02	01	H3822_007_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3822	007	0	1	02	01	H3822_007_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3822	007	0	1	02	01	H3822_007_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3822	008	0	1	02	01	H3822_008_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3822	008	0	1	02	01	H3822_008_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3822	008	0	1	02	01	H3822_008_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3822	008	0	1	02	01	H3822_008_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3822	008	0	1	02	01	H3822_008_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3822	012	0	1	01	01	H3822_012_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3822	012	0	1	01	01	H3822_012_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3822	012	0	1	01	01	H3822_012_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3822	012	0	1	01	01	H3822_012_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3822	012	0	1	01	01	H3822_012_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3822	014	0	1	01	01	H3822_014_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3822	014	0	1	01	01	H3822_014_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3822	014	0	1	01	01	H3822_014_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3822	014	0	1	01	01	H3822_014_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3822	014	0	1	01	01	H3822_014_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3828	001	0	1	04	01	H3828_001_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3828	001	0	1	04	01	H3828_001_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	20.00	
H3828	001	0	1	04	01	H3828_001_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3828	001	0	1	04	01	H3828_001_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3828	001	0	1	04	01	H3828_001_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3832	007	0	1	04	01	H3832_007_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3832	007	0	1	04	01	H3832_007_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3832	007	0	1	04	01	H3832_007_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3832	007	0	1	04	01	H3832_007_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3832	007	0	1	04	01	H3832_007_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3832	008	0	1	04	01	H3832_008_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3832	008	0	1	04	01	H3832_008_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3832	008	0	1	04	01	H3832_008_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3832	008	0	1	04	01	H3832_008_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3832	008	0	1	04	01	H3832_008_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3832	009	0	1	04	01	H3832_009_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3832	009	0	1	04	01	H3832_009_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3832	009	0	1	04	01	H3832_009_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3832	009	0	1	04	01	H3832_009_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3832	009	0	1	04	01	H3832_009_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3832	010	0	1	04	01	H3832_010_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3832	010	0	1	04	01	H3832_010_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3832	010	0	1	04	01	H3832_010_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3832	010	0	1	04	01	H3832_010_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3832	010	0	1	04	01	H3832_010_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3864	006	0	1	01	01	H3864_006_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3864	006	0	1	01	01	H3864_006_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3864	006	0	1	01	01	H3864_006_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H3864	006	0	1	01	01	H3864_006_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3864	006	0	1	01	01	H3864_006_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3864	014	0	1	02	01	H3864_014_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3864	014	0	1	02	01	H3864_014_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3864	014	0	1	02	01	H3864_014_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H3864	014	0	1	02	01	H3864_014_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3864	014	0	1	02	01	H3864_014_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3864	024	0	1	02	01	H3864_024_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3864	024	0	1	02	01	H3864_024_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3864	024	0	1	02	01	H3864_024_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H3864	024	0	1	02	01	H3864_024_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3864	024	0	1	02	01	H3864_024_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3864	027	0	1	01	01	H3864_027_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3864	027	0	1	01	01	H3864_027_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3864	027	0	1	01	01	H3864_027_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H3864	027	0	1	01	01	H3864_027_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3864	027	0	1	01	01	H3864_027_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3864	029	0	1	02	01	H3864_029_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3864	029	0	1	02	01	H3864_029_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3864	029	0	1	02	01	H3864_029_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H3864	029	0	1	02	01	H3864_029_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3864	029	0	1	02	01	H3864_029_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3864	034	0	1	02	01	H3864_034_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3864	034	0	1	02	01	H3864_034_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3864	034	0	1	02	01	H3864_034_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H3864	034	0	1	02	01	H3864_034_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3864	034	0	1	02	01	H3864_034_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3864	036	0	1	02	01	H3864_036_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3864	036	0	1	02	01	H3864_036_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3864	036	0	1	02	01	H3864_036_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H3864	036	0	1	02	01	H3864_036_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3864	036	0	1	02	01	H3864_036_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3864	040	0	1	01	01	H3864_040_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3864	040	0	1	01	01	H3864_040_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3864	040	0	1	01	01	H3864_040_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H3864	040	0	1	01	01	H3864_040_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3864	040	0	1	01	01	H3864_040_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3864	041	0	1	01	01	H3864_041_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3864	041	0	1	01	01	H3864_041_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3864	041	0	1	01	01	H3864_041_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H3864	041	0	1	01	01	H3864_041_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3864	041	0	1	01	01	H3864_041_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3864	043	0	1	01	01	H3864_043_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3864	043	0	1	01	01	H3864_043_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3864	043	0	1	01	01	H3864_043_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H3864	043	0	1	01	01	H3864_043_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3864	043	0	1	01	01	H3864_043_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3864	045	0	1	01	01	H3864_045_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3864	045	0	1	01	01	H3864_045_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3864	045	0	1	01	01	H3864_045_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H3864	045	0	1	01	01	H3864_045_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3864	045	0	1	01	01	H3864_045_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3868	001	0	1	02	01	H3868_001_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3868	001	0	1	02	01	H3868_001_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3868	001	0	1	02	01	H3868_001_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3868	001	0	1	02	01	H3868_001_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3868	001	0	1	02	01	H3868_001_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3890	001	0	1	04	01	H3890_001_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3890	001	0	1	04	01	H3890_001_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H3890	001	0	1	04	01	H3890_001_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3890	001	0	1	04	01	H3890_001_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3890	001	0	1	04	01	H3890_001_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3890	002	0	1	04	01	H3890_002_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3890	002	0	1	04	01	H3890_002_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H3890	002	0	1	04	01	H3890_002_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3890	002	0	1	04	01	H3890_002_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3890	002	0	1	04	01	H3890_002_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3890	005	0	1	04	01	H3890_005_0	10			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3890	005	0	1	04	01	H3890_005_0	10			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H3890	005	0	1	04	01	H3890_005_0	10			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3890	005	0	1	04	01	H3890_005_0	10			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3890	005	0	1	04	01	H3890_005_0	10			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3907	006	0	1	01	01	H3907_006_0	18			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3907	006	0	1	01	01	H3907_006_0	18			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3907	006	0	1	01	01	H3907_006_0	18			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3907	006	0	1	01	01	H3907_006_0	18			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3907	006	0	1	01	01	H3907_006_0	18			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3907	037	0	1	01	01	H3907_037_0	16			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3907	037	0	1	01	01	H3907_037_0	16			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3907	037	0	1	01	01	H3907_037_0	16			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3907	037	0	1	01	01	H3907_037_0	16			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3907	037	0	1	01	01	H3907_037_0	16			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3907	057	1	1	01	01	H3907_057_1	18			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3907	057	1	1	01	01	H3907_057_1	18			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3907	057	1	1	01	01	H3907_057_1	18			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3907	057	1	1	01	01	H3907_057_1	18			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3907	057	1	1	01	01	H3907_057_1	18			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3907	057	2	1	01	01	H3907_057_2	17			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3907	057	2	1	01	01	H3907_057_2	17			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3907	057	2	1	01	01	H3907_057_2	17			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3907	057	2	1	01	01	H3907_057_2	17			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3907	057	2	1	01	01	H3907_057_2	17			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3907	057	3	1	01	01	H3907_057_3	17			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3907	057	3	1	01	01	H3907_057_3	17			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3907	057	3	1	01	01	H3907_057_3	17			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3907	057	3	1	01	01	H3907_057_3	17			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3907	057	3	1	01	01	H3907_057_3	17			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3907	057	4	1	01	01	H3907_057_4	15			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3907	057	4	1	01	01	H3907_057_4	15			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3907	057	4	1	01	01	H3907_057_4	15			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3907	057	4	1	01	01	H3907_057_4	15			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3907	057	4	1	01	01	H3907_057_4	15			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3907	057	5	1	01	01	H3907_057_5	16			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3907	057	5	1	01	01	H3907_057_5	16			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3907	057	5	1	01	01	H3907_057_5	16			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3907	057	5	1	01	01	H3907_057_5	16			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3907	057	5	1	01	01	H3907_057_5	16			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3907	057	6	1	01	01	H3907_057_6	16			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3907	057	6	1	01	01	H3907_057_6	16			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3907	057	6	1	01	01	H3907_057_6	16			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3907	057	6	1	01	01	H3907_057_6	16			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3907	057	6	1	01	01	H3907_057_6	16			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3907	057	7	1	01	01	H3907_057_7	16			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3907	057	7	1	01	01	H3907_057_7	16			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3907	057	7	1	01	01	H3907_057_7	16			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3907	057	7	1	01	01	H3907_057_7	16			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3907	057	7	1	01	01	H3907_057_7	16			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3907	058	1	1	01	01	H3907_058_1	16			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3907	058	1	1	01	01	H3907_058_1	16			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3907	058	1	1	01	01	H3907_058_1	16			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3907	058	1	1	01	01	H3907_058_1	16			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3907	058	1	1	01	01	H3907_058_1	16			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3907	058	2	1	01	01	H3907_058_2	17			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3907	058	2	1	01	01	H3907_058_2	17			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3907	058	2	1	01	01	H3907_058_2	17			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3907	058	2	1	01	01	H3907_058_2	17			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3907	058	2	1	01	01	H3907_058_2	17			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3907	058	3	1	01	01	H3907_058_3	17			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3907	058	3	1	01	01	H3907_058_3	17			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3907	058	3	1	01	01	H3907_058_3	17			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3907	058	3	1	01	01	H3907_058_3	17			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3907	058	3	1	01	01	H3907_058_3	17			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3907	059	1	1	01	01	H3907_059_1	18			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3907	059	1	1	01	01	H3907_059_1	18			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3907	059	1	1	01	01	H3907_059_1	18			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3907	059	1	1	01	01	H3907_059_1	18			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3907	059	1	1	01	01	H3907_059_1	18			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3907	059	2	1	01	01	H3907_059_2	18			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3907	059	2	1	01	01	H3907_059_2	18			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3907	059	2	1	01	01	H3907_059_2	18			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3907	059	2	1	01	01	H3907_059_2	18			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3907	059	2	1	01	01	H3907_059_2	18			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3907	059	3	1	01	01	H3907_059_3	18			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3907	059	3	1	01	01	H3907_059_3	18			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3907	059	3	1	01	01	H3907_059_3	18			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3907	059	3	1	01	01	H3907_059_3	18			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3907	059	3	1	01	01	H3907_059_3	18			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3907	059	4	1	01	01	H3907_059_4	18			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3907	059	4	1	01	01	H3907_059_4	18			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3907	059	4	1	01	01	H3907_059_4	18			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3907	059	4	1	01	01	H3907_059_4	18			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3907	059	4	1	01	01	H3907_059_4	18			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3907	059	5	1	01	01	H3907_059_5	18			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3907	059	5	1	01	01	H3907_059_5	18			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3907	059	5	1	01	01	H3907_059_5	18			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3907	059	5	1	01	01	H3907_059_5	18			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3907	059	5	1	01	01	H3907_059_5	18			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3909	001	0	1	04	01	H3909_001_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3909	001	0	1	04	01	H3909_001_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3909	001	0	1	04	01	H3909_001_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3909	001	0	1	04	01	H3909_001_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3909	001	0	1	04	01	H3909_001_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3909	009	0	1	04	01	H3909_009_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3909	009	0	1	04	01	H3909_009_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3909	009	0	1	04	01	H3909_009_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3909	009	0	1	04	01	H3909_009_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3909	009	0	1	04	01	H3909_009_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3909	018	0	1	04	01	H3909_018_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3909	018	0	1	04	01	H3909_018_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3909	018	0	1	04	01	H3909_018_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3909	018	0	1	04	01	H3909_018_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3909	018	0	1	04	01	H3909_018_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3909	020	0	1	04	01	H3909_020_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3909	020	0	1	04	01	H3909_020_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3909	020	0	1	04	01	H3909_020_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3909	020	0	1	04	01	H3909_020_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3909	020	0	1	04	01	H3909_020_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3916	001	0	1	04	01	H3916_001_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3916	001	0	1	04	01	H3916_001_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3916	001	0	1	04	01	H3916_001_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3916	001	0	1	04	01	H3916_001_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3916	001	0	1	04	01	H3916_001_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3916	002	0	1	04	01	H3916_002_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3916	002	0	1	04	01	H3916_002_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3916	002	0	1	04	01	H3916_002_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3916	002	0	1	04	01	H3916_002_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3916	002	0	1	04	01	H3916_002_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3916	005	0	1	04	01	H3916_005_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3916	005	0	1	04	01	H3916_005_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3916	005	0	1	04	01	H3916_005_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3916	005	0	1	04	01	H3916_005_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3916	005	0	1	04	01	H3916_005_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3916	015	0	1	04	01	H3916_015_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3916	015	0	1	04	01	H3916_015_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3916	015	0	1	04	01	H3916_015_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3916	015	0	1	04	01	H3916_015_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3916	015	0	1	04	01	H3916_015_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3916	018	0	1	04	01	H3916_018_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3916	018	0	1	04	01	H3916_018_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3916	018	0	1	04	01	H3916_018_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3916	018	0	1	04	01	H3916_018_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3916	018	0	1	04	01	H3916_018_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3916	022	0	1	04	01	H3916_022_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3916	022	0	1	04	01	H3916_022_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3916	022	0	1	04	01	H3916_022_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3916	022	0	1	04	01	H3916_022_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3916	022	0	1	04	01	H3916_022_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3916	024	0	1	04	01	H3916_024_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3916	024	0	1	04	01	H3916_024_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3916	024	0	1	04	01	H3916_024_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3916	024	0	1	04	01	H3916_024_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3916	024	0	1	04	01	H3916_024_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3916	032	0	1	04	01	H3916_032_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3916	032	0	1	04	01	H3916_032_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3916	032	0	1	04	01	H3916_032_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3916	032	0	1	04	01	H3916_032_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3916	032	0	1	04	01	H3916_032_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3916	033	0	1	04	01	H3916_033_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3916	033	0	1	04	01	H3916_033_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3916	033	0	1	04	01	H3916_033_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3916	033	0	1	04	01	H3916_033_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3916	033	0	1	04	01	H3916_033_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3916	035	1	1	04	01	H3916_035_1	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3916	035	1	1	04	01	H3916_035_1	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3916	035	1	1	04	01	H3916_035_1	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3916	035	1	1	04	01	H3916_035_1	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3916	035	1	1	04	01	H3916_035_1	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3916	035	2	1	04	01	H3916_035_2	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3916	035	2	1	04	01	H3916_035_2	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3916	035	2	1	04	01	H3916_035_2	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3916	035	2	1	04	01	H3916_035_2	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3916	035	2	1	04	01	H3916_035_2	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3916	037	2	1	04	01	H3916_037_2	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3916	037	2	1	04	01	H3916_037_2	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3916	037	2	1	04	01	H3916_037_2	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3916	037	2	1	04	01	H3916_037_2	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3916	037	2	1	04	01	H3916_037_2	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3916	037	4	1	04	01	H3916_037_4	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3916	037	4	1	04	01	H3916_037_4	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3916	037	4	1	04	01	H3916_037_4	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3916	037	4	1	04	01	H3916_037_4	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3916	037	4	1	04	01	H3916_037_4	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3916	037	5	1	04	01	H3916_037_5	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3916	037	5	1	04	01	H3916_037_5	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3916	037	5	1	04	01	H3916_037_5	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3916	037	5	1	04	01	H3916_037_5	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3916	037	5	1	04	01	H3916_037_5	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3916	037	6	1	04	01	H3916_037_6	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3916	037	6	1	04	01	H3916_037_6	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3916	037	6	1	04	01	H3916_037_6	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3916	037	6	1	04	01	H3916_037_6	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3916	037	6	1	04	01	H3916_037_6	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3916	037	7	1	04	01	H3916_037_7	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3916	037	7	1	04	01	H3916_037_7	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3916	037	7	1	04	01	H3916_037_7	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3916	037	7	1	04	01	H3916_037_7	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3916	037	7	1	04	01	H3916_037_7	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3916	037	8	1	04	01	H3916_037_8	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3916	037	8	1	04	01	H3916_037_8	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3916	037	8	1	04	01	H3916_037_8	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3916	037	8	1	04	01	H3916_037_8	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3916	037	8	1	04	01	H3916_037_8	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3916	038	0	1	04	01	H3916_038_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3916	038	0	1	04	01	H3916_038_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3916	038	0	1	04	01	H3916_038_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3916	038	0	1	04	01	H3916_038_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3916	038	0	1	04	01	H3916_038_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3916	039	0	1	04	01	H3916_039_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3916	039	0	1	04	01	H3916_039_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3916	039	0	1	04	01	H3916_039_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3916	039	0	1	04	01	H3916_039_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3916	039	0	1	04	01	H3916_039_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3916	041	1	1	04	01	H3916_041_1	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3916	041	1	1	04	01	H3916_041_1	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3916	041	1	1	04	01	H3916_041_1	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3916	041	1	1	04	01	H3916_041_1	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3916	041	1	1	04	01	H3916_041_1	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3916	041	2	1	04	01	H3916_041_2	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3916	041	2	1	04	01	H3916_041_2	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3916	041	2	1	04	01	H3916_041_2	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3916	041	2	1	04	01	H3916_041_2	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3916	041	2	1	04	01	H3916_041_2	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3916	041	3	1	04	01	H3916_041_3	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3916	041	3	1	04	01	H3916_041_3	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3916	041	3	1	04	01	H3916_041_3	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3916	041	3	1	04	01	H3916_041_3	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3916	041	3	1	04	01	H3916_041_3	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3916	057	0	1	04	01	H3916_057_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3916	057	0	1	04	01	H3916_057_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3916	057	0	1	04	01	H3916_057_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3916	057	0	1	04	01	H3916_057_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3916	057	0	1	04	01	H3916_057_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3916	058	0	1	04	01	H3916_058_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3916	058	0	1	04	01	H3916_058_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3916	058	0	1	04	01	H3916_058_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3916	058	0	1	04	01	H3916_058_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3916	058	0	1	04	01	H3916_058_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3916	059	1	1	04	01	H3916_059_1	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3916	059	1	1	04	01	H3916_059_1	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3916	059	1	1	04	01	H3916_059_1	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3916	059	1	1	04	01	H3916_059_1	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3916	059	1	1	04	01	H3916_059_1	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3916	059	2	1	04	01	H3916_059_2	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3916	059	2	1	04	01	H3916_059_2	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3916	059	2	1	04	01	H3916_059_2	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3916	059	2	1	04	01	H3916_059_2	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3916	059	2	1	04	01	H3916_059_2	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3916	060	1	1	04	01	H3916_060_1	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3916	060	1	1	04	01	H3916_060_1	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3916	060	1	1	04	01	H3916_060_1	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3916	060	1	1	04	01	H3916_060_1	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3916	060	1	1	04	01	H3916_060_1	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3916	060	2	1	04	01	H3916_060_2	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3916	060	2	1	04	01	H3916_060_2	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3916	060	2	1	04	01	H3916_060_2	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3916	060	2	1	04	01	H3916_060_2	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3916	060	2	1	04	01	H3916_060_2	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3916	060	3	1	04	01	H3916_060_3	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3916	060	3	1	04	01	H3916_060_3	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3916	060	3	1	04	01	H3916_060_3	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3916	060	3	1	04	01	H3916_060_3	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3916	060	3	1	04	01	H3916_060_3	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3916	060	4	1	04	01	H3916_060_4	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3916	060	4	1	04	01	H3916_060_4	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3916	060	4	1	04	01	H3916_060_4	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3916	060	4	1	04	01	H3916_060_4	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3916	060	4	1	04	01	H3916_060_4	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3916	060	5	1	04	01	H3916_060_5	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3916	060	5	1	04	01	H3916_060_5	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3916	060	5	1	04	01	H3916_060_5	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3916	060	5	1	04	01	H3916_060_5	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3916	060	5	1	04	01	H3916_060_5	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3916	060	6	1	04	01	H3916_060_6	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3916	060	6	1	04	01	H3916_060_6	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3916	060	6	1	04	01	H3916_060_6	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3916	060	6	1	04	01	H3916_060_6	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3916	060	6	1	04	01	H3916_060_6	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3916	061	1	1	04	01	H3916_061_1	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3916	061	1	1	04	01	H3916_061_1	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3916	061	1	1	04	01	H3916_061_1	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3916	061	1	1	04	01	H3916_061_1	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3916	061	1	1	04	01	H3916_061_1	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3916	061	2	1	04	01	H3916_061_2	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3916	061	2	1	04	01	H3916_061_2	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3916	061	2	1	04	01	H3916_061_2	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3916	061	2	1	04	01	H3916_061_2	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3916	061	2	1	04	01	H3916_061_2	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3916	062	0	1	04	01	H3916_062_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3916	062	0	1	04	01	H3916_062_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3916	062	0	1	04	01	H3916_062_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3916	062	0	1	04	01	H3916_062_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3916	062	0	1	04	01	H3916_062_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3916	063	0	1	04	01	H3916_063_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3916	063	0	1	04	01	H3916_063_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3916	063	0	1	04	01	H3916_063_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3916	063	0	1	04	01	H3916_063_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3916	063	0	1	04	01	H3916_063_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3916	064	0	1	04	01	H3916_064_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3916	064	0	1	04	01	H3916_064_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3916	064	0	1	04	01	H3916_064_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3916	064	0	1	04	01	H3916_064_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3916	064	0	1	04	01	H3916_064_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3916	065	0	1	04	01	H3916_065_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3916	065	0	1	04	01	H3916_065_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3916	065	0	1	04	01	H3916_065_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3916	065	0	1	04	01	H3916_065_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3916	065	0	1	04	01	H3916_065_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3916	066	0	1	04	01	H3916_066_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3916	066	0	1	04	01	H3916_066_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3916	066	0	1	04	01	H3916_066_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3916	066	0	1	04	01	H3916_066_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3916	066	0	1	04	01	H3916_066_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3923	013	0	1	04	01	H3923_013_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3923	013	0	1	04	01	H3923_013_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3923	013	0	1	04	01	H3923_013_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3923	013	0	1	04	01	H3923_013_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3923	013	0	1	04	01	H3923_013_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3923	017	0	1	04	01	H3923_017_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3923	017	0	1	04	01	H3923_017_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3923	017	0	1	04	01	H3923_017_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3923	017	0	1	04	01	H3923_017_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3923	017	0	1	04	01	H3923_017_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3923	044	1	1	04	01	H3923_044_1	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3923	044	1	1	04	01	H3923_044_1	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3923	044	1	1	04	01	H3923_044_1	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3923	044	1	1	04	01	H3923_044_1	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3923	044	1	1	04	01	H3923_044_1	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3923	044	2	1	04	01	H3923_044_2	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3923	044	2	1	04	01	H3923_044_2	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3923	044	2	1	04	01	H3923_044_2	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3923	044	2	1	04	01	H3923_044_2	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3923	044	2	1	04	01	H3923_044_2	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3923	044	3	1	04	01	H3923_044_3	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3923	044	3	1	04	01	H3923_044_3	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3923	044	3	1	04	01	H3923_044_3	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3923	044	3	1	04	01	H3923_044_3	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3923	044	3	1	04	01	H3923_044_3	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3923	044	4	1	04	01	H3923_044_4	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3923	044	4	1	04	01	H3923_044_4	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3923	044	4	1	04	01	H3923_044_4	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3923	044	4	1	04	01	H3923_044_4	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3923	044	4	1	04	01	H3923_044_4	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3923	045	1	1	04	01	H3923_045_1	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3923	045	1	1	04	01	H3923_045_1	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3923	045	1	1	04	01	H3923_045_1	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3923	045	1	1	04	01	H3923_045_1	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3923	045	1	1	04	01	H3923_045_1	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3923	045	2	1	04	01	H3923_045_2	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3923	045	2	1	04	01	H3923_045_2	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3923	045	2	1	04	01	H3923_045_2	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3923	045	2	1	04	01	H3923_045_2	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3923	045	2	1	04	01	H3923_045_2	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3923	045	3	1	04	01	H3923_045_3	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3923	045	3	1	04	01	H3923_045_3	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3923	045	3	1	04	01	H3923_045_3	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3923	045	3	1	04	01	H3923_045_3	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3923	045	3	1	04	01	H3923_045_3	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3923	045	4	1	04	01	H3923_045_4	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3923	045	4	1	04	01	H3923_045_4	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3923	045	4	1	04	01	H3923_045_4	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3923	045	4	1	04	01	H3923_045_4	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3923	045	4	1	04	01	H3923_045_4	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3923	045	5	1	04	01	H3923_045_5	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3923	045	5	1	04	01	H3923_045_5	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3923	045	5	1	04	01	H3923_045_5	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3923	045	5	1	04	01	H3923_045_5	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3923	045	5	1	04	01	H3923_045_5	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3923	046	1	1	04	01	H3923_046_1	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3923	046	1	1	04	01	H3923_046_1	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3923	046	1	1	04	01	H3923_046_1	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3923	046	1	1	04	01	H3923_046_1	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3923	046	1	1	04	01	H3923_046_1	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3923	046	2	1	04	01	H3923_046_2	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3923	046	2	1	04	01	H3923_046_2	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3923	046	2	1	04	01	H3923_046_2	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3923	046	2	1	04	01	H3923_046_2	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3923	046	2	1	04	01	H3923_046_2	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3923	046	3	1	04	01	H3923_046_3	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3923	046	3	1	04	01	H3923_046_3	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3923	046	3	1	04	01	H3923_046_3	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3923	046	3	1	04	01	H3923_046_3	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3923	046	3	1	04	01	H3923_046_3	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3923	046	4	1	04	01	H3923_046_4	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3923	046	4	1	04	01	H3923_046_4	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3923	046	4	1	04	01	H3923_046_4	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3923	046	4	1	04	01	H3923_046_4	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3923	046	4	1	04	01	H3923_046_4	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3923	047	1	1	04	01	H3923_047_1	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3923	047	1	1	04	01	H3923_047_1	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3923	047	1	1	04	01	H3923_047_1	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3923	047	1	1	04	01	H3923_047_1	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3923	047	1	1	04	01	H3923_047_1	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3923	047	2	1	04	01	H3923_047_2	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3923	047	2	1	04	01	H3923_047_2	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3923	047	2	1	04	01	H3923_047_2	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3923	047	2	1	04	01	H3923_047_2	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3923	047	2	1	04	01	H3923_047_2	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3923	047	3	1	04	01	H3923_047_3	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3923	047	3	1	04	01	H3923_047_3	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3923	047	3	1	04	01	H3923_047_3	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3923	047	3	1	04	01	H3923_047_3	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3923	047	3	1	04	01	H3923_047_3	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3923	047	4	1	04	01	H3923_047_4	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3923	047	4	1	04	01	H3923_047_4	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3923	047	4	1	04	01	H3923_047_4	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3923	047	4	1	04	01	H3923_047_4	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3923	047	4	1	04	01	H3923_047_4	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3923	047	5	1	04	01	H3923_047_5	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3923	047	5	1	04	01	H3923_047_5	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3923	047	5	1	04	01	H3923_047_5	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3923	047	5	1	04	01	H3923_047_5	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3923	047	5	1	04	01	H3923_047_5	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3923	048	2	1	04	01	H3923_048_2	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3923	048	2	1	04	01	H3923_048_2	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3923	048	2	1	04	01	H3923_048_2	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3923	048	2	1	04	01	H3923_048_2	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3923	048	2	1	04	01	H3923_048_2	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3923	048	3	1	04	01	H3923_048_3	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3923	048	3	1	04	01	H3923_048_3	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3923	048	3	1	04	01	H3923_048_3	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3923	048	3	1	04	01	H3923_048_3	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3923	048	3	1	04	01	H3923_048_3	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3923	048	5	1	04	01	H3923_048_5	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3923	048	5	1	04	01	H3923_048_5	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3923	048	5	1	04	01	H3923_048_5	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3923	048	5	1	04	01	H3923_048_5	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3923	048	5	1	04	01	H3923_048_5	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3924	059	21	1	04	01	H3924_059_21	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3924	059	21	1	04	01	H3924_059_21	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H3924	059	21	1	04	01	H3924_059_21	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H3924	059	21	1	04	01	H3924_059_21	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3924	059	21	1	04	01	H3924_059_21	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3924	059	21	1	04	01	H3924_059_21	3			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3924	059	22	1	04	01	H3924_059_22	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3924	059	22	1	04	01	H3924_059_22	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H3924	059	22	1	04	01	H3924_059_22	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H3924	059	22	1	04	01	H3924_059_22	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3924	059	22	1	04	01	H3924_059_22	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3924	059	22	1	04	01	H3924_059_22	3			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3924	065	0	1	04	01	H3924_065_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3924	065	0	1	04	01	H3924_065_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H3924	065	0	1	04	01	H3924_065_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H3924	065	0	1	04	01	H3924_065_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3924	065	0	1	04	01	H3924_065_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3924	065	0	1	04	01	H3924_065_0	3			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3928	001	0	1	01	01	H3928_001_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3928	001	0	1	01	01	H3928_001_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3928	001	0	1	01	01	H3928_001_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3928	001	0	1	01	01	H3928_001_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3928	001	0	1	01	01	H3928_001_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3931	004	0	1	02	01	H3931_004_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3931	004	0	1	02	01	H3931_004_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3931	004	0	1	02	01	H3931_004_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3931	004	0	1	02	01	H3931_004_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3931	004	0	1	02	01	H3931_004_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3931	091	0	1	02	01	H3931_091_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3931	091	0	1	02	01	H3931_091_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3931	091	0	1	02	01	H3931_091_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3931	091	0	1	02	01	H3931_091_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3931	091	0	1	02	01	H3931_091_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3931	092	0	1	01	01	H3931_092_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3931	092	0	1	01	01	H3931_092_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3931	092	0	1	01	01	H3931_092_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3931	092	0	1	01	01	H3931_092_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3931	092	0	1	01	01	H3931_092_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3931	094	0	1	01	01	H3931_094_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3931	094	0	1	01	01	H3931_094_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3931	094	0	1	01	01	H3931_094_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3931	094	0	1	01	01	H3931_094_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3931	094	0	1	01	01	H3931_094_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3931	095	0	1	02	01	H3931_095_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3931	095	0	1	02	01	H3931_095_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3931	095	0	1	02	01	H3931_095_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3931	095	0	1	02	01	H3931_095_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3931	095	0	1	02	01	H3931_095_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3931	099	0	1	02	01	H3931_099_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3931	099	0	1	02	01	H3931_099_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3931	099	0	1	02	01	H3931_099_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3931	099	0	1	02	01	H3931_099_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3931	099	0	1	02	01	H3931_099_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3931	100	0	1	02	01	H3931_100_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3931	100	0	1	02	01	H3931_100_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3931	100	0	1	02	01	H3931_100_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3931	100	0	1	02	01	H3931_100_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3931	100	0	1	02	01	H3931_100_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3931	101	0	1	02	01	H3931_101_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3931	101	0	1	02	01	H3931_101_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3931	101	0	1	02	01	H3931_101_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3931	101	0	1	02	01	H3931_101_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3931	101	0	1	02	01	H3931_101_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3931	102	0	1	01	01	H3931_102_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3931	102	0	1	01	01	H3931_102_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3931	102	0	1	01	01	H3931_102_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3931	102	0	1	01	01	H3931_102_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3931	102	0	1	01	01	H3931_102_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3931	107	0	1	02	01	H3931_107_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3931	107	0	1	02	01	H3931_107_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3931	107	0	1	02	01	H3931_107_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3931	107	0	1	02	01	H3931_107_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3931	107	0	1	02	01	H3931_107_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3931	108	0	1	01	01	H3931_108_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3931	108	0	1	01	01	H3931_108_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3931	108	0	1	01	01	H3931_108_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3931	108	0	1	01	01	H3931_108_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3931	108	0	1	01	01	H3931_108_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3931	109	0	1	02	01	H3931_109_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3931	109	0	1	02	01	H3931_109_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3931	109	0	1	02	01	H3931_109_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3931	109	0	1	02	01	H3931_109_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3931	109	0	1	02	01	H3931_109_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3931	126	0	1	01	01	H3931_126_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3931	126	0	1	01	01	H3931_126_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3931	126	0	1	01	01	H3931_126_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3931	126	0	1	01	01	H3931_126_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3931	126	0	1	01	01	H3931_126_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3931	129	0	1	01	01	H3931_129_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3931	129	0	1	01	01	H3931_129_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3931	129	0	1	01	01	H3931_129_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3931	129	0	1	01	01	H3931_129_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3931	129	0	1	01	01	H3931_129_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3931	143	0	1	02	01	H3931_143_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3931	143	0	1	02	01	H3931_143_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3931	143	0	1	02	01	H3931_143_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3931	143	0	1	02	01	H3931_143_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3931	143	0	1	02	01	H3931_143_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3931	146	0	1	01	01	H3931_146_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3931	146	0	1	01	01	H3931_146_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3931	146	0	1	01	01	H3931_146_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3931	146	0	1	01	01	H3931_146_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3931	146	0	1	01	01	H3931_146_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3931	151	0	1	01	01	H3931_151_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3931	151	0	1	01	01	H3931_151_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3931	151	0	1	01	01	H3931_151_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3931	151	0	1	01	01	H3931_151_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3931	151	0	1	01	01	H3931_151_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3931	152	0	1	01	01	H3931_152_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3931	152	0	1	01	01	H3931_152_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3931	152	0	1	01	01	H3931_152_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3931	152	0	1	01	01	H3931_152_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3931	152	0	1	01	01	H3931_152_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3931	153	0	1	02	01	H3931_153_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3931	153	0	1	02	01	H3931_153_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3931	153	0	1	02	01	H3931_153_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3931	153	0	1	02	01	H3931_153_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3931	153	0	1	02	01	H3931_153_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3931	154	0	1	02	01	H3931_154_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3931	154	0	1	02	01	H3931_154_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3931	154	0	1	02	01	H3931_154_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3931	154	0	1	02	01	H3931_154_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3931	154	0	1	02	01	H3931_154_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3931	157	0	1	01	01	H3931_157_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3931	157	0	1	01	01	H3931_157_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3931	157	0	1	01	01	H3931_157_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3931	157	0	1	01	01	H3931_157_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3931	157	0	1	01	01	H3931_157_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3931	158	0	1	02	01	H3931_158_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3931	158	0	1	02	01	H3931_158_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3931	158	0	1	02	01	H3931_158_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3931	158	0	1	02	01	H3931_158_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3931	158	0	1	02	01	H3931_158_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3931	160	0	1	01	01	H3931_160_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3931	160	0	1	01	01	H3931_160_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3931	160	0	1	01	01	H3931_160_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3931	160	0	1	01	01	H3931_160_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3931	160	0	1	01	01	H3931_160_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3931	162	0	1	01	01	H3931_162_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3931	162	0	1	01	01	H3931_162_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3931	162	0	1	01	01	H3931_162_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3931	162	0	1	01	01	H3931_162_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3931	162	0	1	01	01	H3931_162_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3931	175	0	1	01	01	H3931_175_0	3		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3931	175	0	1	01	01	H3931_175_0	3		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3931	175	0	1	01	01	H3931_175_0	3		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3931	175	0	1	01	01	H3931_175_0	3		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3931	175	0	1	01	01	H3931_175_0	3		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3931	188	0	1	01	01	H3931_188_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3931	188	0	1	01	01	H3931_188_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3931	188	0	1	01	01	H3931_188_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3931	188	0	1	01	01	H3931_188_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3931	188	0	1	01	01	H3931_188_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3931	190	0	1	02	01	H3931_190_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3931	190	0	1	02	01	H3931_190_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3931	190	0	1	02	01	H3931_190_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3931	190	0	1	02	01	H3931_190_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3931	190	0	1	02	01	H3931_190_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3931	191	0	1	01	01	H3931_191_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3931	191	0	1	01	01	H3931_191_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3931	191	0	1	01	01	H3931_191_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3931	191	0	1	01	01	H3931_191_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3931	191	0	1	01	01	H3931_191_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3931	196	0	1	01	01	H3931_196_0	3		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3931	196	0	1	01	01	H3931_196_0	3		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3931	196	0	1	01	01	H3931_196_0	3		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3931	196	0	1	01	01	H3931_196_0	3		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3931	196	0	1	01	01	H3931_196_0	3		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3931	197	0	1	01	01	H3931_197_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3931	197	0	1	01	01	H3931_197_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3931	197	0	1	01	01	H3931_197_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3931	197	0	1	01	01	H3931_197_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3931	197	0	1	01	01	H3931_197_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3949	009	0	1	01	01	H3949_009_0	9		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3949	009	0	1	01	01	H3949_009_0	9		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3949	009	0	1	01	01	H3949_009_0	9		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3949	009	0	1	01	01	H3949_009_0	9		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3949	009	0	1	01	01	H3949_009_0	9		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3949	024	0	1	01	01	H3949_024_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	1	2	01	3	2	9.00	
H3949	024	0	1	01	01	H3949_024_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	2	2	01	1	2	0.00	
H3949	024	0	1	01	01	H3949_024_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	3	2	11	1	2	0.00	
H3949	024	0	1	01	01	H3949_024_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	4	2	11	1	2	0.00	
H3949	024	0	1	01	01	H3949_024_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	5	2	11	1	2	0.00	
H3949	024	0	1	01	01	H3949_024_0	5			Select Diabetic Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	6	2	11	1	2	0.00	
H3949	030	0	1	01	01	H3949_030_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	9.00	
H3949	030	0	1	01	01	H3949_030_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3949	030	0	1	01	01	H3949_030_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3949	030	0	1	01	01	H3949_030_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3949	030	0	1	01	01	H3949_030_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3949	031	0	1	01	01	H3949_031_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	9.00	
H3949	031	0	1	01	01	H3949_031_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3949	031	0	1	01	01	H3949_031_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3949	031	0	1	01	01	H3949_031_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3949	031	0	1	01	01	H3949_031_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3949	035	0	1	01	01	H3949_035_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	9.00	
H3949	035	0	1	01	01	H3949_035_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3949	035	0	1	01	01	H3949_035_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3949	035	0	1	01	01	H3949_035_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3949	035	0	1	01	01	H3949_035_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3949	045	0	1	01	01	H3949_045_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	9.00	
H3949	045	0	1	01	01	H3949_045_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3949	045	0	1	01	01	H3949_045_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3949	045	0	1	01	01	H3949_045_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3949	045	0	1	01	01	H3949_045_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3949	047	0	1	01	01	H3949_047_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H3949	047	0	1	01	01	H3949_047_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3949	047	0	1	01	01	H3949_047_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3949	047	0	1	01	01	H3949_047_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3949	047	0	1	01	01	H3949_047_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3949	048	0	1	01	01	H3949_048_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H3949	048	0	1	01	01	H3949_048_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3949	048	0	1	01	01	H3949_048_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3949	048	0	1	01	01	H3949_048_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3949	048	0	1	01	01	H3949_048_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3949	049	0	1	01	01	H3949_049_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H3949	049	0	1	01	01	H3949_049_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3949	049	0	1	01	01	H3949_049_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3949	049	0	1	01	01	H3949_049_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3949	049	0	1	01	01	H3949_049_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3949	052	0	1	01	01	H3949_052_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	9.00	
H3949	052	0	1	01	01	H3949_052_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3949	052	0	1	01	01	H3949_052_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3949	052	0	1	01	01	H3949_052_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3949	052	0	1	01	01	H3949_052_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3949	053	0	1	01	01	H3949_053_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	9.00	
H3949	053	0	1	01	01	H3949_053_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3949	053	0	1	01	01	H3949_053_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3949	053	0	1	01	01	H3949_053_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3949	053	0	1	01	01	H3949_053_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3949	054	0	1	01	01	H3949_054_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	9.00	
H3949	054	0	1	01	01	H3949_054_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3949	054	0	1	01	01	H3949_054_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3949	054	0	1	01	01	H3949_054_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3949	054	0	1	01	01	H3949_054_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3952	020	0	1	01	01	H3952_020_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3952	020	0	1	01	01	H3952_020_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3952	020	0	1	01	01	H3952_020_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3952	020	0	1	01	01	H3952_020_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3952	020	0	1	01	01	H3952_020_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3952	045	0	1	01	01	H3952_045_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3952	045	0	1	01	01	H3952_045_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3952	045	0	1	01	01	H3952_045_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3952	045	0	1	01	01	H3952_045_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3952	045	0	1	01	01	H3952_045_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3952	049	0	1	01	01	H3952_049_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3952	049	0	1	01	01	H3952_049_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3952	049	0	1	01	01	H3952_049_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3952	049	0	1	01	01	H3952_049_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3952	049	0	1	01	01	H3952_049_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3952	051	0	1	01	01	H3952_051_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3952	051	0	1	01	01	H3952_051_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3952	051	0	1	01	01	H3952_051_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3952	051	0	1	01	01	H3952_051_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3952	051	0	1	01	01	H3952_051_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3952	053	0	1	02	01	H3952_053_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3952	053	0	1	02	01	H3952_053_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3952	053	0	1	02	01	H3952_053_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3952	053	0	1	02	01	H3952_053_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3952	053	0	1	02	01	H3952_053_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3952	054	0	1	02	01	H3952_054_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3952	054	0	1	02	01	H3952_054_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3952	054	0	1	02	01	H3952_054_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3952	054	0	1	02	01	H3952_054_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3952	054	0	1	02	01	H3952_054_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3952	055	0	1	01	01	H3952_055_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3952	055	0	1	01	01	H3952_055_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3952	055	0	1	01	01	H3952_055_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3952	055	0	1	01	01	H3952_055_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3952	055	0	1	01	01	H3952_055_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3952	060	0	1	02	01	H3952_060_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3952	060	0	1	02	01	H3952_060_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3952	060	0	1	02	01	H3952_060_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3952	060	0	1	02	01	H3952_060_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3952	060	0	1	02	01	H3952_060_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3954	097	0	1	01	01	H3954_097_0	3		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3954	097	0	1	01	01	H3954_097_0	3		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H3954	097	0	1	01	01	H3954_097_0	3		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H3954	097	0	1	01	01	H3954_097_0	3		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3954	097	0	1	01	01	H3954_097_0	3		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3954	097	0	1	01	01	H3954_097_0	3		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3954	157	21	1	01	01	H3954_157_21	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3954	157	21	1	01	01	H3954_157_21	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H3954	157	21	1	01	01	H3954_157_21	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H3954	157	21	1	01	01	H3954_157_21	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3954	157	21	1	01	01	H3954_157_21	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3954	157	21	1	01	01	H3954_157_21	3			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3954	157	22	1	01	01	H3954_157_22	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3954	157	22	1	01	01	H3954_157_22	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H3954	157	22	1	01	01	H3954_157_22	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H3954	157	22	1	01	01	H3954_157_22	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3954	157	22	1	01	01	H3954_157_22	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3954	157	22	1	01	01	H3954_157_22	3			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3954	157	23	1	01	01	H3954_157_23	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3954	157	23	1	01	01	H3954_157_23	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H3954	157	23	1	01	01	H3954_157_23	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H3954	157	23	1	01	01	H3954_157_23	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3954	157	23	1	01	01	H3954_157_23	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3954	157	23	1	01	01	H3954_157_23	3			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3954	158	13	1	01	01	H3954_158_13	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3954	158	13	1	01	01	H3954_158_13	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H3954	158	13	1	01	01	H3954_158_13	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H3954	158	13	1	01	01	H3954_158_13	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3954	158	13	1	01	01	H3954_158_13	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3954	158	13	1	01	01	H3954_158_13	3			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3954	158	14	1	01	01	H3954_158_14	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3954	158	14	1	01	01	H3954_158_14	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H3954	158	14	1	01	01	H3954_158_14	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H3954	158	14	1	01	01	H3954_158_14	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3954	158	14	1	01	01	H3954_158_14	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3954	158	14	1	01	01	H3954_158_14	3			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3954	160	0	1	01	01	H3954_160_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3954	160	0	1	01	01	H3954_160_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H3954	160	0	1	01	01	H3954_160_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H3954	160	0	1	01	01	H3954_160_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3954	160	0	1	01	01	H3954_160_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3954	160	0	1	01	01	H3954_160_0	3			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3954	161	0	1	01	01	H3954_161_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3954	161	0	1	01	01	H3954_161_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H3954	161	0	1	01	01	H3954_161_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H3954	161	0	1	01	01	H3954_161_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3954	161	0	1	01	01	H3954_161_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3954	161	0	1	01	01	H3954_161_0	3			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3954	163	0	1	01	01	H3954_163_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H3954	163	0	1	01	01	H3954_163_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H3954	163	0	1	01	01	H3954_163_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H3954	163	0	1	01	01	H3954_163_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3954	163	0	1	01	01	H3954_163_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3954	163	0	1	01	01	H3954_163_0	3			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3957	031	0	1	02	01	H3957_031_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3957	031	0	1	02	01	H3957_031_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3957	031	0	1	02	01	H3957_031_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3957	031	0	1	02	01	H3957_031_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3957	031	0	1	02	01	H3957_031_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3957	042	1	1	01	01	H3957_042_1	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3957	042	1	1	01	01	H3957_042_1	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3957	042	1	1	01	01	H3957_042_1	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3957	042	1	1	01	01	H3957_042_1	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3957	042	1	1	01	01	H3957_042_1	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3957	042	2	1	01	01	H3957_042_2	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3957	042	2	1	01	01	H3957_042_2	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3957	042	2	1	01	01	H3957_042_2	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3957	042	2	1	01	01	H3957_042_2	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3957	042	2	1	01	01	H3957_042_2	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3957	042	4	1	01	01	H3957_042_4	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3957	042	4	1	01	01	H3957_042_4	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3957	042	4	1	01	01	H3957_042_4	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3957	042	4	1	01	01	H3957_042_4	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3957	042	4	1	01	01	H3957_042_4	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3957	042	5	1	01	01	H3957_042_5	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3957	042	5	1	01	01	H3957_042_5	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3957	042	5	1	01	01	H3957_042_5	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3957	042	5	1	01	01	H3957_042_5	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3957	042	5	1	01	01	H3957_042_5	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3957	042	6	1	01	01	H3957_042_6	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3957	042	6	1	01	01	H3957_042_6	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3957	042	6	1	01	01	H3957_042_6	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3957	042	6	1	01	01	H3957_042_6	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3957	042	6	1	01	01	H3957_042_6	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3957	042	7	1	01	01	H3957_042_7	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3957	042	7	1	01	01	H3957_042_7	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3957	042	7	1	01	01	H3957_042_7	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3957	042	7	1	01	01	H3957_042_7	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3957	042	7	1	01	01	H3957_042_7	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3957	044	1	1	02	01	H3957_044_1	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3957	044	1	1	02	01	H3957_044_1	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3957	044	1	1	02	01	H3957_044_1	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3957	044	1	1	02	01	H3957_044_1	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3957	044	1	1	02	01	H3957_044_1	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3957	044	4	1	02	01	H3957_044_4	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3957	044	4	1	02	01	H3957_044_4	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3957	044	4	1	02	01	H3957_044_4	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3957	044	4	1	02	01	H3957_044_4	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3957	044	4	1	02	01	H3957_044_4	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3957	045	1	1	02	01	H3957_045_1	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3957	045	1	1	02	01	H3957_045_1	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3957	045	1	1	02	01	H3957_045_1	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3957	045	1	1	02	01	H3957_045_1	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3957	045	1	1	02	01	H3957_045_1	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3957	045	2	1	02	01	H3957_045_2	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3957	045	2	1	02	01	H3957_045_2	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3957	045	2	1	02	01	H3957_045_2	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3957	045	2	1	02	01	H3957_045_2	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3957	045	2	1	02	01	H3957_045_2	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3957	046	1	1	02	01	H3957_046_1	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3957	046	1	1	02	01	H3957_046_1	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3957	046	1	1	02	01	H3957_046_1	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3957	046	1	1	02	01	H3957_046_1	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3957	046	1	1	02	01	H3957_046_1	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3957	046	2	1	02	01	H3957_046_2	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3957	046	2	1	02	01	H3957_046_2	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3957	046	2	1	02	01	H3957_046_2	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3957	046	2	1	02	01	H3957_046_2	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3957	046	2	1	02	01	H3957_046_2	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3957	047	1	1	01	01	H3957_047_1	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3957	047	1	1	01	01	H3957_047_1	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3957	047	1	1	01	01	H3957_047_1	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3957	047	1	1	01	01	H3957_047_1	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3957	047	1	1	01	01	H3957_047_1	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3957	047	2	1	01	01	H3957_047_2	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3957	047	2	1	01	01	H3957_047_2	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3957	047	2	1	01	01	H3957_047_2	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3957	047	2	1	01	01	H3957_047_2	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3957	047	2	1	01	01	H3957_047_2	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3957	047	3	1	01	01	H3957_047_3	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3957	047	3	1	01	01	H3957_047_3	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3957	047	3	1	01	01	H3957_047_3	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3957	047	3	1	01	01	H3957_047_3	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3957	047	3	1	01	01	H3957_047_3	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3957	047	4	1	01	01	H3957_047_4	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3957	047	4	1	01	01	H3957_047_4	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3957	047	4	1	01	01	H3957_047_4	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3957	047	4	1	01	01	H3957_047_4	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3957	047	4	1	01	01	H3957_047_4	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3957	047	5	1	01	01	H3957_047_5	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3957	047	5	1	01	01	H3957_047_5	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3957	047	5	1	01	01	H3957_047_5	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3957	047	5	1	01	01	H3957_047_5	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3957	047	5	1	01	01	H3957_047_5	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3957	048	0	1	01	01	H3957_048_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3957	048	0	1	01	01	H3957_048_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3957	048	0	1	01	01	H3957_048_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3957	048	0	1	01	01	H3957_048_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3957	048	0	1	01	01	H3957_048_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3957	049	1	1	01	01	H3957_049_1	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3957	049	1	1	01	01	H3957_049_1	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3957	049	1	1	01	01	H3957_049_1	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3957	049	1	1	01	01	H3957_049_1	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3957	049	1	1	01	01	H3957_049_1	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3957	049	2	1	01	01	H3957_049_2	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3957	049	2	1	01	01	H3957_049_2	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3957	049	2	1	01	01	H3957_049_2	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3957	049	2	1	01	01	H3957_049_2	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3957	049	2	1	01	01	H3957_049_2	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3957	049	3	1	01	01	H3957_049_3	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3957	049	3	1	01	01	H3957_049_3	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3957	049	3	1	01	01	H3957_049_3	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3957	049	3	1	01	01	H3957_049_3	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3957	049	3	1	01	01	H3957_049_3	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3957	049	4	1	01	01	H3957_049_4	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3957	049	4	1	01	01	H3957_049_4	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3957	049	4	1	01	01	H3957_049_4	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3957	049	4	1	01	01	H3957_049_4	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3957	049	4	1	01	01	H3957_049_4	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3957	049	5	1	01	01	H3957_049_5	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3957	049	5	1	01	01	H3957_049_5	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3957	049	5	1	01	01	H3957_049_5	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3957	049	5	1	01	01	H3957_049_5	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3957	049	5	1	01	01	H3957_049_5	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3957	049	6	1	01	01	H3957_049_6	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3957	049	6	1	01	01	H3957_049_6	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3957	049	6	1	01	01	H3957_049_6	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3957	049	6	1	01	01	H3957_049_6	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3957	049	6	1	01	01	H3957_049_6	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3957	049	7	1	01	01	H3957_049_7	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3957	049	7	1	01	01	H3957_049_7	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3957	049	7	1	01	01	H3957_049_7	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3957	049	7	1	01	01	H3957_049_7	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3957	049	7	1	01	01	H3957_049_7	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3957	050	1	1	01	01	H3957_050_1	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3957	050	1	1	01	01	H3957_050_1	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3957	050	1	1	01	01	H3957_050_1	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3957	050	1	1	01	01	H3957_050_1	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3957	050	1	1	01	01	H3957_050_1	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3957	050	2	1	01	01	H3957_050_2	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3957	050	2	1	01	01	H3957_050_2	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3957	050	2	1	01	01	H3957_050_2	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3957	050	2	1	01	01	H3957_050_2	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3957	050	2	1	01	01	H3957_050_2	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3957	050	3	1	01	01	H3957_050_3	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3957	050	3	1	01	01	H3957_050_3	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3957	050	3	1	01	01	H3957_050_3	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3957	050	3	1	01	01	H3957_050_3	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3957	050	3	1	01	01	H3957_050_3	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3957	050	4	1	01	01	H3957_050_4	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3957	050	4	1	01	01	H3957_050_4	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3957	050	4	1	01	01	H3957_050_4	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3957	050	4	1	01	01	H3957_050_4	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3957	050	4	1	01	01	H3957_050_4	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3957	050	5	1	01	01	H3957_050_5	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3957	050	5	1	01	01	H3957_050_5	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3957	050	5	1	01	01	H3957_050_5	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3957	050	5	1	01	01	H3957_050_5	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3957	050	5	1	01	01	H3957_050_5	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3959	001	0	1	02	01	H3959_001_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3959	001	0	1	02	01	H3959_001_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3959	001	0	1	02	01	H3959_001_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3959	001	0	1	02	01	H3959_001_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3959	001	0	1	02	01	H3959_001_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3959	002	0	1	02	01	H3959_002_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3959	002	0	1	02	01	H3959_002_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3959	002	0	1	02	01	H3959_002_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3959	002	0	1	02	01	H3959_002_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3959	002	0	1	02	01	H3959_002_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3959	010	0	1	02	01	H3959_010_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3959	010	0	1	02	01	H3959_010_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3959	010	0	1	02	01	H3959_010_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3959	010	0	1	02	01	H3959_010_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3959	010	0	1	02	01	H3959_010_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3959	011	0	1	02	01	H3959_011_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3959	011	0	1	02	01	H3959_011_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3959	011	0	1	02	01	H3959_011_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3959	011	0	1	02	01	H3959_011_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3959	011	0	1	02	01	H3959_011_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3959	032	0	1	02	01	H3959_032_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3959	032	0	1	02	01	H3959_032_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3959	032	0	1	02	01	H3959_032_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3959	032	0	1	02	01	H3959_032_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3959	032	0	1	02	01	H3959_032_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3959	033	0	1	02	01	H3959_033_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3959	033	0	1	02	01	H3959_033_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3959	033	0	1	02	01	H3959_033_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3959	033	0	1	02	01	H3959_033_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3959	033	0	1	02	01	H3959_033_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3959	035	0	1	01	01	H3959_035_0	2		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3959	035	0	1	01	01	H3959_035_0	2		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3959	035	0	1	01	01	H3959_035_0	2		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3959	035	0	1	01	01	H3959_035_0	2		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3959	035	0	1	01	01	H3959_035_0	2		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3959	036	0	1	01	01	H3959_036_0	2		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3959	036	0	1	01	01	H3959_036_0	2		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3959	036	0	1	01	01	H3959_036_0	2		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3959	036	0	1	01	01	H3959_036_0	2		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3959	036	0	1	01	01	H3959_036_0	2		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3959	037	0	1	02	01	H3959_037_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3959	037	0	1	02	01	H3959_037_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3959	037	0	1	02	01	H3959_037_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3959	037	0	1	02	01	H3959_037_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3959	037	0	1	02	01	H3959_037_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3959	039	0	1	02	01	H3959_039_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3959	039	0	1	02	01	H3959_039_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3959	039	0	1	02	01	H3959_039_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3959	039	0	1	02	01	H3959_039_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3959	039	0	1	02	01	H3959_039_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3959	052	0	1	02	01	H3959_052_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3959	052	0	1	02	01	H3959_052_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3959	052	0	1	02	01	H3959_052_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3959	052	0	1	02	01	H3959_052_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3959	052	0	1	02	01	H3959_052_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3959	053	0	1	02	01	H3959_053_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3959	053	0	1	02	01	H3959_053_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3959	053	0	1	02	01	H3959_053_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3959	053	0	1	02	01	H3959_053_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3959	053	0	1	02	01	H3959_053_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3959	055	0	1	01	01	H3959_055_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3959	055	0	1	01	01	H3959_055_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3959	055	0	1	01	01	H3959_055_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3959	055	0	1	01	01	H3959_055_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3959	055	0	1	01	01	H3959_055_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3959	069	0	1	01	01	H3959_069_0	3		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3959	069	0	1	01	01	H3959_069_0	3		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3959	069	0	1	01	01	H3959_069_0	3		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3959	069	0	1	01	01	H3959_069_0	3		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3959	069	0	1	01	01	H3959_069_0	3		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3959	070	0	1	01	01	H3959_070_0	3		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3959	070	0	1	01	01	H3959_070_0	3		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3959	070	0	1	01	01	H3959_070_0	3		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3959	070	0	1	01	01	H3959_070_0	3		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3959	070	0	1	01	01	H3959_070_0	3		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3959	071	0	1	01	01	H3959_071_0	3		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3959	071	0	1	01	01	H3959_071_0	3		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3959	071	0	1	01	01	H3959_071_0	3		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3959	071	0	1	01	01	H3959_071_0	3		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3959	071	0	1	01	01	H3959_071_0	3		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3959	072	0	1	01	01	H3959_072_0	3		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3959	072	0	1	01	01	H3959_072_0	3		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3959	072	0	1	01	01	H3959_072_0	3		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3959	072	0	1	01	01	H3959_072_0	3		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3959	072	0	1	01	01	H3959_072_0	3		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3959	073	0	1	01	01	H3959_073_0	3		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3959	073	0	1	01	01	H3959_073_0	3		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3959	073	0	1	01	01	H3959_073_0	3		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3959	073	0	1	01	01	H3959_073_0	3		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3959	073	0	1	01	01	H3959_073_0	3		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3959	074	0	1	01	01	H3959_074_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3959	074	0	1	01	01	H3959_074_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3959	074	0	1	01	01	H3959_074_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3959	074	0	1	01	01	H3959_074_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3959	074	0	1	01	01	H3959_074_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3959	075	0	1	01	01	H3959_075_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3959	075	0	1	01	01	H3959_075_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3959	075	0	1	01	01	H3959_075_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3959	075	0	1	01	01	H3959_075_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3959	075	0	1	01	01	H3959_075_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3959	076	0	1	01	01	H3959_076_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3959	076	0	1	01	01	H3959_076_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3959	076	0	1	01	01	H3959_076_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3959	076	0	1	01	01	H3959_076_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3959	076	0	1	01	01	H3959_076_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3959	083	0	1	01	01	H3959_083_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3959	083	0	1	01	01	H3959_083_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3959	083	0	1	01	01	H3959_083_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3959	083	0	1	01	01	H3959_083_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3959	083	0	1	01	01	H3959_083_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3959	084	0	1	01	01	H3959_084_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3959	084	0	1	01	01	H3959_084_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3959	084	0	1	01	01	H3959_084_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3959	084	0	1	01	01	H3959_084_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3959	084	0	1	01	01	H3959_084_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3959	085	0	1	01	01	H3959_085_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3959	085	0	1	01	01	H3959_085_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H3959	085	0	1	01	01	H3959_085_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3959	085	0	1	01	01	H3959_085_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3959	085	0	1	01	01	H3959_085_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3962	001	0	1	01	01	H3962_001_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3962	001	0	1	01	01	H3962_001_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3962	001	0	1	01	01	H3962_001_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3962	001	0	1	01	01	H3962_001_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3962	001	0	1	01	01	H3962_001_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3962	004	0	1	01	01	H3962_004_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3962	004	0	1	01	01	H3962_004_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3962	004	0	1	01	01	H3962_004_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3962	004	0	1	01	01	H3962_004_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3962	004	0	1	01	01	H3962_004_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3962	022	1	1	01	01	H3962_022_1	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3962	022	1	1	01	01	H3962_022_1	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3962	022	1	1	01	01	H3962_022_1	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3962	022	1	1	01	01	H3962_022_1	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3962	022	1	1	01	01	H3962_022_1	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3962	022	2	1	01	01	H3962_022_2	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3962	022	2	1	01	01	H3962_022_2	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3962	022	2	1	01	01	H3962_022_2	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3962	022	2	1	01	01	H3962_022_2	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3962	022	2	1	01	01	H3962_022_2	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3962	022	3	1	01	01	H3962_022_3	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3962	022	3	1	01	01	H3962_022_3	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3962	022	3	1	01	01	H3962_022_3	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3962	022	3	1	01	01	H3962_022_3	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3962	022	3	1	01	01	H3962_022_3	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3962	022	4	1	01	01	H3962_022_4	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3962	022	4	1	01	01	H3962_022_4	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3962	022	4	1	01	01	H3962_022_4	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3962	022	4	1	01	01	H3962_022_4	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3962	022	4	1	01	01	H3962_022_4	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3962	022	5	1	01	01	H3962_022_5	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H3962	022	5	1	01	01	H3962_022_5	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3962	022	5	1	01	01	H3962_022_5	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3962	022	5	1	01	01	H3962_022_5	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3962	022	5	1	01	01	H3962_022_5	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H3975	001	0	1	04	01	H3975_001_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H3975	001	0	1	04	01	H3975_001_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3975	001	0	1	04	01	H3975_001_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3975	001	0	1	04	01	H3975_001_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3975	001	0	1	04	01	H3975_001_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3975	001	0	1	04	01	H3975_001_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3975	004	0	1	04	01	H3975_004_0	7		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H3975	004	0	1	04	01	H3975_004_0	7		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H3975	004	0	1	04	01	H3975_004_0	7		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H3975	004	0	1	04	01	H3975_004_0	7		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H3975	004	0	1	04	01	H3975_004_0	7		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H3975	004	0	1	04	01	H3975_004_0	7		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H3979	001	0	1	01	01	H3979_001_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H3979	001	0	1	01	01	H3979_001_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H3979	001	0	1	01	01	H3979_001_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H3979	001	0	1	01	01	H3979_001_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H3979	001	0	1	01	01	H3979_001_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4003	009	0	1	01	01	H4003_009_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H4003	009	0	1	01	01	H4003_009_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H4003	009	0	1	01	01	H4003_009_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H4003	009	0	1	01	01	H4003_009_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4003	009	0	1	01	01	H4003_009_0	5			Preferred Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4003	009	0	1	01	01	H4003_009_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4003	009	0	1	01	01	H4003_009_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	7	2	10	1	2	0.00	
H4003	019	0	1	02	01	H4003_019_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H4003	019	0	1	02	01	H4003_019_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	2	2	01	3	2	0.00	
H4003	019	0	1	02	01	H4003_019_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H4003	019	0	1	02	01	H4003_019_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4003	019	0	1	02	01	H4003_019_0	6			Preferred Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4003	019	0	1	02	01	H4003_019_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4003	019	0	1	02	01	H4003_019_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	7	2	10	1	2	0.00	
H4003	034	0	1	02	01	H4003_034_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H4003	034	0	1	02	01	H4003_034_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	2	2	01	3	2	0.00	
H4003	034	0	1	02	01	H4003_034_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H4003	034	0	1	02	01	H4003_034_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4003	034	0	1	02	01	H4003_034_0	5			Preferred Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4003	034	0	1	02	01	H4003_034_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4003	034	0	1	02	01	H4003_034_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	7	2	10	1	2	0.00	
H4003	055	0	1	02	01	H4003_055_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H4003	055	0	1	02	01	H4003_055_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H4003	055	0	1	02	01	H4003_055_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H4003	055	0	1	02	01	H4003_055_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4003	055	0	1	02	01	H4003_055_0	6			Preferred Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4003	055	0	1	02	01	H4003_055_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4003	055	0	1	02	01	H4003_055_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	7	2	10	1	2	0.00	
H4004	056	0	1	02	01	H4004_056_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H4004	056	0	1	02	01	H4004_056_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	2	2	01	3	2	0.00	
H4004	056	0	1	02	01	H4004_056_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H4004	056	0	1	02	01	H4004_056_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4004	056	0	1	02	01	H4004_056_0	7			Preferred Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4004	056	0	1	02	01	H4004_056_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4004	056	0	1	02	01	H4004_056_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	7	2	10	1	2	0.00	
H4004	065	0	1	02	01	H4004_065_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H4004	065	0	1	02	01	H4004_065_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	2	2	01	3	2	0.00	
H4004	065	0	1	02	01	H4004_065_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H4004	065	0	1	02	01	H4004_065_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4004	065	0	1	02	01	H4004_065_0	5			Preferred Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4004	065	0	1	02	01	H4004_065_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4004	065	0	1	02	01	H4004_065_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	7	2	10	1	2	0.00	
H4004	066	0	1	02	01	H4004_066_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H4004	066	0	1	02	01	H4004_066_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H4004	066	0	1	02	01	H4004_066_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H4004	066	0	1	02	01	H4004_066_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4004	066	0	1	02	01	H4004_066_0	6			Preferred Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4004	066	0	1	02	01	H4004_066_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4004	066	0	1	02	01	H4004_066_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	7	2	10	1	2	0.00	
H4004	070	0	1	02	01	H4004_070_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H4004	070	0	1	02	01	H4004_070_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H4004	070	0	1	02	01	H4004_070_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H4004	070	0	1	02	01	H4004_070_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4004	070	0	1	02	01	H4004_070_0	5			Preferred Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4004	070	0	1	02	01	H4004_070_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4004	070	0	1	02	01	H4004_070_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	7	2	10	1	2	0.00	
H4004	071	0	1	02	01	H4004_071_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H4004	071	0	1	02	01	H4004_071_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H4004	071	0	1	02	01	H4004_071_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H4004	071	0	1	02	01	H4004_071_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4004	071	0	1	02	01	H4004_071_0	5			Preferred Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4004	071	0	1	02	01	H4004_071_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4004	071	0	1	02	01	H4004_071_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	7	2	10	1	2	0.00	
H4004	073	1	1	02	01	H4004_073_1	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H4004	073	1	1	02	01	H4004_073_1	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H4004	073	1	1	02	01	H4004_073_1	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H4004	073	1	1	02	01	H4004_073_1	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4004	073	1	1	02	01	H4004_073_1	6			Preferred Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4004	073	1	1	02	01	H4004_073_1	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4004	073	1	1	02	01	H4004_073_1	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	7	2	10	1	2	0.00	
H4004	073	2	1	02	01	H4004_073_2	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H4004	073	2	1	02	01	H4004_073_2	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H4004	073	2	1	02	01	H4004_073_2	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H4004	073	2	1	02	01	H4004_073_2	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4004	073	2	1	02	01	H4004_073_2	6			Preferred Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4004	073	2	1	02	01	H4004_073_2	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4004	073	2	1	02	01	H4004_073_2	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	7	2	10	1	2	0.00	
H4004	073	3	1	02	01	H4004_073_3	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H4004	073	3	1	02	01	H4004_073_3	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H4004	073	3	1	02	01	H4004_073_3	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H4004	073	3	1	02	01	H4004_073_3	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4004	073	3	1	02	01	H4004_073_3	6			Preferred Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4004	073	3	1	02	01	H4004_073_3	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4004	073	3	1	02	01	H4004_073_3	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	7	2	10	1	2	0.00	
H4005	004	0	1	04	01	H4005_004_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H4005	004	0	1	04	01	H4005_004_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	2	2	01	3	2	0.00	
H4005	004	0	1	04	01	H4005_004_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	3	2	10	3	2	0.00	
H4005	004	0	1	04	01	H4005_004_0	5			Non-Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	4	2	10	3	2	0.00	
H4005	004	0	1	04	01	H4005_004_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4005	004	0	1	04	01	H4005_004_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4026	001	0	1	01	01	H4026_001_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H4026	001	0	1	01	01	H4026_001_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4026	001	0	1	01	01	H4026_001_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4026	001	0	1	01	01	H4026_001_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4026	001	0	1	01	01	H4026_001_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4026	002	0	1	01	01	H4026_002_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H4026	002	0	1	01	01	H4026_002_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4026	002	0	1	01	01	H4026_002_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4026	002	0	1	01	01	H4026_002_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4026	002	0	1	01	01	H4026_002_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4032	001	0	1	02	01	H4032_001_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4032	001	0	1	02	01	H4032_001_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4032	001	0	1	02	01	H4032_001_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4032	001	0	1	02	01	H4032_001_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4032	001	0	1	02	01	H4032_001_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4032	002	0	1	02	01	H4032_002_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4032	002	0	1	02	01	H4032_002_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4032	002	0	1	02	01	H4032_002_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4032	002	0	1	02	01	H4032_002_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4032	002	0	1	02	01	H4032_002_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4036	008	0	1	04	01	H4036_008_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H4036	008	0	1	04	01	H4036_008_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4036	008	0	1	04	01	H4036_008_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4036	008	0	1	04	01	H4036_008_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4036	008	0	1	04	01	H4036_008_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4036	008	0	1	04	01	H4036_008_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4036	017	0	1	04	01	H4036_017_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H4036	017	0	1	04	01	H4036_017_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4036	017	0	1	04	01	H4036_017_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4036	017	0	1	04	01	H4036_017_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4036	017	0	1	04	01	H4036_017_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4036	017	0	1	04	01	H4036_017_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4036	025	0	1	04	01	H4036_025_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H4036	025	0	1	04	01	H4036_025_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4036	025	0	1	04	01	H4036_025_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4036	025	0	1	04	01	H4036_025_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4036	025	0	1	04	01	H4036_025_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4036	025	0	1	04	01	H4036_025_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4036	026	0	1	04	01	H4036_026_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H4036	026	0	1	04	01	H4036_026_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4036	026	0	1	04	01	H4036_026_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4036	026	0	1	04	01	H4036_026_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4036	026	0	1	04	01	H4036_026_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4036	026	0	1	04	01	H4036_026_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4036	030	0	1	04	01	H4036_030_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H4036	030	0	1	04	01	H4036_030_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4036	030	0	1	04	01	H4036_030_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4036	030	0	1	04	01	H4036_030_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4036	030	0	1	04	01	H4036_030_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4036	030	0	1	04	01	H4036_030_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4036	034	0	1	04	01	H4036_034_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H4036	034	0	1	04	01	H4036_034_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4036	034	0	1	04	01	H4036_034_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4036	034	0	1	04	01	H4036_034_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4036	034	0	1	04	01	H4036_034_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4036	034	0	1	04	01	H4036_034_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4036	036	0	1	04	01	H4036_036_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H4036	036	0	1	04	01	H4036_036_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4036	036	0	1	04	01	H4036_036_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4036	036	0	1	04	01	H4036_036_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4036	036	0	1	04	01	H4036_036_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4036	036	0	1	04	01	H4036_036_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4045	001	0	1	01	01	H4045_001_0	3		N	Generic	4	Generic, Preferred Brand, Non-Preferred Brand, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H4045	001	0	1	01	01	H4045_001_0	3		N	Preferred Brand	4	Generic, Preferred Brand, Non-Preferred Brand, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	2	2	10	1	2	0.00	
H4045	001	0	1	01	01	H4045_001_0	3		N	Non-Preferred Brand	4	Generic, Preferred Brand, Non-Preferred Brand, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H4045	001	0	1	01	01	H4045_001_0	3		N	Preferred Specialty Tier	4	Generic, Preferred Brand, Non-Preferred Brand, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4045	001	0	1	01	01	H4045_001_0	3		N	Specialty Tier	4	Generic, Preferred Brand, Non-Preferred Brand, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4045	001	0	1	01	01	H4045_001_0	3		N	Select Care Drugs	4	Generic, Preferred Brand, Non-Preferred Brand, Preferred Specialty Tier, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H4057	001	0	1	01	01	H4057_001_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H4057	001	0	1	01	01	H4057_001_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H4057	001	0	1	01	01	H4057_001_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H4057	001	0	1	01	01	H4057_001_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	3	2	0.00	
H4057	001	0	1	01	01	H4057_001_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4057	001	0	1	01	01	H4057_001_0	4		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4073	001	0	1	02	01	H4073_001_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H4073	001	0	1	02	01	H4073_001_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4073	001	0	1	02	01	H4073_001_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4073	001	0	1	02	01	H4073_001_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4073	001	0	1	02	01	H4073_001_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4073	001	0	1	02	01	H4073_001_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4073	002	0	1	02	01	H4073_002_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H4073	002	0	1	02	01	H4073_002_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4073	002	0	1	02	01	H4073_002_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4073	002	0	1	02	01	H4073_002_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4073	002	0	1	02	01	H4073_002_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4073	002	0	1	02	01	H4073_002_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4073	003	0	1	02	01	H4073_003_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H4073	003	0	1	02	01	H4073_003_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4073	003	0	1	02	01	H4073_003_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4073	003	0	1	02	01	H4073_003_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4073	003	0	1	02	01	H4073_003_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4073	003	0	1	02	01	H4073_003_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4073	004	0	1	02	01	H4073_004_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H4073	004	0	1	02	01	H4073_004_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4073	004	0	1	02	01	H4073_004_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4073	004	0	1	02	01	H4073_004_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4073	004	0	1	02	01	H4073_004_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4073	004	0	1	02	01	H4073_004_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4091	003	0	1	04	01	H4091_003_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4091	003	0	1	04	01	H4091_003_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4091	003	0	1	04	01	H4091_003_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H4091	003	0	1	04	01	H4091_003_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	10	1	2	0.00	
H4091	003	0	1	04	01	H4091_003_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4140	001	0	1	01	01	H4140_001_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	01	1	2	0.00	
H4140	001	0	1	01	01	H4140_001_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H4140	001	0	1	01	01	H4140_001_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H4140	001	0	1	01	01	H4140_001_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H4140	001	0	1	01	01	H4140_001_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H4140	001	0	1	01	01	H4140_001_0	8			Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H4140	002	0	1	01	01	H4140_002_0	8		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	01	1	2	0.00	
H4140	002	0	1	01	01	H4140_002_0	8		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H4140	002	0	1	01	01	H4140_002_0	8		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H4140	002	0	1	01	01	H4140_002_0	8		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H4140	002	0	1	01	01	H4140_002_0	8		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H4140	002	0	1	01	01	H4140_002_0	8		N	Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H4140	004	0	1	01	01	H4140_004_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	01	1	2	0.00	
H4140	004	0	1	01	01	H4140_004_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H4140	004	0	1	01	01	H4140_004_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H4140	004	0	1	01	01	H4140_004_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H4140	004	0	1	01	01	H4140_004_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H4140	004	0	1	01	01	H4140_004_0	8			Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H4140	012	0	1	01	01	H4140_012_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	01	1	2	0.00	
H4140	012	0	1	01	01	H4140_012_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H4140	012	0	1	01	01	H4140_012_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H4140	012	0	1	01	01	H4140_012_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H4140	012	0	1	01	01	H4140_012_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H4140	012	0	1	01	01	H4140_012_0	8			Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H4140	013	0	1	01	01	H4140_013_0	8		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	01	1	2	0.00	
H4140	013	0	1	01	01	H4140_013_0	8		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H4140	013	0	1	01	01	H4140_013_0	8		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H4140	013	0	1	01	01	H4140_013_0	8		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H4140	013	0	1	01	01	H4140_013_0	8		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H4140	013	0	1	01	01	H4140_013_0	8		N	Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H4140	016	0	1	01	01	H4140_016_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	01	1	2	0.00	
H4140	016	0	1	01	01	H4140_016_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H4140	016	0	1	01	01	H4140_016_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H4140	016	0	1	01	01	H4140_016_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H4140	016	0	1	01	01	H4140_016_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H4140	016	0	1	01	01	H4140_016_0	8			Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H4140	017	0	1	01	01	H4140_017_0	8		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	01	1	2	0.00	
H4140	017	0	1	01	01	H4140_017_0	8		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H4140	017	0	1	01	01	H4140_017_0	8		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H4140	017	0	1	01	01	H4140_017_0	8		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H4140	017	0	1	01	01	H4140_017_0	8		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H4140	017	0	1	01	01	H4140_017_0	8		N	Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H4140	018	0	1	01	01	H4140_018_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	01	1	2	0.00	
H4140	018	0	1	01	01	H4140_018_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H4140	018	0	1	01	01	H4140_018_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H4140	018	0	1	01	01	H4140_018_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H4140	018	0	1	01	01	H4140_018_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H4140	018	0	1	01	01	H4140_018_0	8			Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H4140	019	0	1	01	01	H4140_019_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	01	1	2	0.00	
H4140	019	0	1	01	01	H4140_019_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H4140	019	0	1	01	01	H4140_019_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H4140	019	0	1	01	01	H4140_019_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H4140	019	0	1	01	01	H4140_019_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H4140	019	0	1	01	01	H4140_019_0	6			Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H4141	003	0	1	01	01	H4141_003_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4141	003	0	1	01	01	H4141_003_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4141	003	0	1	01	01	H4141_003_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4141	003	0	1	01	01	H4141_003_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4141	003	0	1	01	01	H4141_003_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4141	015	0	1	01	01	H4141_015_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H4141	015	0	1	01	01	H4141_015_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4141	015	0	1	01	01	H4141_015_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4141	015	0	1	01	01	H4141_015_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4141	015	0	1	01	01	H4141_015_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4141	017	3	1	01	01	H4141_017_3	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H4141	017	3	1	01	01	H4141_017_3	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4141	017	3	1	01	01	H4141_017_3	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4141	017	3	1	01	01	H4141_017_3	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4141	017	3	1	01	01	H4141_017_3	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4141	017	5	1	01	01	H4141_017_5	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H4141	017	5	1	01	01	H4141_017_5	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4141	017	5	1	01	01	H4141_017_5	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4141	017	5	1	01	01	H4141_017_5	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4141	017	5	1	01	01	H4141_017_5	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4141	022	0	1	01	01	H4141_022_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4141	022	0	1	01	01	H4141_022_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4141	022	0	1	01	01	H4141_022_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4141	022	0	1	01	01	H4141_022_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4141	022	0	1	01	01	H4141_022_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4141	023	0	1	01	01	H4141_023_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4141	023	0	1	01	01	H4141_023_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4141	023	0	1	01	01	H4141_023_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4141	023	0	1	01	01	H4141_023_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4141	023	0	1	01	01	H4141_023_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4141	024	0	1	01	01	H4141_024_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4141	024	0	1	01	01	H4141_024_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4141	024	0	1	01	01	H4141_024_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4141	024	0	1	01	01	H4141_024_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4141	024	0	1	01	01	H4141_024_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4141	025	0	1	01	01	H4141_025_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4141	025	0	1	01	01	H4141_025_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4141	025	0	1	01	01	H4141_025_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4141	025	0	1	01	01	H4141_025_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4141	025	0	1	01	01	H4141_025_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4152	013	0	1	02	01	H4152_013_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4152	013	0	1	02	01	H4152_013_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4152	013	0	1	02	01	H4152_013_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4152	013	0	1	02	01	H4152_013_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4152	013	0	1	02	01	H4152_013_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4152	018	0	1	02	01	H4152_018_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4152	018	0	1	02	01	H4152_018_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4152	018	0	1	02	01	H4152_018_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4152	018	0	1	02	01	H4152_018_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4152	018	0	1	02	01	H4152_018_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4152	021	0	1	01	01	H4152_021_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4152	021	0	1	01	01	H4152_021_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4152	021	0	1	01	01	H4152_021_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4152	021	0	1	01	01	H4152_021_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4152	021	0	1	01	01	H4152_021_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4152	023	0	1	02	01	H4152_023_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4152	023	0	1	02	01	H4152_023_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4152	023	0	1	02	01	H4152_023_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4152	023	0	1	02	01	H4152_023_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4152	023	0	1	02	01	H4152_023_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4158	001	0	1	01	01	H4158_001_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H4158	001	0	1	01	01	H4158_001_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4158	001	0	1	01	01	H4158_001_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4158	001	0	1	01	01	H4158_001_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4158	001	0	1	01	01	H4158_001_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4158	001	0	1	01	01	H4158_001_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4161	002	0	1	02	01	H4161_002_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H4161	002	0	1	02	01	H4161_002_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4161	002	0	1	02	01	H4161_002_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4161	002	0	1	02	01	H4161_002_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4161	002	0	1	02	01	H4161_002_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4161	003	0	1	02	01	H4161_003_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4161	003	0	1	02	01	H4161_003_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4161	003	0	1	02	01	H4161_003_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4161	003	0	1	02	01	H4161_003_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4161	003	0	1	02	01	H4161_003_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4161	004	0	1	02	01	H4161_004_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4161	004	0	1	02	01	H4161_004_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4161	004	0	1	02	01	H4161_004_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4161	004	0	1	02	01	H4161_004_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4161	004	0	1	02	01	H4161_004_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4161	005	0	1	02	01	H4161_005_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4161	005	0	1	02	01	H4161_005_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4161	005	0	1	02	01	H4161_005_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4161	005	0	1	02	01	H4161_005_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4161	005	0	1	02	01	H4161_005_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4161	006	0	1	02	01	H4161_006_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4161	006	0	1	02	01	H4161_006_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4161	006	0	1	02	01	H4161_006_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4161	006	0	1	02	01	H4161_006_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4161	006	0	1	02	01	H4161_006_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4161	007	0	1	02	01	H4161_007_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4161	007	0	1	02	01	H4161_007_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4161	007	0	1	02	01	H4161_007_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4161	007	0	1	02	01	H4161_007_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4161	007	0	1	02	01	H4161_007_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4161	009	0	1	02	01	H4161_009_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H4161	009	0	1	02	01	H4161_009_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4161	009	0	1	02	01	H4161_009_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4161	009	0	1	02	01	H4161_009_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4161	009	0	1	02	01	H4161_009_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4161	010	0	1	02	01	H4161_010_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H4161	010	0	1	02	01	H4161_010_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4161	010	0	1	02	01	H4161_010_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4161	010	0	1	02	01	H4161_010_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4161	010	0	1	02	01	H4161_010_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4161	011	0	1	02	01	H4161_011_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H4161	011	0	1	02	01	H4161_011_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4161	011	0	1	02	01	H4161_011_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4161	011	0	1	02	01	H4161_011_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4161	011	0	1	02	01	H4161_011_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4161	011	0	1	02	01	H4161_011_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4161	012	0	1	02	01	H4161_012_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H4161	012	0	1	02	01	H4161_012_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4161	012	0	1	02	01	H4161_012_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4161	012	0	1	02	01	H4161_012_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4161	012	0	1	02	01	H4161_012_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4161	012	0	1	02	01	H4161_012_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4161	013	0	1	02	01	H4161_013_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H4161	013	0	1	02	01	H4161_013_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4161	013	0	1	02	01	H4161_013_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4161	013	0	1	02	01	H4161_013_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4161	013	0	1	02	01	H4161_013_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4161	013	0	1	02	01	H4161_013_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4161	014	0	1	02	01	H4161_014_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H4161	014	0	1	02	01	H4161_014_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4161	014	0	1	02	01	H4161_014_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4161	014	0	1	02	01	H4161_014_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4161	014	0	1	02	01	H4161_014_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4161	014	0	1	02	01	H4161_014_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4161	015	0	1	02	01	H4161_015_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H4161	015	0	1	02	01	H4161_015_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4161	015	0	1	02	01	H4161_015_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4161	015	0	1	02	01	H4161_015_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4161	015	0	1	02	01	H4161_015_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4161	015	0	1	02	01	H4161_015_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4161	016	0	1	02	01	H4161_016_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H4161	016	0	1	02	01	H4161_016_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4161	016	0	1	02	01	H4161_016_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4161	016	0	1	02	01	H4161_016_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4161	016	0	1	02	01	H4161_016_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4161	016	0	1	02	01	H4161_016_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4161	017	0	1	02	01	H4161_017_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H4161	017	0	1	02	01	H4161_017_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4161	017	0	1	02	01	H4161_017_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4161	017	0	1	02	01	H4161_017_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4161	017	0	1	02	01	H4161_017_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4161	017	0	1	02	01	H4161_017_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4172	003	0	1	01	01	H4172_003_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4172	003	0	1	01	01	H4172_003_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4172	003	0	1	01	01	H4172_003_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H4172	003	0	1	01	01	H4172_003_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	10	1	2	0.00	
H4172	003	0	1	01	01	H4172_003_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4213	017	1	1	09	04	H4213_017_1	5			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4213	017	1	1	09	04	H4213_017_1	5			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4213	017	1	1	09	04	H4213_017_1	5			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4213	017	1	1	09	04	H4213_017_1	5			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4213	017	1	1	09	04	H4213_017_1	5			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4213	017	5	1	09	04	H4213_017_5	5			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4213	017	5	1	09	04	H4213_017_5	5			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4213	017	5	1	09	04	H4213_017_5	5			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4213	017	5	1	09	04	H4213_017_5	5			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4213	017	5	1	09	04	H4213_017_5	5			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4213	017	6	1	09	04	H4213_017_6	5			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4213	017	6	1	09	04	H4213_017_6	5			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4213	017	6	1	09	04	H4213_017_6	5			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4213	017	6	1	09	04	H4213_017_6	5			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4213	017	6	1	09	04	H4213_017_6	5			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4227	001	0	1	01	01	H4227_001_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H4227	001	0	1	01	01	H4227_001_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H4227	001	0	1	01	01	H4227_001_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H4227	001	0	1	01	01	H4227_001_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4227	001	0	1	01	01	H4227_001_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4227	001	0	1	01	01	H4227_001_0	5		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H4227	002	0	1	01	01	H4227_002_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H4227	002	0	1	01	01	H4227_002_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H4227	002	0	1	01	01	H4227_002_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H4227	002	0	1	01	01	H4227_002_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4227	002	0	1	01	01	H4227_002_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4227	002	0	1	01	01	H4227_002_0	5		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H4279	001	0	1	01	01	H4279_001_0	17		N	Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4279	001	0	1	01	01	H4279_001_0	17		N	Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4279	001	0	1	01	01	H4279_001_0	17		N	Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4279	001	0	1	01	01	H4279_001_0	17		N	Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4279	001	0	1	01	01	H4279_001_0	17		N	Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4279	004	0	1	01	01	H4279_004_0	18		N	Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4279	004	0	1	01	01	H4279_004_0	18		N	Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4279	004	0	1	01	01	H4279_004_0	18		N	Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4279	004	0	1	01	01	H4279_004_0	18		N	Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4279	004	0	1	01	01	H4279_004_0	18		N	Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4286	001	0	1	01	01	H4286_001_0	6			Generic	4	Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	01	1	2	0.00	
H4286	001	0	1	01	01	H4286_001_0	6			Preferred Brand	4	Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H4286	001	0	1	01	01	H4286_001_0	6			Non-Preferred Drug	4	Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H4286	001	0	1	01	01	H4286_001_0	6			Specialty Tier	4	Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H4286	001	0	1	01	01	H4286_001_0	6			Supplemental Drugs	4	Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	01	2	2	10.00	
H4286	002	0	1	01	01	H4286_002_0	6		N	Generic	4	Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	01	1	2	0.00	
H4286	002	0	1	01	01	H4286_002_0	6		N	Preferred Brand	4	Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H4286	002	0	1	01	01	H4286_002_0	6		N	Non-Preferred Drug	4	Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H4286	002	0	1	01	01	H4286_002_0	6		N	Specialty Tier	4	Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H4286	002	0	1	01	01	H4286_002_0	6		N	Supplemental Drugs	4	Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	01	2	2	0.00	
H4286	003	0	1	01	01	H4286_003_0	6			Generic	4	Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	01	1	2	0.00	
H4286	003	0	1	01	01	H4286_003_0	6			Preferred Brand	4	Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H4286	003	0	1	01	01	H4286_003_0	6			Non-Preferred Drug	4	Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H4286	003	0	1	01	01	H4286_003_0	6			Specialty Tier	4	Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H4286	003	0	1	01	01	H4286_003_0	6			Supplemental Drugs	4	Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	01	2	2	10.00	
H4286	005	0	1	01	01	H4286_005_0	6		N	Generic	4	Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	01	1	2	0.00	
H4286	005	0	1	01	01	H4286_005_0	6		N	Preferred Brand	4	Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H4286	005	0	1	01	01	H4286_005_0	6		N	Non-Preferred Drug	4	Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H4286	005	0	1	01	01	H4286_005_0	6		N	Specialty Tier	4	Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H4286	005	0	1	01	01	H4286_005_0	6		N	Supplemental Drugs	4	Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	01	2	2	0.00	
H4329	001	0	1	01	01	H4329_001_0	3		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H4329	001	0	1	01	01	H4329_001_0	3		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4329	001	0	1	01	01	H4329_001_0	3		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4329	001	0	1	01	01	H4329_001_0	3		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4329	001	0	1	01	01	H4329_001_0	3		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4329	001	0	1	01	01	H4329_001_0	3		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4346	001	0	1	02	01	H4346_001_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H4346	001	0	1	02	01	H4346_001_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4346	001	0	1	02	01	H4346_001_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4346	001	0	1	02	01	H4346_001_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4346	001	0	1	02	01	H4346_001_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4346	001	0	1	02	01	H4346_001_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4346	005	0	1	02	01	H4346_005_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H4346	005	0	1	02	01	H4346_005_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4346	005	0	1	02	01	H4346_005_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4346	005	0	1	02	01	H4346_005_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4346	005	0	1	02	01	H4346_005_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4346	005	0	1	02	01	H4346_005_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4346	006	0	1	02	01	H4346_006_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H4346	006	0	1	02	01	H4346_006_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4346	006	0	1	02	01	H4346_006_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4346	006	0	1	02	01	H4346_006_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4346	006	0	1	02	01	H4346_006_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4346	006	0	1	02	01	H4346_006_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4346	010	0	1	01	01	H4346_010_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H4346	010	0	1	01	01	H4346_010_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4346	010	0	1	01	01	H4346_010_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4346	010	0	1	01	01	H4346_010_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4346	010	0	1	01	01	H4346_010_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4346	010	0	1	01	01	H4346_010_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4346	012	0	1	01	01	H4346_012_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H4346	012	0	1	01	01	H4346_012_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4346	012	0	1	01	01	H4346_012_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4346	012	0	1	01	01	H4346_012_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4346	012	0	1	01	01	H4346_012_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4346	012	0	1	01	01	H4346_012_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4346	014	0	1	01	01	H4346_014_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H4346	014	0	1	01	01	H4346_014_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4346	014	0	1	01	01	H4346_014_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4346	014	0	1	01	01	H4346_014_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4346	014	0	1	01	01	H4346_014_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4346	014	0	1	01	01	H4346_014_0	7		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4346	017	0	1	02	01	H4346_017_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H4346	017	0	1	02	01	H4346_017_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4346	017	0	1	02	01	H4346_017_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4346	017	0	1	02	01	H4346_017_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4346	017	0	1	02	01	H4346_017_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4346	025	0	1	01	01	H4346_025_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4346	025	0	1	01	01	H4346_025_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4346	025	0	1	01	01	H4346_025_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4346	025	0	1	01	01	H4346_025_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4346	025	0	1	01	01	H4346_025_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4346	030	0	1	02	01	H4346_030_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H4346	030	0	1	02	01	H4346_030_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4346	030	0	1	02	01	H4346_030_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4346	030	0	1	02	01	H4346_030_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4346	030	0	1	02	01	H4346_030_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4346	030	0	1	02	01	H4346_030_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4346	031	0	1	01	01	H4346_031_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4346	031	0	1	01	01	H4346_031_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4346	031	0	1	01	01	H4346_031_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4346	031	0	1	01	01	H4346_031_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4346	031	0	1	01	01	H4346_031_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4348	001	0	1	04	01	H4348_001_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4348	001	0	1	04	01	H4348_001_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H4348	001	0	1	04	01	H4348_001_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4348	001	0	1	04	01	H4348_001_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4348	001	0	1	04	01	H4348_001_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4348	002	0	1	04	01	H4348_002_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4348	002	0	1	04	01	H4348_002_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H4348	002	0	1	04	01	H4348_002_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4348	002	0	1	04	01	H4348_002_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4348	002	0	1	04	01	H4348_002_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4348	003	0	1	04	01	H4348_003_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H4348	003	0	1	04	01	H4348_003_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4348	003	0	1	04	01	H4348_003_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4348	003	0	1	04	01	H4348_003_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4348	003	0	1	04	01	H4348_003_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4348	003	0	1	04	01	H4348_003_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4348	004	0	1	04	01	H4348_004_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H4348	004	0	1	04	01	H4348_004_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4348	004	0	1	04	01	H4348_004_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4348	004	0	1	04	01	H4348_004_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4348	004	0	1	04	01	H4348_004_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4348	004	0	1	04	01	H4348_004_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4348	005	0	1	04	01	H4348_005_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4348	005	0	1	04	01	H4348_005_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H4348	005	0	1	04	01	H4348_005_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4348	005	0	1	04	01	H4348_005_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4348	005	0	1	04	01	H4348_005_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4348	006	0	1	04	01	H4348_006_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4348	006	0	1	04	01	H4348_006_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H4348	006	0	1	04	01	H4348_006_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4348	006	0	1	04	01	H4348_006_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4348	006	0	1	04	01	H4348_006_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4348	007	0	1	04	01	H4348_007_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H4348	007	0	1	04	01	H4348_007_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4348	007	0	1	04	01	H4348_007_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4348	007	0	1	04	01	H4348_007_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4348	007	0	1	04	01	H4348_007_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4348	007	0	1	04	01	H4348_007_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4407	004	0	1	01	01	H4407_004_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4407	004	0	1	01	01	H4407_004_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4407	004	0	1	01	01	H4407_004_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4407	004	0	1	01	01	H4407_004_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4407	004	0	1	01	01	H4407_004_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4407	027	0	1	01	01	H4407_027_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H4407	027	0	1	01	01	H4407_027_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4407	027	0	1	01	01	H4407_027_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4407	027	0	1	01	01	H4407_027_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4407	027	0	1	01	01	H4407_027_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4407	029	0	1	01	01	H4407_029_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4407	029	0	1	01	01	H4407_029_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4407	029	0	1	01	01	H4407_029_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4407	029	0	1	01	01	H4407_029_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4407	029	0	1	01	01	H4407_029_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4407	030	1	1	01	01	H4407_030_1	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H4407	030	1	1	01	01	H4407_030_1	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4407	030	1	1	01	01	H4407_030_1	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4407	030	1	1	01	01	H4407_030_1	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4407	030	1	1	01	01	H4407_030_1	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4407	030	2	1	01	01	H4407_030_2	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H4407	030	2	1	01	01	H4407_030_2	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4407	030	2	1	01	01	H4407_030_2	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4407	030	2	1	01	01	H4407_030_2	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4407	030	2	1	01	01	H4407_030_2	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4407	030	3	1	01	01	H4407_030_3	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H4407	030	3	1	01	01	H4407_030_3	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4407	030	3	1	01	01	H4407_030_3	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4407	030	3	1	01	01	H4407_030_3	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4407	030	3	1	01	01	H4407_030_3	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4407	033	0	1	01	01	H4407_033_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	9.00	
H4407	033	0	1	01	01	H4407_033_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4407	033	0	1	01	01	H4407_033_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4407	033	0	1	01	01	H4407_033_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4407	033	0	1	01	01	H4407_033_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4407	034	0	1	01	01	H4407_034_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	1	2	01	3	2	9.00	
H4407	034	0	1	01	01	H4407_034_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	2	2	01	1	2	0.00	
H4407	034	0	1	01	01	H4407_034_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	3	2	11	1	2	0.00	
H4407	034	0	1	01	01	H4407_034_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	4	2	11	1	2	0.00	
H4407	034	0	1	01	01	H4407_034_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	5	2	11	1	2	0.00	
H4407	034	0	1	01	01	H4407_034_0	5			Select Diabetic Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	6	2	11	1	2	0.00	
H4407	035	0	1	01	01	H4407_035_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H4407	035	0	1	01	01	H4407_035_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4407	035	0	1	01	01	H4407_035_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4407	035	0	1	01	01	H4407_035_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4407	035	0	1	01	01	H4407_035_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4461	022	0	1	01	01	H4461_022_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4461	022	0	1	01	01	H4461_022_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4461	022	0	1	01	01	H4461_022_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4461	022	0	1	01	01	H4461_022_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4461	022	0	1	01	01	H4461_022_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4461	025	0	1	01	01	H4461_025_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H4461	025	0	1	01	01	H4461_025_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4461	025	0	1	01	01	H4461_025_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4461	025	0	1	01	01	H4461_025_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4461	025	0	1	01	01	H4461_025_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4461	035	0	1	01	01	H4461_035_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H4461	035	0	1	01	01	H4461_035_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4461	035	0	1	01	01	H4461_035_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4461	035	0	1	01	01	H4461_035_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4461	035	0	1	01	01	H4461_035_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4461	038	0	1	01	01	H4461_038_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4461	038	0	1	01	01	H4461_038_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4461	038	0	1	01	01	H4461_038_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4461	038	0	1	01	01	H4461_038_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4461	038	0	1	01	01	H4461_038_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4461	039	0	1	01	01	H4461_039_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H4461	039	0	1	01	01	H4461_039_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4461	039	0	1	01	01	H4461_039_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4461	039	0	1	01	01	H4461_039_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4461	039	0	1	01	01	H4461_039_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4461	040	0	1	01	01	H4461_040_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H4461	040	0	1	01	01	H4461_040_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4461	040	0	1	01	01	H4461_040_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4461	040	0	1	01	01	H4461_040_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4461	040	0	1	01	01	H4461_040_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4461	041	0	1	01	01	H4461_041_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H4461	041	0	1	01	01	H4461_041_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4461	041	0	1	01	01	H4461_041_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4461	041	0	1	01	01	H4461_041_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4461	041	0	1	01	01	H4461_041_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4461	042	0	1	01	01	H4461_042_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H4461	042	0	1	01	01	H4461_042_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4461	042	0	1	01	01	H4461_042_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4461	042	0	1	01	01	H4461_042_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4461	042	0	1	01	01	H4461_042_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4461	042	0	1	01	01	H4461_042_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4461	043	1	1	01	01	H4461_043_1	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H4461	043	1	1	01	01	H4461_043_1	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4461	043	1	1	01	01	H4461_043_1	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4461	043	1	1	01	01	H4461_043_1	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4461	043	1	1	01	01	H4461_043_1	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4461	043	2	1	01	01	H4461_043_2	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H4461	043	2	1	01	01	H4461_043_2	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4461	043	2	1	01	01	H4461_043_2	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4461	043	2	1	01	01	H4461_043_2	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4461	043	2	1	01	01	H4461_043_2	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4461	044	0	1	02	01	H4461_044_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H4461	044	0	1	02	01	H4461_044_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4461	044	0	1	02	01	H4461_044_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4461	044	0	1	02	01	H4461_044_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4461	044	0	1	02	01	H4461_044_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4461	045	0	1	01	01	H4461_045_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H4461	045	0	1	01	01	H4461_045_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4461	045	0	1	01	01	H4461_045_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4461	045	0	1	01	01	H4461_045_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4461	045	0	1	01	01	H4461_045_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4461	046	0	1	01	01	H4461_046_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H4461	046	0	1	01	01	H4461_046_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4461	046	0	1	01	01	H4461_046_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4461	046	0	1	01	01	H4461_046_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4461	046	0	1	01	01	H4461_046_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4461	047	0	1	02	01	H4461_047_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H4461	047	0	1	02	01	H4461_047_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4461	047	0	1	02	01	H4461_047_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4461	047	0	1	02	01	H4461_047_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4461	047	0	1	02	01	H4461_047_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4461	048	0	1	02	01	H4461_048_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H4461	048	0	1	02	01	H4461_048_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4461	048	0	1	02	01	H4461_048_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4461	048	0	1	02	01	H4461_048_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4461	048	0	1	02	01	H4461_048_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4461	049	0	1	01	01	H4461_049_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4461	049	0	1	01	01	H4461_049_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4461	049	0	1	01	01	H4461_049_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4461	049	0	1	01	01	H4461_049_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4461	049	0	1	01	01	H4461_049_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4461	050	0	1	01	01	H4461_050_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4461	050	0	1	01	01	H4461_050_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4461	050	0	1	01	01	H4461_050_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4461	050	0	1	01	01	H4461_050_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4461	050	0	1	01	01	H4461_050_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4461	051	0	1	01	01	H4461_051_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4461	051	0	1	01	01	H4461_051_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4461	051	0	1	01	01	H4461_051_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4461	051	0	1	01	01	H4461_051_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4461	051	0	1	01	01	H4461_051_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4461	052	0	1	01	01	H4461_052_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4461	052	0	1	01	01	H4461_052_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4461	052	0	1	01	01	H4461_052_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4461	052	0	1	01	01	H4461_052_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4461	052	0	1	01	01	H4461_052_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4461	053	0	1	01	01	H4461_053_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4461	053	0	1	01	01	H4461_053_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4461	053	0	1	01	01	H4461_053_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4461	053	0	1	01	01	H4461_053_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4461	053	0	1	01	01	H4461_053_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4461	054	0	1	01	01	H4461_054_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4461	054	0	1	01	01	H4461_054_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4461	054	0	1	01	01	H4461_054_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4461	054	0	1	01	01	H4461_054_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4461	054	0	1	01	01	H4461_054_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4461	055	0	1	01	01	H4461_055_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4461	055	0	1	01	01	H4461_055_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4461	055	0	1	01	01	H4461_055_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4461	055	0	1	01	01	H4461_055_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4461	055	0	1	01	01	H4461_055_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4461	056	0	1	01	01	H4461_056_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H4461	056	0	1	01	01	H4461_056_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4461	056	0	1	01	01	H4461_056_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4461	056	0	1	01	01	H4461_056_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4461	056	0	1	01	01	H4461_056_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4461	057	0	1	01	01	H4461_057_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4461	057	0	1	01	01	H4461_057_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4461	057	0	1	01	01	H4461_057_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4461	057	0	1	01	01	H4461_057_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4461	057	0	1	01	01	H4461_057_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4461	058	0	1	01	01	H4461_058_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4461	058	0	1	01	01	H4461_058_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4461	058	0	1	01	01	H4461_058_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4461	058	0	1	01	01	H4461_058_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4461	058	0	1	01	01	H4461_058_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4461	059	0	1	01	01	H4461_059_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H4461	059	0	1	01	01	H4461_059_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4461	059	0	1	01	01	H4461_059_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4461	059	0	1	01	01	H4461_059_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4461	059	0	1	01	01	H4461_059_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4461	060	0	1	01	01	H4461_060_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4461	060	0	1	01	01	H4461_060_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4461	060	0	1	01	01	H4461_060_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4461	060	0	1	01	01	H4461_060_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4461	060	0	1	01	01	H4461_060_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4461	061	0	1	01	01	H4461_061_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4461	061	0	1	01	01	H4461_061_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4461	061	0	1	01	01	H4461_061_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4461	061	0	1	01	01	H4461_061_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4461	061	0	1	01	01	H4461_061_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4461	062	0	1	01	01	H4461_062_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4461	062	0	1	01	01	H4461_062_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4461	062	0	1	01	01	H4461_062_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4461	062	0	1	01	01	H4461_062_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4461	062	0	1	01	01	H4461_062_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4461	063	0	1	01	01	H4461_063_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H4461	063	0	1	01	01	H4461_063_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4461	063	0	1	01	01	H4461_063_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4461	063	0	1	01	01	H4461_063_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4461	063	0	1	01	01	H4461_063_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4461	063	0	1	01	01	H4461_063_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4461	064	0	1	01	01	H4461_064_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H4461	064	0	1	01	01	H4461_064_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4461	064	0	1	01	01	H4461_064_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4461	064	0	1	01	01	H4461_064_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4461	064	0	1	01	01	H4461_064_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4461	065	0	1	01	01	H4461_065_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H4461	065	0	1	01	01	H4461_065_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4461	065	0	1	01	01	H4461_065_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4461	065	0	1	01	01	H4461_065_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4461	065	0	1	01	01	H4461_065_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4461	065	0	1	01	01	H4461_065_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4461	066	0	1	01	01	H4461_066_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H4461	066	0	1	01	01	H4461_066_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4461	066	0	1	01	01	H4461_066_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4461	066	0	1	01	01	H4461_066_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4461	066	0	1	01	01	H4461_066_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4461	066	0	1	01	01	H4461_066_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4461	067	0	1	01	01	H4461_067_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H4461	067	0	1	01	01	H4461_067_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4461	067	0	1	01	01	H4461_067_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4461	067	0	1	01	01	H4461_067_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4461	067	0	1	01	01	H4461_067_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4461	067	0	1	01	01	H4461_067_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4461	068	0	1	01	01	H4461_068_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H4461	068	0	1	01	01	H4461_068_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4461	068	0	1	01	01	H4461_068_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4461	068	0	1	01	01	H4461_068_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4461	068	0	1	01	01	H4461_068_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4461	068	0	1	01	01	H4461_068_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4461	069	0	1	01	01	H4461_069_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4461	069	0	1	01	01	H4461_069_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4461	069	0	1	01	01	H4461_069_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4461	069	0	1	01	01	H4461_069_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4461	069	0	1	01	01	H4461_069_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4461	070	0	1	01	01	H4461_070_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4461	070	0	1	01	01	H4461_070_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4461	070	0	1	01	01	H4461_070_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4461	070	0	1	01	01	H4461_070_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4461	070	0	1	01	01	H4461_070_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4461	071	0	1	01	01	H4461_071_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4461	071	0	1	01	01	H4461_071_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4461	071	0	1	01	01	H4461_071_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4461	071	0	1	01	01	H4461_071_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4461	071	0	1	01	01	H4461_071_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4461	072	0	1	01	01	H4461_072_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4461	072	0	1	01	01	H4461_072_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4461	072	0	1	01	01	H4461_072_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4461	072	0	1	01	01	H4461_072_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4461	072	0	1	01	01	H4461_072_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4461	073	0	1	01	01	H4461_073_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H4461	073	0	1	01	01	H4461_073_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4461	073	0	1	01	01	H4461_073_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4461	073	0	1	01	01	H4461_073_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4461	073	0	1	01	01	H4461_073_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4461	074	0	1	01	01	H4461_074_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4461	074	0	1	01	01	H4461_074_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4461	074	0	1	01	01	H4461_074_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4461	074	0	1	01	01	H4461_074_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4461	074	0	1	01	01	H4461_074_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4461	076	0	1	01	01	H4461_076_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4461	076	0	1	01	01	H4461_076_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4461	076	0	1	01	01	H4461_076_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4461	076	0	1	01	01	H4461_076_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4461	076	0	1	01	01	H4461_076_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4461	077	0	1	01	01	H4461_077_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4461	077	0	1	01	01	H4461_077_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4461	077	0	1	01	01	H4461_077_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4461	077	0	1	01	01	H4461_077_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4461	077	0	1	01	01	H4461_077_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4461	078	0	1	01	01	H4461_078_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H4461	078	0	1	01	01	H4461_078_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4461	078	0	1	01	01	H4461_078_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4461	078	0	1	01	01	H4461_078_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4461	078	0	1	01	01	H4461_078_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4461	079	0	1	01	01	H4461_079_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4461	079	0	1	01	01	H4461_079_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4461	079	0	1	01	01	H4461_079_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4461	079	0	1	01	01	H4461_079_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4461	079	0	1	01	01	H4461_079_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4471	005	0	1	01	01	H4471_005_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4471	005	0	1	01	01	H4471_005_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4471	005	0	1	01	01	H4471_005_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4471	005	0	1	01	01	H4471_005_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4471	005	0	1	01	01	H4471_005_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4471	010	1	1	01	01	H4471_010_1	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4471	010	1	1	01	01	H4471_010_1	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4471	010	1	1	01	01	H4471_010_1	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4471	010	1	1	01	01	H4471_010_1	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4471	010	1	1	01	01	H4471_010_1	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4471	010	2	1	01	01	H4471_010_2	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4471	010	2	1	01	01	H4471_010_2	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4471	010	2	1	01	01	H4471_010_2	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4471	010	2	1	01	01	H4471_010_2	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4471	010	2	1	01	01	H4471_010_2	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4471	011	0	1	01	01	H4471_011_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H4471	011	0	1	01	01	H4471_011_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4471	011	0	1	01	01	H4471_011_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4471	011	0	1	01	01	H4471_011_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4471	011	0	1	01	01	H4471_011_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4471	011	0	1	01	01	H4471_011_0	6		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4473	001	0	1	04	01	H4473_001_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4473	001	0	1	04	01	H4473_001_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H4473	001	0	1	04	01	H4473_001_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4473	001	0	1	04	01	H4473_001_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4473	001	0	1	04	01	H4473_001_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4473	002	0	1	04	01	H4473_002_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4473	002	0	1	04	01	H4473_002_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H4473	002	0	1	04	01	H4473_002_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4473	002	0	1	04	01	H4473_002_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4473	002	0	1	04	01	H4473_002_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4473	003	0	1	04	01	H4473_003_0	7			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H4473	003	0	1	04	01	H4473_003_0	7			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4473	003	0	1	04	01	H4473_003_0	7			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4473	003	0	1	04	01	H4473_003_0	7			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4473	003	0	1	04	01	H4473_003_0	7			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4473	003	0	1	04	01	H4473_003_0	7			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4473	004	0	1	04	01	H4473_004_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H4473	004	0	1	04	01	H4473_004_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4473	004	0	1	04	01	H4473_004_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4473	004	0	1	04	01	H4473_004_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4473	004	0	1	04	01	H4473_004_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4473	004	0	1	04	01	H4473_004_0	6		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H4473	007	0	1	04	01	H4473_007_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H4473	007	0	1	04	01	H4473_007_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4473	007	0	1	04	01	H4473_007_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4473	007	0	1	04	01	H4473_007_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4473	007	0	1	04	01	H4473_007_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4473	007	0	1	04	01	H4473_007_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4497	001	1	1	04	01	H4497_001_1	15			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H4497	001	1	1	04	01	H4497_001_1	15			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H4497	001	1	1	04	01	H4497_001_1	15			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4497	001	1	1	04	01	H4497_001_1	15			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4497	001	1	1	04	01	H4497_001_1	15			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4497	001	1	1	04	01	H4497_001_1	15			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H4497	001	3	1	04	01	H4497_001_3	15			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H4497	001	3	1	04	01	H4497_001_3	15			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H4497	001	3	1	04	01	H4497_001_3	15			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4497	001	3	1	04	01	H4497_001_3	15			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4497	001	3	1	04	01	H4497_001_3	15			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4497	001	3	1	04	01	H4497_001_3	15			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H4497	002	1	1	04	01	H4497_002_1	15			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H4497	002	1	1	04	01	H4497_002_1	15			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H4497	002	1	1	04	01	H4497_002_1	15			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4497	002	1	1	04	01	H4497_002_1	15			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4497	002	1	1	04	01	H4497_002_1	15			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4497	002	1	1	04	01	H4497_002_1	15			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H4497	002	3	1	04	01	H4497_002_3	15			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H4497	002	3	1	04	01	H4497_002_3	15			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H4497	002	3	1	04	01	H4497_002_3	15			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4497	002	3	1	04	01	H4497_002_3	15			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4497	002	3	1	04	01	H4497_002_3	15			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4497	002	3	1	04	01	H4497_002_3	15			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H4497	003	1	1	04	01	H4497_003_1	14			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H4497	003	1	1	04	01	H4497_003_1	14			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H4497	003	1	1	04	01	H4497_003_1	14			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4497	003	1	1	04	01	H4497_003_1	14			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4497	003	1	1	04	01	H4497_003_1	14			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4497	003	1	1	04	01	H4497_003_1	14			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H4497	003	3	1	04	01	H4497_003_3	14			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H4497	003	3	1	04	01	H4497_003_3	14			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H4497	003	3	1	04	01	H4497_003_3	14			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4497	003	3	1	04	01	H4497_003_3	14			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4497	003	3	1	04	01	H4497_003_3	14			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4497	003	3	1	04	01	H4497_003_3	14			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H4497	005	3	1	04	01	H4497_005_3	14			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H4497	005	3	1	04	01	H4497_005_3	14			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H4497	005	3	1	04	01	H4497_005_3	14			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4497	005	3	1	04	01	H4497_005_3	14			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4497	005	3	1	04	01	H4497_005_3	14			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4497	005	3	1	04	01	H4497_005_3	14			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H4497	005	4	1	04	01	H4497_005_4	14			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H4497	005	4	1	04	01	H4497_005_4	14			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H4497	005	4	1	04	01	H4497_005_4	14			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4497	005	4	1	04	01	H4497_005_4	14			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4497	005	4	1	04	01	H4497_005_4	14			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4497	005	4	1	04	01	H4497_005_4	14			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H4506	003	0	1	02	01	H4506_003_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H4506	003	0	1	02	01	H4506_003_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4506	003	0	1	02	01	H4506_003_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4506	003	0	1	02	01	H4506_003_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4506	003	0	1	02	01	H4506_003_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4506	003	0	1	02	01	H4506_003_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4506	030	0	1	02	01	H4506_030_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H4506	030	0	1	02	01	H4506_030_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4506	030	0	1	02	01	H4506_030_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4506	030	0	1	02	01	H4506_030_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4506	030	0	1	02	01	H4506_030_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4506	030	0	1	02	01	H4506_030_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4513	026	0	1	01	01	H4513_026_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	9.00	
H4513	026	0	1	01	01	H4513_026_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4513	026	0	1	01	01	H4513_026_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	026	0	1	01	01	H4513_026_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	026	0	1	01	01	H4513_026_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	027	0	1	01	01	H4513_027_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4513	027	0	1	01	01	H4513_027_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4513	027	0	1	01	01	H4513_027_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	027	0	1	01	01	H4513_027_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	027	0	1	01	01	H4513_027_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	030	0	1	01	01	H4513_030_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H4513	030	0	1	01	01	H4513_030_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4513	030	0	1	01	01	H4513_030_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	030	0	1	01	01	H4513_030_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	030	0	1	01	01	H4513_030_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	034	0	1	01	01	H4513_034_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4513	034	0	1	01	01	H4513_034_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4513	034	0	1	01	01	H4513_034_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	034	0	1	01	01	H4513_034_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	034	0	1	01	01	H4513_034_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	036	0	1	02	01	H4513_036_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H4513	036	0	1	02	01	H4513_036_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4513	036	0	1	02	01	H4513_036_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	036	0	1	02	01	H4513_036_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	036	0	1	02	01	H4513_036_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	037	0	1	01	01	H4513_037_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H4513	037	0	1	01	01	H4513_037_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4513	037	0	1	01	01	H4513_037_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	037	0	1	01	01	H4513_037_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	037	0	1	01	01	H4513_037_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	038	0	1	01	01	H4513_038_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H4513	038	0	1	01	01	H4513_038_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4513	038	0	1	01	01	H4513_038_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	038	0	1	01	01	H4513_038_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	038	0	1	01	01	H4513_038_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	039	0	1	01	01	H4513_039_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4513	039	0	1	01	01	H4513_039_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4513	039	0	1	01	01	H4513_039_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	039	0	1	01	01	H4513_039_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	039	0	1	01	01	H4513_039_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	046	1	1	01	01	H4513_046_1	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H4513	046	1	1	01	01	H4513_046_1	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4513	046	1	1	01	01	H4513_046_1	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	046	1	1	01	01	H4513_046_1	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	046	1	1	01	01	H4513_046_1	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	046	2	1	01	01	H4513_046_2	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H4513	046	2	1	01	01	H4513_046_2	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4513	046	2	1	01	01	H4513_046_2	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	046	2	1	01	01	H4513_046_2	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	046	2	1	01	01	H4513_046_2	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	049	1	1	01	01	H4513_049_1	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H4513	049	1	1	01	01	H4513_049_1	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4513	049	1	1	01	01	H4513_049_1	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	049	1	1	01	01	H4513_049_1	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	049	1	1	01	01	H4513_049_1	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	049	2	1	01	01	H4513_049_2	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H4513	049	2	1	01	01	H4513_049_2	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4513	049	2	1	01	01	H4513_049_2	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	049	2	1	01	01	H4513_049_2	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	049	2	1	01	01	H4513_049_2	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	049	3	1	01	01	H4513_049_3	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H4513	049	3	1	01	01	H4513_049_3	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4513	049	3	1	01	01	H4513_049_3	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	049	3	1	01	01	H4513_049_3	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	049	3	1	01	01	H4513_049_3	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	049	4	1	01	01	H4513_049_4	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H4513	049	4	1	01	01	H4513_049_4	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4513	049	4	1	01	01	H4513_049_4	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	049	4	1	01	01	H4513_049_4	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	049	4	1	01	01	H4513_049_4	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	049	5	1	01	01	H4513_049_5	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H4513	049	5	1	01	01	H4513_049_5	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4513	049	5	1	01	01	H4513_049_5	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	049	5	1	01	01	H4513_049_5	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	049	5	1	01	01	H4513_049_5	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	050	0	1	01	01	H4513_050_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H4513	050	0	1	01	01	H4513_050_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4513	050	0	1	01	01	H4513_050_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	050	0	1	01	01	H4513_050_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	050	0	1	01	01	H4513_050_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	052	0	1	01	01	H4513_052_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H4513	052	0	1	01	01	H4513_052_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4513	052	0	1	01	01	H4513_052_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	052	0	1	01	01	H4513_052_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	052	0	1	01	01	H4513_052_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	055	0	1	01	01	H4513_055_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4513	055	0	1	01	01	H4513_055_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4513	055	0	1	01	01	H4513_055_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	055	0	1	01	01	H4513_055_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	055	0	1	01	01	H4513_055_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	060	1	1	01	01	H4513_060_1	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4513	060	1	1	01	01	H4513_060_1	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4513	060	1	1	01	01	H4513_060_1	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	060	1	1	01	01	H4513_060_1	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	060	1	1	01	01	H4513_060_1	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	060	2	1	01	01	H4513_060_2	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4513	060	2	1	01	01	H4513_060_2	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4513	060	2	1	01	01	H4513_060_2	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	060	2	1	01	01	H4513_060_2	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	060	2	1	01	01	H4513_060_2	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	060	3	1	01	01	H4513_060_3	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4513	060	3	1	01	01	H4513_060_3	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4513	060	3	1	01	01	H4513_060_3	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	060	3	1	01	01	H4513_060_3	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	060	3	1	01	01	H4513_060_3	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	060	4	1	01	01	H4513_060_4	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4513	060	4	1	01	01	H4513_060_4	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4513	060	4	1	01	01	H4513_060_4	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	060	4	1	01	01	H4513_060_4	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	060	4	1	01	01	H4513_060_4	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	060	5	1	01	01	H4513_060_5	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4513	060	5	1	01	01	H4513_060_5	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4513	060	5	1	01	01	H4513_060_5	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	060	5	1	01	01	H4513_060_5	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	060	5	1	01	01	H4513_060_5	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	061	1	1	01	01	H4513_061_1	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	5.00	
H4513	061	1	1	01	01	H4513_061_1	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4513	061	1	1	01	01	H4513_061_1	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	061	1	1	01	01	H4513_061_1	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	061	1	1	01	01	H4513_061_1	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	061	2	1	01	01	H4513_061_2	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	5.00	
H4513	061	2	1	01	01	H4513_061_2	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4513	061	2	1	01	01	H4513_061_2	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	061	2	1	01	01	H4513_061_2	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	061	2	1	01	01	H4513_061_2	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	061	3	1	01	01	H4513_061_3	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	5.00	
H4513	061	3	1	01	01	H4513_061_3	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4513	061	3	1	01	01	H4513_061_3	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	061	3	1	01	01	H4513_061_3	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	061	3	1	01	01	H4513_061_3	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	061	4	1	01	01	H4513_061_4	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	5.00	
H4513	061	4	1	01	01	H4513_061_4	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4513	061	4	1	01	01	H4513_061_4	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	061	4	1	01	01	H4513_061_4	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	061	4	1	01	01	H4513_061_4	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	061	5	1	01	01	H4513_061_5	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	5.00	
H4513	061	5	1	01	01	H4513_061_5	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4513	061	5	1	01	01	H4513_061_5	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	061	5	1	01	01	H4513_061_5	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	061	5	1	01	01	H4513_061_5	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	063	0	1	01	01	H4513_063_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4513	063	0	1	01	01	H4513_063_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4513	063	0	1	01	01	H4513_063_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	063	0	1	01	01	H4513_063_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	063	0	1	01	01	H4513_063_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	064	0	1	01	01	H4513_064_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	5.00	
H4513	064	0	1	01	01	H4513_064_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4513	064	0	1	01	01	H4513_064_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	064	0	1	01	01	H4513_064_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	064	0	1	01	01	H4513_064_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	068	1	1	01	01	H4513_068_1	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H4513	068	1	1	01	01	H4513_068_1	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4513	068	1	1	01	01	H4513_068_1	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	068	1	1	01	01	H4513_068_1	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	068	1	1	01	01	H4513_068_1	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	068	2	1	01	01	H4513_068_2	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H4513	068	2	1	01	01	H4513_068_2	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4513	068	2	1	01	01	H4513_068_2	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	068	2	1	01	01	H4513_068_2	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	068	2	1	01	01	H4513_068_2	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	068	3	1	01	01	H4513_068_3	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H4513	068	3	1	01	01	H4513_068_3	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4513	068	3	1	01	01	H4513_068_3	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	068	3	1	01	01	H4513_068_3	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	068	3	1	01	01	H4513_068_3	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	073	0	1	01	01	H4513_073_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	5.00	
H4513	073	0	1	01	01	H4513_073_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4513	073	0	1	01	01	H4513_073_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	073	0	1	01	01	H4513_073_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	073	0	1	01	01	H4513_073_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	074	0	1	01	01	H4513_074_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	5.00	
H4513	074	0	1	01	01	H4513_074_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4513	074	0	1	01	01	H4513_074_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	074	0	1	01	01	H4513_074_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	074	0	1	01	01	H4513_074_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	075	0	1	01	01	H4513_075_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4513	075	0	1	01	01	H4513_075_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4513	075	0	1	01	01	H4513_075_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	075	0	1	01	01	H4513_075_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	075	0	1	01	01	H4513_075_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	077	1	1	01	01	H4513_077_1	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H4513	077	1	1	01	01	H4513_077_1	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4513	077	1	1	01	01	H4513_077_1	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	077	1	1	01	01	H4513_077_1	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	077	1	1	01	01	H4513_077_1	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	077	2	1	01	01	H4513_077_2	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H4513	077	2	1	01	01	H4513_077_2	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4513	077	2	1	01	01	H4513_077_2	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	077	2	1	01	01	H4513_077_2	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	077	2	1	01	01	H4513_077_2	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	077	3	1	01	01	H4513_077_3	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H4513	077	3	1	01	01	H4513_077_3	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4513	077	3	1	01	01	H4513_077_3	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	077	3	1	01	01	H4513_077_3	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	077	3	1	01	01	H4513_077_3	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	077	4	1	01	01	H4513_077_4	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H4513	077	4	1	01	01	H4513_077_4	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4513	077	4	1	01	01	H4513_077_4	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	077	4	1	01	01	H4513_077_4	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	077	4	1	01	01	H4513_077_4	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	079	0	1	01	01	H4513_079_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4513	079	0	1	01	01	H4513_079_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4513	079	0	1	01	01	H4513_079_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	079	0	1	01	01	H4513_079_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	079	0	1	01	01	H4513_079_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	080	0	1	01	01	H4513_080_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4513	080	0	1	01	01	H4513_080_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4513	080	0	1	01	01	H4513_080_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	080	0	1	01	01	H4513_080_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	080	0	1	01	01	H4513_080_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	081	0	1	01	01	H4513_081_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4513	081	0	1	01	01	H4513_081_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4513	081	0	1	01	01	H4513_081_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	081	0	1	01	01	H4513_081_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	081	0	1	01	01	H4513_081_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	083	1	1	01	01	H4513_083_1	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	5.00	
H4513	083	1	1	01	01	H4513_083_1	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4513	083	1	1	01	01	H4513_083_1	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	083	1	1	01	01	H4513_083_1	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	083	1	1	01	01	H4513_083_1	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	083	2	1	01	01	H4513_083_2	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	5.00	
H4513	083	2	1	01	01	H4513_083_2	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4513	083	2	1	01	01	H4513_083_2	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	083	2	1	01	01	H4513_083_2	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	083	2	1	01	01	H4513_083_2	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	083	3	1	01	01	H4513_083_3	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	5.00	
H4513	083	3	1	01	01	H4513_083_3	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4513	083	3	1	01	01	H4513_083_3	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	083	3	1	01	01	H4513_083_3	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	083	3	1	01	01	H4513_083_3	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	083	4	1	01	01	H4513_083_4	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	5.00	
H4513	083	4	1	01	01	H4513_083_4	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4513	083	4	1	01	01	H4513_083_4	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	083	4	1	01	01	H4513_083_4	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	083	4	1	01	01	H4513_083_4	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	083	5	1	01	01	H4513_083_5	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	5.00	
H4513	083	5	1	01	01	H4513_083_5	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4513	083	5	1	01	01	H4513_083_5	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	083	5	1	01	01	H4513_083_5	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	083	5	1	01	01	H4513_083_5	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	083	6	1	01	01	H4513_083_6	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	5.00	
H4513	083	6	1	01	01	H4513_083_6	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4513	083	6	1	01	01	H4513_083_6	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	083	6	1	01	01	H4513_083_6	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	083	6	1	01	01	H4513_083_6	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	083	7	1	01	01	H4513_083_7	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	5.00	
H4513	083	7	1	01	01	H4513_083_7	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4513	083	7	1	01	01	H4513_083_7	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	083	7	1	01	01	H4513_083_7	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	083	7	1	01	01	H4513_083_7	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	084	0	1	02	01	H4513_084_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H4513	084	0	1	02	01	H4513_084_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4513	084	0	1	02	01	H4513_084_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	084	0	1	02	01	H4513_084_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	084	0	1	02	01	H4513_084_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	085	0	1	01	01	H4513_085_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	5.00	
H4513	085	0	1	01	01	H4513_085_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4513	085	0	1	01	01	H4513_085_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	085	0	1	01	01	H4513_085_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	085	0	1	01	01	H4513_085_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	086	0	1	01	01	H4513_086_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	5.00	
H4513	086	0	1	01	01	H4513_086_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4513	086	0	1	01	01	H4513_086_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	086	0	1	01	01	H4513_086_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	086	0	1	01	01	H4513_086_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	087	1	1	01	01	H4513_087_1	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H4513	087	1	1	01	01	H4513_087_1	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4513	087	1	1	01	01	H4513_087_1	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	087	1	1	01	01	H4513_087_1	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	087	1	1	01	01	H4513_087_1	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	087	2	1	01	01	H4513_087_2	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H4513	087	2	1	01	01	H4513_087_2	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4513	087	2	1	01	01	H4513_087_2	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	087	2	1	01	01	H4513_087_2	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	087	2	1	01	01	H4513_087_2	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	087	3	1	01	01	H4513_087_3	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H4513	087	3	1	01	01	H4513_087_3	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4513	087	3	1	01	01	H4513_087_3	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	087	3	1	01	01	H4513_087_3	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	087	3	1	01	01	H4513_087_3	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	087	4	1	01	01	H4513_087_4	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H4513	087	4	1	01	01	H4513_087_4	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4513	087	4	1	01	01	H4513_087_4	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	087	4	1	01	01	H4513_087_4	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	087	4	1	01	01	H4513_087_4	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	088	0	1	01	01	H4513_088_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H4513	088	0	1	01	01	H4513_088_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4513	088	0	1	01	01	H4513_088_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	088	0	1	01	01	H4513_088_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	088	0	1	01	01	H4513_088_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	089	0	1	01	01	H4513_089_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H4513	089	0	1	01	01	H4513_089_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4513	089	0	1	01	01	H4513_089_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	089	0	1	01	01	H4513_089_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	089	0	1	01	01	H4513_089_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	090	0	1	01	01	H4513_090_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H4513	090	0	1	01	01	H4513_090_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4513	090	0	1	01	01	H4513_090_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	090	0	1	01	01	H4513_090_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	090	0	1	01	01	H4513_090_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	091	0	1	01	01	H4513_091_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	5.00	
H4513	091	0	1	01	01	H4513_091_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4513	091	0	1	01	01	H4513_091_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	091	0	1	01	01	H4513_091_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	091	0	1	01	01	H4513_091_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	092	0	1	01	01	H4513_092_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	5.00	
H4513	092	0	1	01	01	H4513_092_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4513	092	0	1	01	01	H4513_092_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	092	0	1	01	01	H4513_092_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	092	0	1	01	01	H4513_092_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	093	0	1	01	01	H4513_093_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	5.00	
H4513	093	0	1	01	01	H4513_093_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4513	093	0	1	01	01	H4513_093_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	093	0	1	01	01	H4513_093_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	093	0	1	01	01	H4513_093_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	094	0	1	01	01	H4513_094_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	1	2	01	3	2	10.00	
H4513	094	0	1	01	01	H4513_094_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	2	2	01	1	2	0.00	
H4513	094	0	1	01	01	H4513_094_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	3	2	11	1	2	0.00	
H4513	094	0	1	01	01	H4513_094_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	4	2	11	1	2	0.00	
H4513	094	0	1	01	01	H4513_094_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	5	2	11	1	2	0.00	
H4513	094	0	1	01	01	H4513_094_0	5			Select Diabetic Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	6	2	11	1	2	0.00	
H4513	095	0	1	01	01	H4513_095_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	9.00	
H4513	095	0	1	01	01	H4513_095_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4513	095	0	1	01	01	H4513_095_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	095	0	1	01	01	H4513_095_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	095	0	1	01	01	H4513_095_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	096	0	1	02	01	H4513_096_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H4513	096	0	1	02	01	H4513_096_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4513	096	0	1	02	01	H4513_096_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4513	096	0	1	02	01	H4513_096_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4513	096	0	1	02	01	H4513_096_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4513	097	0	1	01	01	H4513_097_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	1	2	01	3	2	10.00	
H4513	097	0	1	01	01	H4513_097_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	2	2	01	1	2	0.00	
H4513	097	0	1	01	01	H4513_097_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	3	2	11	1	2	0.00	
H4513	097	0	1	01	01	H4513_097_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	4	2	11	1	2	0.00	
H4513	097	0	1	01	01	H4513_097_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	5	2	11	1	2	0.00	
H4513	097	0	1	01	01	H4513_097_0	5			Select Diabetic Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	6	2	11	1	2	0.00	
H4513	098	0	1	01	01	H4513_098_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	1	2	01	3	2	5.00	
H4513	098	0	1	01	01	H4513_098_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	2	2	01	1	2	0.00	
H4513	098	0	1	01	01	H4513_098_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	3	2	11	1	2	0.00	
H4513	098	0	1	01	01	H4513_098_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	4	2	11	1	2	0.00	
H4513	098	0	1	01	01	H4513_098_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	5	2	11	1	2	0.00	
H4513	098	0	1	01	01	H4513_098_0	4			Select Diabetic Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	6	2	11	1	2	0.00	
H4514	007	0	1	02	01	H4514_007_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4514	007	0	1	02	01	H4514_007_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H4514	007	0	1	02	01	H4514_007_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4514	007	0	1	02	01	H4514_007_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4514	007	0	1	02	01	H4514_007_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4514	014	0	1	02	01	H4514_014_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4514	014	0	1	02	01	H4514_014_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H4514	014	0	1	02	01	H4514_014_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4514	014	0	1	02	01	H4514_014_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4514	014	0	1	02	01	H4514_014_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4514	015	0	1	02	01	H4514_015_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4514	015	0	1	02	01	H4514_015_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H4514	015	0	1	02	01	H4514_015_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4514	015	0	1	02	01	H4514_015_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4514	015	0	1	02	01	H4514_015_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4514	016	0	1	02	01	H4514_016_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4514	016	0	1	02	01	H4514_016_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4514	016	0	1	02	01	H4514_016_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4514	016	0	1	02	01	H4514_016_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4514	016	0	1	02	01	H4514_016_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4514	017	0	1	02	01	H4514_017_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4514	017	0	1	02	01	H4514_017_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H4514	017	0	1	02	01	H4514_017_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4514	017	0	1	02	01	H4514_017_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4514	017	0	1	02	01	H4514_017_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4514	018	0	1	02	01	H4514_018_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4514	018	0	1	02	01	H4514_018_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4514	018	0	1	02	01	H4514_018_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4514	018	0	1	02	01	H4514_018_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4514	018	0	1	02	01	H4514_018_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4514	021	0	1	02	01	H4514_021_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4514	021	0	1	02	01	H4514_021_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4514	021	0	1	02	01	H4514_021_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4514	021	0	1	02	01	H4514_021_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4514	021	0	1	02	01	H4514_021_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4514	022	0	1	02	01	H4514_022_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4514	022	0	1	02	01	H4514_022_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H4514	022	0	1	02	01	H4514_022_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4514	022	0	1	02	01	H4514_022_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4514	022	0	1	02	01	H4514_022_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4514	023	0	1	02	01	H4514_023_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4514	023	0	1	02	01	H4514_023_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4514	023	0	1	02	01	H4514_023_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4514	023	0	1	02	01	H4514_023_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4514	023	0	1	02	01	H4514_023_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4514	024	0	1	02	01	H4514_024_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4514	024	0	1	02	01	H4514_024_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4514	024	0	1	02	01	H4514_024_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4514	024	0	1	02	01	H4514_024_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4514	024	0	1	02	01	H4514_024_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4523	001	0	1	01	01	H4523_001_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4523	001	0	1	01	01	H4523_001_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4523	001	0	1	01	01	H4523_001_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4523	001	0	1	01	01	H4523_001_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4523	001	0	1	01	01	H4523_001_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4523	015	0	1	01	01	H4523_015_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4523	015	0	1	01	01	H4523_015_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4523	015	0	1	01	01	H4523_015_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4523	015	0	1	01	01	H4523_015_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4523	015	0	1	01	01	H4523_015_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4523	020	0	1	01	01	H4523_020_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4523	020	0	1	01	01	H4523_020_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4523	020	0	1	01	01	H4523_020_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4523	020	0	1	01	01	H4523_020_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4523	020	0	1	01	01	H4523_020_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4523	021	0	1	01	01	H4523_021_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4523	021	0	1	01	01	H4523_021_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4523	021	0	1	01	01	H4523_021_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4523	021	0	1	01	01	H4523_021_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4523	021	0	1	01	01	H4523_021_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4523	024	0	1	01	01	H4523_024_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4523	024	0	1	01	01	H4523_024_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4523	024	0	1	01	01	H4523_024_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4523	024	0	1	01	01	H4523_024_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4523	024	0	1	01	01	H4523_024_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4523	027	0	1	01	01	H4523_027_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4523	027	0	1	01	01	H4523_027_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4523	027	0	1	01	01	H4523_027_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4523	027	0	1	01	01	H4523_027_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4523	027	0	1	01	01	H4523_027_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4523	028	0	1	01	01	H4523_028_0	3		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4523	028	0	1	01	01	H4523_028_0	3		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4523	028	0	1	01	01	H4523_028_0	3		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4523	028	0	1	01	01	H4523_028_0	3		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4523	028	0	1	01	01	H4523_028_0	3		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4523	029	0	1	01	01	H4523_029_0	3		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4523	029	0	1	01	01	H4523_029_0	3		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4523	029	0	1	01	01	H4523_029_0	3		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4523	029	0	1	01	01	H4523_029_0	3		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4523	029	0	1	01	01	H4523_029_0	3		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4523	030	0	1	01	01	H4523_030_0	3		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4523	030	0	1	01	01	H4523_030_0	3		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4523	030	0	1	01	01	H4523_030_0	3		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4523	030	0	1	01	01	H4523_030_0	3		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4523	030	0	1	01	01	H4523_030_0	3		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4523	031	0	1	01	01	H4523_031_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4523	031	0	1	01	01	H4523_031_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4523	031	0	1	01	01	H4523_031_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4523	031	0	1	01	01	H4523_031_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4523	031	0	1	01	01	H4523_031_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4523	034	0	1	01	01	H4523_034_0	3		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4523	034	0	1	01	01	H4523_034_0	3		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4523	034	0	1	01	01	H4523_034_0	3		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4523	034	0	1	01	01	H4523_034_0	3		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4523	034	0	1	01	01	H4523_034_0	3		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4523	037	0	1	01	01	H4523_037_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4523	037	0	1	01	01	H4523_037_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4523	037	0	1	01	01	H4523_037_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4523	037	0	1	01	01	H4523_037_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4523	037	0	1	01	01	H4523_037_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4523	038	0	1	01	01	H4523_038_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4523	038	0	1	01	01	H4523_038_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4523	038	0	1	01	01	H4523_038_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4523	038	0	1	01	01	H4523_038_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4523	038	0	1	01	01	H4523_038_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4523	039	0	1	01	01	H4523_039_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4523	039	0	1	01	01	H4523_039_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4523	039	0	1	01	01	H4523_039_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4523	039	0	1	01	01	H4523_039_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4523	039	0	1	01	01	H4523_039_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4523	041	0	1	01	01	H4523_041_0	3		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4523	041	0	1	01	01	H4523_041_0	3		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4523	041	0	1	01	01	H4523_041_0	3		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4523	041	0	1	01	01	H4523_041_0	3		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4523	041	0	1	01	01	H4523_041_0	3		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4523	042	0	1	01	01	H4523_042_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4523	042	0	1	01	01	H4523_042_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4523	042	0	1	01	01	H4523_042_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4523	042	0	1	01	01	H4523_042_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4523	042	0	1	01	01	H4523_042_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4523	043	0	1	01	01	H4523_043_0	3		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4523	043	0	1	01	01	H4523_043_0	3		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4523	043	0	1	01	01	H4523_043_0	3		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4523	043	0	1	01	01	H4523_043_0	3		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4523	043	0	1	01	01	H4523_043_0	3		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4523	044	0	1	01	01	H4523_044_0	3		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4523	044	0	1	01	01	H4523_044_0	3		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4523	044	0	1	01	01	H4523_044_0	3		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4523	044	0	1	01	01	H4523_044_0	3		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4523	044	0	1	01	01	H4523_044_0	3		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4527	001	0	1	02	01	H4527_001_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4527	001	0	1	02	01	H4527_001_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H4527	001	0	1	02	01	H4527_001_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4527	001	0	1	02	01	H4527_001_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4527	001	0	1	02	01	H4527_001_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4527	002	0	1	02	01	H4527_002_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4527	002	0	1	02	01	H4527_002_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H4527	002	0	1	02	01	H4527_002_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4527	002	0	1	02	01	H4527_002_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4527	002	0	1	02	01	H4527_002_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4527	003	0	1	02	01	H4527_003_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4527	003	0	1	02	01	H4527_003_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4527	003	0	1	02	01	H4527_003_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4527	003	0	1	02	01	H4527_003_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4527	003	0	1	02	01	H4527_003_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4527	005	0	1	02	01	H4527_005_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4527	005	0	1	02	01	H4527_005_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H4527	005	0	1	02	01	H4527_005_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4527	005	0	1	02	01	H4527_005_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4527	005	0	1	02	01	H4527_005_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4527	013	0	1	02	01	H4527_013_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4527	013	0	1	02	01	H4527_013_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H4527	013	0	1	02	01	H4527_013_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4527	013	0	1	02	01	H4527_013_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4527	013	0	1	02	01	H4527_013_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4527	015	0	1	02	01	H4527_015_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4527	015	0	1	02	01	H4527_015_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4527	015	0	1	02	01	H4527_015_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4527	015	0	1	02	01	H4527_015_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4527	015	0	1	02	01	H4527_015_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4527	037	0	1	02	01	H4527_037_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4527	037	0	1	02	01	H4527_037_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H4527	037	0	1	02	01	H4527_037_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4527	037	0	1	02	01	H4527_037_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4527	037	0	1	02	01	H4527_037_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4527	039	0	1	02	01	H4527_039_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4527	039	0	1	02	01	H4527_039_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H4527	039	0	1	02	01	H4527_039_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4527	039	0	1	02	01	H4527_039_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4527	039	0	1	02	01	H4527_039_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4527	040	0	1	02	01	H4527_040_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4527	040	0	1	02	01	H4527_040_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H4527	040	0	1	02	01	H4527_040_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4527	040	0	1	02	01	H4527_040_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4527	040	0	1	02	01	H4527_040_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4527	041	0	1	02	01	H4527_041_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4527	041	0	1	02	01	H4527_041_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H4527	041	0	1	02	01	H4527_041_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4527	041	0	1	02	01	H4527_041_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4527	041	0	1	02	01	H4527_041_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4527	042	0	1	02	01	H4527_042_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4527	042	0	1	02	01	H4527_042_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H4527	042	0	1	02	01	H4527_042_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4527	042	0	1	02	01	H4527_042_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4527	042	0	1	02	01	H4527_042_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4527	045	0	1	02	01	H4527_045_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4527	045	0	1	02	01	H4527_045_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H4527	045	0	1	02	01	H4527_045_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4527	045	0	1	02	01	H4527_045_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4527	045	0	1	02	01	H4527_045_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4527	048	0	1	02	01	H4527_048_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4527	048	0	1	02	01	H4527_048_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H4527	048	0	1	02	01	H4527_048_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4527	048	0	1	02	01	H4527_048_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4527	048	0	1	02	01	H4527_048_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4527	051	0	1	02	01	H4527_051_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4527	051	0	1	02	01	H4527_051_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H4527	051	0	1	02	01	H4527_051_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4527	051	0	1	02	01	H4527_051_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4527	051	0	1	02	01	H4527_051_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4527	052	0	1	02	01	H4527_052_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4527	052	0	1	02	01	H4527_052_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H4527	052	0	1	02	01	H4527_052_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4527	052	0	1	02	01	H4527_052_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4527	052	0	1	02	01	H4527_052_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4527	053	0	1	02	01	H4527_053_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4527	053	0	1	02	01	H4527_053_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H4527	053	0	1	02	01	H4527_053_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4527	053	0	1	02	01	H4527_053_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4527	053	0	1	02	01	H4527_053_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4527	054	0	1	02	01	H4527_054_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4527	054	0	1	02	01	H4527_054_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4527	054	0	1	02	01	H4527_054_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4527	054	0	1	02	01	H4527_054_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4527	054	0	1	02	01	H4527_054_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4527	055	0	1	02	01	H4527_055_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4527	055	0	1	02	01	H4527_055_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	5.00	
H4527	055	0	1	02	01	H4527_055_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4527	055	0	1	02	01	H4527_055_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4527	055	0	1	02	01	H4527_055_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4527	056	0	1	02	01	H4527_056_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4527	056	0	1	02	01	H4527_056_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H4527	056	0	1	02	01	H4527_056_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4527	056	0	1	02	01	H4527_056_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4527	056	0	1	02	01	H4527_056_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4527	057	0	1	02	01	H4527_057_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4527	057	0	1	02	01	H4527_057_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4527	057	0	1	02	01	H4527_057_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4527	057	0	1	02	01	H4527_057_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4527	057	0	1	02	01	H4527_057_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4527	058	0	1	02	01	H4527_058_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4527	058	0	1	02	01	H4527_058_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H4527	058	0	1	02	01	H4527_058_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4527	058	0	1	02	01	H4527_058_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4527	058	0	1	02	01	H4527_058_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4527	059	0	1	02	01	H4527_059_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4527	059	0	1	02	01	H4527_059_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H4527	059	0	1	02	01	H4527_059_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4527	059	0	1	02	01	H4527_059_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4527	059	0	1	02	01	H4527_059_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4537	001	0	1	04	01	H4537_001_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H4537	001	0	1	04	01	H4537_001_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4537	001	0	1	04	01	H4537_001_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4537	001	0	1	04	01	H4537_001_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4537	001	0	1	04	01	H4537_001_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4537	001	0	1	04	01	H4537_001_0	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4537	004	0	1	04	01	H4537_004_0	9		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H4537	004	0	1	04	01	H4537_004_0	9		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4537	004	0	1	04	01	H4537_004_0	9		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4537	004	0	1	04	01	H4537_004_0	9		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4537	004	0	1	04	01	H4537_004_0	9		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4537	004	0	1	04	01	H4537_004_0	9		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4544	001	0	1	04	01	H4544_001_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4544	001	0	1	04	01	H4544_001_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H4544	001	0	1	04	01	H4544_001_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4544	001	0	1	04	01	H4544_001_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4544	001	0	1	04	01	H4544_001_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4604	003	0	1	02	01	H4604_003_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4604	003	0	1	02	01	H4604_003_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H4604	003	0	1	02	01	H4604_003_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4604	003	0	1	02	01	H4604_003_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4604	003	0	1	02	01	H4604_003_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4604	011	0	1	02	01	H4604_011_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4604	011	0	1	02	01	H4604_011_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H4604	011	0	1	02	01	H4604_011_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4604	011	0	1	02	01	H4604_011_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4604	011	0	1	02	01	H4604_011_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4604	012	0	1	02	01	H4604_012_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4604	012	0	1	02	01	H4604_012_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H4604	012	0	1	02	01	H4604_012_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4604	012	0	1	02	01	H4604_012_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4604	012	0	1	02	01	H4604_012_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4604	013	0	1	02	01	H4604_013_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4604	013	0	1	02	01	H4604_013_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H4604	013	0	1	02	01	H4604_013_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4604	013	0	1	02	01	H4604_013_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4604	013	0	1	02	01	H4604_013_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4604	014	0	1	02	01	H4604_014_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4604	014	0	1	02	01	H4604_014_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	6.00	
H4604	014	0	1	02	01	H4604_014_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4604	014	0	1	02	01	H4604_014_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4604	014	0	1	02	01	H4604_014_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4604	016	0	1	02	01	H4604_016_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4604	016	0	1	02	01	H4604_016_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H4604	016	0	1	02	01	H4604_016_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4604	016	0	1	02	01	H4604_016_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4604	016	0	1	02	01	H4604_016_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4604	017	0	1	02	01	H4604_017_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4604	017	0	1	02	01	H4604_017_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H4604	017	0	1	02	01	H4604_017_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4604	017	0	1	02	01	H4604_017_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4604	017	0	1	02	01	H4604_017_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4604	018	0	1	02	01	H4604_018_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4604	018	0	1	02	01	H4604_018_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H4604	018	0	1	02	01	H4604_018_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4604	018	0	1	02	01	H4604_018_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4604	018	0	1	02	01	H4604_018_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4604	020	0	1	02	01	H4604_020_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4604	020	0	1	02	01	H4604_020_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H4604	020	0	1	02	01	H4604_020_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4604	020	0	1	02	01	H4604_020_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4604	020	0	1	02	01	H4604_020_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4604	022	0	1	02	01	H4604_022_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4604	022	0	1	02	01	H4604_022_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H4604	022	0	1	02	01	H4604_022_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4604	022	0	1	02	01	H4604_022_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4604	022	0	1	02	01	H4604_022_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4604	024	0	1	02	01	H4604_024_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4604	024	0	1	02	01	H4604_024_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H4604	024	0	1	02	01	H4604_024_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4604	024	0	1	02	01	H4604_024_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4604	024	0	1	02	01	H4604_024_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4604	025	0	1	02	01	H4604_025_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4604	025	0	1	02	01	H4604_025_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H4604	025	0	1	02	01	H4604_025_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4604	025	0	1	02	01	H4604_025_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4604	025	0	1	02	01	H4604_025_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4604	026	0	1	02	01	H4604_026_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4604	026	0	1	02	01	H4604_026_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4604	026	0	1	02	01	H4604_026_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4604	026	0	1	02	01	H4604_026_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4604	026	0	1	02	01	H4604_026_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4604	027	0	1	02	01	H4604_027_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4604	027	0	1	02	01	H4604_027_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H4604	027	0	1	02	01	H4604_027_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4604	027	0	1	02	01	H4604_027_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4604	027	0	1	02	01	H4604_027_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4604	028	0	1	02	01	H4604_028_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4604	028	0	1	02	01	H4604_028_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H4604	028	0	1	02	01	H4604_028_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4604	028	0	1	02	01	H4604_028_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4604	028	0	1	02	01	H4604_028_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4605	002	0	1	04	01	H4605_002_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4605	002	0	1	04	01	H4605_002_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4605	002	0	1	04	01	H4605_002_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4605	002	0	1	04	01	H4605_002_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4605	002	0	1	04	01	H4605_002_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4605	004	0	1	04	01	H4605_004_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4605	004	0	1	04	01	H4605_004_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4605	004	0	1	04	01	H4605_004_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4605	004	0	1	04	01	H4605_004_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4605	004	0	1	04	01	H4605_004_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4610	001	0	1	01	01	H4610_001_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4610	001	0	1	01	01	H4610_001_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4610	001	0	1	01	01	H4610_001_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4610	001	0	1	01	01	H4610_001_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4610	001	0	1	01	01	H4610_001_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4623	001	0	1	02	01	H4623_001_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H4623	001	0	1	02	01	H4623_001_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4623	001	0	1	02	01	H4623_001_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4623	001	0	1	02	01	H4623_001_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4623	001	0	1	02	01	H4623_001_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4623	002	0	1	02	01	H4623_002_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H4623	002	0	1	02	01	H4623_002_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4623	002	0	1	02	01	H4623_002_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4623	002	0	1	02	01	H4623_002_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4623	002	0	1	02	01	H4623_002_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4624	001	0	1	01	01	H4624_001_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4624	001	0	1	01	01	H4624_001_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H4624	001	0	1	01	01	H4624_001_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4624	001	0	1	01	01	H4624_001_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4624	001	0	1	01	01	H4624_001_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4624	003	0	1	01	01	H4624_003_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4624	003	0	1	01	01	H4624_003_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H4624	003	0	1	01	01	H4624_003_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4624	003	0	1	01	01	H4624_003_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4624	003	0	1	01	01	H4624_003_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4624	006	0	1	01	01	H4624_006_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4624	006	0	1	01	01	H4624_006_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H4624	006	0	1	01	01	H4624_006_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4624	006	0	1	01	01	H4624_006_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4624	006	0	1	01	01	H4624_006_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4624	010	0	1	01	01	H4624_010_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H4624	010	0	1	01	01	H4624_010_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	3	2	0.00	
H4624	010	0	1	01	01	H4624_010_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4624	010	0	1	01	01	H4624_010_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4624	010	0	1	01	01	H4624_010_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4624	010	0	1	01	01	H4624_010_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4624	011	0	1	01	01	H4624_011_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H4624	011	0	1	01	01	H4624_011_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	3	2	0.00	
H4624	011	0	1	01	01	H4624_011_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4624	011	0	1	01	01	H4624_011_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4624	011	0	1	01	01	H4624_011_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4624	011	0	1	01	01	H4624_011_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4624	012	0	1	01	01	H4624_012_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H4624	012	0	1	01	01	H4624_012_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	3	2	0.00	
H4624	012	0	1	01	01	H4624_012_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4624	012	0	1	01	01	H4624_012_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4624	012	0	1	01	01	H4624_012_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4624	012	0	1	01	01	H4624_012_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4624	022	0	1	01	01	H4624_022_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4624	022	0	1	01	01	H4624_022_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H4624	022	0	1	01	01	H4624_022_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4624	022	0	1	01	01	H4624_022_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4624	022	0	1	01	01	H4624_022_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4624	023	0	1	01	01	H4624_023_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H4624	023	0	1	01	01	H4624_023_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	3	2	0.00	
H4624	023	0	1	01	01	H4624_023_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4624	023	0	1	01	01	H4624_023_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4624	023	0	1	01	01	H4624_023_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4624	023	0	1	01	01	H4624_023_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4624	025	0	1	01	01	H4624_025_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H4624	025	0	1	01	01	H4624_025_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	3	2	0.00	
H4624	025	0	1	01	01	H4624_025_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4624	025	0	1	01	01	H4624_025_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4624	025	0	1	01	01	H4624_025_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4624	025	0	1	01	01	H4624_025_0	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4624	026	0	1	01	01	H4624_026_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4624	026	0	1	01	01	H4624_026_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H4624	026	0	1	01	01	H4624_026_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4624	026	0	1	01	01	H4624_026_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4624	026	0	1	01	01	H4624_026_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4624	027	0	1	01	01	H4624_027_0	10			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H4624	027	0	1	01	01	H4624_027_0	10			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	3	2	0.00	
H4624	027	0	1	01	01	H4624_027_0	10			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4624	027	0	1	01	01	H4624_027_0	10			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4624	027	0	1	01	01	H4624_027_0	10			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4624	027	0	1	01	01	H4624_027_0	10			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4624	028	0	1	01	01	H4624_028_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H4624	028	0	1	01	01	H4624_028_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	3	2	0.00	
H4624	028	0	1	01	01	H4624_028_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4624	028	0	1	01	01	H4624_028_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4624	028	0	1	01	01	H4624_028_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4624	028	0	1	01	01	H4624_028_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4624	029	0	1	01	01	H4624_029_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H4624	029	0	1	01	01	H4624_029_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	3	2	0.00	
H4624	029	0	1	01	01	H4624_029_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4624	029	0	1	01	01	H4624_029_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4624	029	0	1	01	01	H4624_029_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4624	029	0	1	01	01	H4624_029_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4624	031	0	1	01	01	H4624_031_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H4624	031	0	1	01	01	H4624_031_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	3	2	0.00	
H4624	031	0	1	01	01	H4624_031_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4624	031	0	1	01	01	H4624_031_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4624	031	0	1	01	01	H4624_031_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4624	031	0	1	01	01	H4624_031_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4624	032	0	1	01	01	H4624_032_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H4624	032	0	1	01	01	H4624_032_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	3	2	0.00	
H4624	032	0	1	01	01	H4624_032_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4624	032	0	1	01	01	H4624_032_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4624	032	0	1	01	01	H4624_032_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4624	032	0	1	01	01	H4624_032_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4624	033	0	1	01	01	H4624_033_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H4624	033	0	1	01	01	H4624_033_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	3	2	0.00	
H4624	033	0	1	01	01	H4624_033_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4624	033	0	1	01	01	H4624_033_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4624	033	0	1	01	01	H4624_033_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4624	033	0	1	01	01	H4624_033_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4624	034	0	1	01	01	H4624_034_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H4624	034	0	1	01	01	H4624_034_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	3	2	0.00	
H4624	034	0	1	01	01	H4624_034_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4624	034	0	1	01	01	H4624_034_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4624	034	0	1	01	01	H4624_034_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4624	034	0	1	01	01	H4624_034_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4624	036	0	1	01	01	H4624_036_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H4624	036	0	1	01	01	H4624_036_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	3	2	0.00	
H4624	036	0	1	01	01	H4624_036_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4624	036	0	1	01	01	H4624_036_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4624	036	0	1	01	01	H4624_036_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4624	036	0	1	01	01	H4624_036_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4624	037	0	1	01	01	H4624_037_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4624	037	0	1	01	01	H4624_037_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H4624	037	0	1	01	01	H4624_037_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4624	037	0	1	01	01	H4624_037_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4624	037	0	1	01	01	H4624_037_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4624	038	0	1	01	01	H4624_038_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4624	038	0	1	01	01	H4624_038_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H4624	038	0	1	01	01	H4624_038_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4624	038	0	1	01	01	H4624_038_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4624	038	0	1	01	01	H4624_038_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4624	039	0	1	01	01	H4624_039_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H4624	039	0	1	01	01	H4624_039_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	3	2	0.00	
H4624	039	0	1	01	01	H4624_039_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4624	039	0	1	01	01	H4624_039_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4624	039	0	1	01	01	H4624_039_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4624	039	0	1	01	01	H4624_039_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4624	040	0	1	01	01	H4624_040_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H4624	040	0	1	01	01	H4624_040_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	3	2	0.00	
H4624	040	0	1	01	01	H4624_040_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4624	040	0	1	01	01	H4624_040_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4624	040	0	1	01	01	H4624_040_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4624	040	0	1	01	01	H4624_040_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4624	042	0	1	01	01	H4624_042_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H4624	042	0	1	01	01	H4624_042_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	3	2	0.00	
H4624	042	0	1	01	01	H4624_042_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4624	042	0	1	01	01	H4624_042_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4624	042	0	1	01	01	H4624_042_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4624	042	0	1	01	01	H4624_042_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4624	043	0	1	01	01	H4624_043_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4624	043	0	1	01	01	H4624_043_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H4624	043	0	1	01	01	H4624_043_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4624	043	0	1	01	01	H4624_043_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4624	043	0	1	01	01	H4624_043_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4624	044	0	1	01	01	H4624_044_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4624	044	0	1	01	01	H4624_044_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H4624	044	0	1	01	01	H4624_044_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4624	044	0	1	01	01	H4624_044_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4624	044	0	1	01	01	H4624_044_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4624	045	0	1	01	01	H4624_045_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4624	045	0	1	01	01	H4624_045_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4624	045	0	1	01	01	H4624_045_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4624	045	0	1	01	01	H4624_045_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4624	045	0	1	01	01	H4624_045_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4624	046	0	1	01	01	H4624_046_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H4624	046	0	1	01	01	H4624_046_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	3	2	0.00	
H4624	046	0	1	01	01	H4624_046_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4624	046	0	1	01	01	H4624_046_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4624	046	0	1	01	01	H4624_046_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4624	046	0	1	01	01	H4624_046_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4647	001	0	1	01	01	H4647_001_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4647	001	0	1	01	01	H4647_001_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H4647	001	0	1	01	01	H4647_001_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4647	001	0	1	01	01	H4647_001_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4647	001	0	1	01	01	H4647_001_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4647	002	0	1	01	01	H4647_002_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4647	002	0	1	01	01	H4647_002_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H4647	002	0	1	01	01	H4647_002_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4647	002	0	1	01	01	H4647_002_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4647	002	0	1	01	01	H4647_002_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4661	001	0	1	02	01	H4661_001_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H4661	001	0	1	02	01	H4661_001_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4661	001	0	1	02	01	H4661_001_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4661	001	0	1	02	01	H4661_001_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4661	001	0	1	02	01	H4661_001_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4661	001	0	1	02	01	H4661_001_0	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4661	003	0	1	02	01	H4661_003_0	9		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H4661	003	0	1	02	01	H4661_003_0	9		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4661	003	0	1	02	01	H4661_003_0	9		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4661	003	0	1	02	01	H4661_003_0	9		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4661	003	0	1	02	01	H4661_003_0	9		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4661	003	0	1	02	01	H4661_003_0	9		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4661	005	0	1	02	01	H4661_005_0	9		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H4661	005	0	1	02	01	H4661_005_0	9		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4661	005	0	1	02	01	H4661_005_0	9		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4661	005	0	1	02	01	H4661_005_0	9		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4661	005	0	1	02	01	H4661_005_0	9		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4661	005	0	1	02	01	H4661_005_0	9		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4676	001	0	1	01	01	H4676_001_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H4676	001	0	1	01	01	H4676_001_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H4676	001	0	1	01	01	H4676_001_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H4676	001	0	1	01	01	H4676_001_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H4676	001	0	1	01	01	H4676_001_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H4676	001	0	1	01	01	H4676_001_0	7			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	11	1	2	0.00	
H4676	002	0	1	01	01	H4676_002_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H4676	002	0	1	01	01	H4676_002_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H4676	002	0	1	01	01	H4676_002_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H4676	002	0	1	01	01	H4676_002_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H4676	002	0	1	01	01	H4676_002_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H4676	002	0	1	01	01	H4676_002_0	7		N	Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	11	1	2	0.00	
H4694	001	0	1	01	01	H4694_001_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H4694	001	0	1	01	01	H4694_001_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4694	001	0	1	01	01	H4694_001_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4694	001	0	1	01	01	H4694_001_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4694	001	0	1	01	01	H4694_001_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4694	001	0	1	01	01	H4694_001_0	6		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4694	002	0	1	01	01	H4694_002_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H4694	002	0	1	01	01	H4694_002_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4694	002	0	1	01	01	H4694_002_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4694	002	0	1	01	01	H4694_002_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4694	002	0	1	01	01	H4694_002_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4694	002	0	1	01	01	H4694_002_0	6		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4694	003	0	1	01	01	H4694_003_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H4694	003	0	1	01	01	H4694_003_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4694	003	0	1	01	01	H4694_003_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4694	003	0	1	01	01	H4694_003_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4694	003	0	1	01	01	H4694_003_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4694	003	0	1	01	01	H4694_003_0	6		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4694	004	0	1	01	01	H4694_004_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H4694	004	0	1	01	01	H4694_004_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4694	004	0	1	01	01	H4694_004_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4694	004	0	1	01	01	H4694_004_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4694	004	0	1	01	01	H4694_004_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4694	004	0	1	01	01	H4694_004_0	6		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4704	001	0	1	04	01	H4704_001_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H4704	001	0	1	04	01	H4704_001_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4704	001	0	1	04	01	H4704_001_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4704	001	0	1	04	01	H4704_001_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4704	001	0	1	04	01	H4704_001_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4704	001	0	1	04	01	H4704_001_0	6		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4704	002	0	1	04	01	H4704_002_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H4704	002	0	1	04	01	H4704_002_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4704	002	0	1	04	01	H4704_002_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4704	002	0	1	04	01	H4704_002_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4704	002	0	1	04	01	H4704_002_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4704	002	0	1	04	01	H4704_002_0	5		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4711	001	0	1	01	01	H4711_001_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4711	001	0	1	01	01	H4711_001_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4711	001	0	1	01	01	H4711_001_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4711	001	0	1	01	01	H4711_001_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4711	001	0	1	01	01	H4711_001_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4711	002	0	1	01	01	H4711_002_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4711	002	0	1	01	01	H4711_002_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4711	002	0	1	01	01	H4711_002_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4711	002	0	1	01	01	H4711_002_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4711	002	0	1	01	01	H4711_002_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4711	005	0	1	01	01	H4711_005_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4711	005	0	1	01	01	H4711_005_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4711	005	0	1	01	01	H4711_005_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4711	005	0	1	01	01	H4711_005_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4711	005	0	1	01	01	H4711_005_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4711	008	0	1	02	01	H4711_008_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4711	008	0	1	02	01	H4711_008_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4711	008	0	1	02	01	H4711_008_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4711	008	0	1	02	01	H4711_008_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4711	008	0	1	02	01	H4711_008_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4711	011	0	1	01	01	H4711_011_0	2		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4711	011	0	1	01	01	H4711_011_0	2		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4711	011	0	1	01	01	H4711_011_0	2		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4711	011	0	1	01	01	H4711_011_0	2		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4711	011	0	1	01	01	H4711_011_0	2		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4711	012	0	1	01	01	H4711_012_0	2		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4711	012	0	1	01	01	H4711_012_0	2		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4711	012	0	1	01	01	H4711_012_0	2		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4711	012	0	1	01	01	H4711_012_0	2		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4711	012	0	1	01	01	H4711_012_0	2		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4711	013	0	1	01	01	H4711_013_0	2		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4711	013	0	1	01	01	H4711_013_0	2		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4711	013	0	1	01	01	H4711_013_0	2		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4711	013	0	1	01	01	H4711_013_0	2		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4711	013	0	1	01	01	H4711_013_0	2		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4733	001	0	1	01	01	H4733_001_0	5		N	Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H4733	001	0	1	01	01	H4733_001_0	5		N	Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H4733	001	0	1	01	01	H4733_001_0	5		N	Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H4733	001	0	1	01	01	H4733_001_0	5		N	Non-Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	4	2	10	1	2	0.00	
H4733	001	0	1	01	01	H4733_001_0	5		N	Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4733	001	0	1	01	01	H4733_001_0	5		N	Select Care Drugs	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H4739	001	0	1	01	01	H4739_001_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H4739	001	0	1	01	01	H4739_001_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H4739	001	0	1	01	01	H4739_001_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H4739	001	0	1	01	01	H4739_001_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4739	001	0	1	01	01	H4739_001_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4739	001	0	1	01	01	H4739_001_0	5		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H4754	004	0	1	04	01	H4754_004_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4754	004	0	1	04	01	H4754_004_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4754	004	0	1	04	01	H4754_004_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H4754	004	0	1	04	01	H4754_004_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4754	004	0	1	04	01	H4754_004_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4808	001	0	1	04	01	H4808_001_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4808	001	0	1	04	01	H4808_001_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	5.00	
H4808	001	0	1	04	01	H4808_001_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4808	001	0	1	04	01	H4808_001_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4808	001	0	1	04	01	H4808_001_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4808	002	0	1	04	01	H4808_002_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4808	002	0	1	04	01	H4808_002_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H4808	002	0	1	04	01	H4808_002_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4808	002	0	1	04	01	H4808_002_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4808	002	0	1	04	01	H4808_002_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4808	003	0	1	04	01	H4808_003_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4808	003	0	1	04	01	H4808_003_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H4808	003	0	1	04	01	H4808_003_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4808	003	0	1	04	01	H4808_003_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4808	003	0	1	04	01	H4808_003_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4808	005	0	1	04	01	H4808_005_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4808	005	0	1	04	01	H4808_005_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H4808	005	0	1	04	01	H4808_005_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4808	005	0	1	04	01	H4808_005_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4808	005	0	1	04	01	H4808_005_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4835	001	0	1	01	01	H4835_001_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4835	001	0	1	01	01	H4835_001_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4835	001	0	1	01	01	H4835_001_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4835	001	0	1	01	01	H4835_001_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4835	001	0	1	01	01	H4835_001_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4835	002	0	1	01	01	H4835_002_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4835	002	0	1	01	01	H4835_002_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4835	002	0	1	01	01	H4835_002_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4835	002	0	1	01	01	H4835_002_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4835	002	0	1	01	01	H4835_002_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4847	001	0	1	02	01	H4847_001_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H4847	001	0	1	02	01	H4847_001_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4847	001	0	1	02	01	H4847_001_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4847	001	0	1	02	01	H4847_001_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4847	001	0	1	02	01	H4847_001_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4847	001	0	1	02	01	H4847_001_0	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4847	005	0	1	02	01	H4847_005_0	9			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H4847	005	0	1	02	01	H4847_005_0	9			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4847	005	0	1	02	01	H4847_005_0	9			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4847	005	0	1	02	01	H4847_005_0	9			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4847	005	0	1	02	01	H4847_005_0	9			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4847	005	0	1	02	01	H4847_005_0	9			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4847	007	0	1	02	01	H4847_007_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H4847	007	0	1	02	01	H4847_007_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4847	007	0	1	02	01	H4847_007_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4847	007	0	1	02	01	H4847_007_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4847	007	0	1	02	01	H4847_007_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4847	007	0	1	02	01	H4847_007_0	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4868	004	0	1	01	01	H4868_004_0	7		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H4868	004	0	1	01	01	H4868_004_0	7		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4868	004	0	1	01	01	H4868_004_0	7		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4868	004	0	1	01	01	H4868_004_0	7		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4868	004	0	1	01	01	H4868_004_0	7		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4868	004	0	1	01	01	H4868_004_0	7		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4868	014	0	1	01	01	H4868_014_0	7		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H4868	014	0	1	01	01	H4868_014_0	7		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4868	014	0	1	01	01	H4868_014_0	7		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4868	014	0	1	01	01	H4868_014_0	7		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4868	014	0	1	01	01	H4868_014_0	7		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4868	014	0	1	01	01	H4868_014_0	7		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4868	016	0	1	02	01	H4868_016_0	9			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H4868	016	0	1	02	01	H4868_016_0	9			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4868	016	0	1	02	01	H4868_016_0	9			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4868	016	0	1	02	01	H4868_016_0	9			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4868	016	0	1	02	01	H4868_016_0	9			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4868	016	0	1	02	01	H4868_016_0	9			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4868	019	0	1	02	01	H4868_019_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H4868	019	0	1	02	01	H4868_019_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4868	019	0	1	02	01	H4868_019_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4868	019	0	1	02	01	H4868_019_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4868	019	0	1	02	01	H4868_019_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4868	019	0	1	02	01	H4868_019_0	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4869	001	0	1	02	01	H4869_001_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Diabetic Drugs	1	2	01	1	2	0.00	
H4869	001	0	1	02	01	H4869_001_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Diabetic Drugs	2	2	01	1	2	0.00	
H4869	001	0	1	02	01	H4869_001_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Diabetic Drugs	3	2	11	1	2	0.00	
H4869	001	0	1	02	01	H4869_001_0	4			Non-Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Diabetic Drugs	4	2	11	1	2	0.00	
H4869	001	0	1	02	01	H4869_001_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Diabetic Drugs	5	2	11	1	2	0.00	
H4869	001	0	1	02	01	H4869_001_0	4			Select Diabetic Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Diabetic Drugs	6	2	11	1	2	0.00	
H4869	003	0	1	02	01	H4869_003_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Diabetic Drugs	1	2	01	1	2	0.00	
H4869	003	0	1	02	01	H4869_003_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Diabetic Drugs	2	2	01	1	2	0.00	
H4869	003	0	1	02	01	H4869_003_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Diabetic Drugs	3	2	11	1	2	0.00	
H4869	003	0	1	02	01	H4869_003_0	5			Non-Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Diabetic Drugs	4	2	11	1	2	0.00	
H4869	003	0	1	02	01	H4869_003_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Diabetic Drugs	5	2	11	1	2	0.00	
H4869	003	0	1	02	01	H4869_003_0	5			Select Diabetic Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Diabetic Drugs	6	2	11	1	2	0.00	
H4869	011	0	1	02	01	H4869_011_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Diabetic Drugs	1	2	01	1	2	0.00	
H4869	011	0	1	02	01	H4869_011_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Diabetic Drugs	2	2	01	1	2	0.00	
H4869	011	0	1	02	01	H4869_011_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Diabetic Drugs	3	2	11	1	2	0.00	
H4869	011	0	1	02	01	H4869_011_0	4			Non-Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Diabetic Drugs	4	2	11	1	2	0.00	
H4869	011	0	1	02	01	H4869_011_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Diabetic Drugs	5	2	11	1	2	0.00	
H4869	011	0	1	02	01	H4869_011_0	4			Select Diabetic Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Diabetic Drugs	6	2	11	1	2	0.00	
H4869	013	0	1	02	01	H4869_013_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Diabetic Drugs	1	2	01	1	2	0.00	
H4869	013	0	1	02	01	H4869_013_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Diabetic Drugs	2	2	01	1	2	0.00	
H4869	013	0	1	02	01	H4869_013_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Diabetic Drugs	3	2	11	1	2	0.00	
H4869	013	0	1	02	01	H4869_013_0	5			Non-Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Diabetic Drugs	4	2	11	1	2	0.00	
H4869	013	0	1	02	01	H4869_013_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Diabetic Drugs	5	2	11	1	2	0.00	
H4869	013	0	1	02	01	H4869_013_0	5			Select Diabetic Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Diabetic Drugs	6	2	11	1	2	0.00	
H4875	016	1	1	04	01	H4875_016_1	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4875	016	1	1	04	01	H4875_016_1	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4875	016	1	1	04	01	H4875_016_1	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4875	016	1	1	04	01	H4875_016_1	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4875	016	1	1	04	01	H4875_016_1	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4875	016	2	1	04	01	H4875_016_2	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4875	016	2	1	04	01	H4875_016_2	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4875	016	2	1	04	01	H4875_016_2	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4875	016	2	1	04	01	H4875_016_2	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4875	016	2	1	04	01	H4875_016_2	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4875	016	3	1	04	01	H4875_016_3	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4875	016	3	1	04	01	H4875_016_3	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4875	016	3	1	04	01	H4875_016_3	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4875	016	3	1	04	01	H4875_016_3	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4875	016	3	1	04	01	H4875_016_3	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4875	016	4	1	04	01	H4875_016_4	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4875	016	4	1	04	01	H4875_016_4	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4875	016	4	1	04	01	H4875_016_4	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4875	016	4	1	04	01	H4875_016_4	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4875	016	4	1	04	01	H4875_016_4	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4875	016	5	1	04	01	H4875_016_5	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4875	016	5	1	04	01	H4875_016_5	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4875	016	5	1	04	01	H4875_016_5	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4875	016	5	1	04	01	H4875_016_5	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4875	016	5	1	04	01	H4875_016_5	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4875	018	1	1	04	01	H4875_018_1	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4875	018	1	1	04	01	H4875_018_1	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H4875	018	1	1	04	01	H4875_018_1	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	3	1		25
H4875	018	1	1	04	01	H4875_018_1	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4875	018	1	1	04	01	H4875_018_1	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4875	018	2	1	04	01	H4875_018_2	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4875	018	2	1	04	01	H4875_018_2	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H4875	018	2	1	04	01	H4875_018_2	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	3	1		25
H4875	018	2	1	04	01	H4875_018_2	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4875	018	2	1	04	01	H4875_018_2	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4875	018	3	1	04	01	H4875_018_3	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4875	018	3	1	04	01	H4875_018_3	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H4875	018	3	1	04	01	H4875_018_3	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	3	1		25
H4875	018	3	1	04	01	H4875_018_3	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4875	018	3	1	04	01	H4875_018_3	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4875	018	4	1	04	01	H4875_018_4	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4875	018	4	1	04	01	H4875_018_4	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H4875	018	4	1	04	01	H4875_018_4	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	3	1		25
H4875	018	4	1	04	01	H4875_018_4	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4875	018	4	1	04	01	H4875_018_4	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4875	018	5	1	04	01	H4875_018_5	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4875	018	5	1	04	01	H4875_018_5	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H4875	018	5	1	04	01	H4875_018_5	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	3	1		25
H4875	018	5	1	04	01	H4875_018_5	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4875	018	5	1	04	01	H4875_018_5	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4875	020	1	1	04	01	H4875_020_1	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4875	020	1	1	04	01	H4875_020_1	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4875	020	1	1	04	01	H4875_020_1	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4875	020	1	1	04	01	H4875_020_1	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4875	020	1	1	04	01	H4875_020_1	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4875	020	2	1	04	01	H4875_020_2	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4875	020	2	1	04	01	H4875_020_2	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4875	020	2	1	04	01	H4875_020_2	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4875	020	2	1	04	01	H4875_020_2	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4875	020	2	1	04	01	H4875_020_2	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4875	020	3	1	04	01	H4875_020_3	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4875	020	3	1	04	01	H4875_020_3	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4875	020	3	1	04	01	H4875_020_3	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4875	020	3	1	04	01	H4875_020_3	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4875	020	3	1	04	01	H4875_020_3	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4875	022	1	1	04	01	H4875_022_1	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4875	022	1	1	04	01	H4875_022_1	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4875	022	1	1	04	01	H4875_022_1	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4875	022	1	1	04	01	H4875_022_1	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4875	022	1	1	04	01	H4875_022_1	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4875	022	2	1	04	01	H4875_022_2	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4875	022	2	1	04	01	H4875_022_2	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4875	022	2	1	04	01	H4875_022_2	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4875	022	2	1	04	01	H4875_022_2	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4875	022	2	1	04	01	H4875_022_2	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4875	022	5	1	04	01	H4875_022_5	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4875	022	5	1	04	01	H4875_022_5	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4875	022	5	1	04	01	H4875_022_5	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4875	022	5	1	04	01	H4875_022_5	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4875	022	5	1	04	01	H4875_022_5	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4875	024	1	1	04	01	H4875_024_1	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4875	024	1	1	04	01	H4875_024_1	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	15.00	
H4875	024	1	1	04	01	H4875_024_1	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	3	1		21
H4875	024	1	1	04	01	H4875_024_1	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4875	024	1	1	04	01	H4875_024_1	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4875	024	2	1	04	01	H4875_024_2	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H4875	024	2	1	04	01	H4875_024_2	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	15.00	
H4875	024	2	1	04	01	H4875_024_2	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	3	1		21
H4875	024	2	1	04	01	H4875_024_2	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4875	024	2	1	04	01	H4875_024_2	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4882	003	0	1	04	01	H4882_003_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4882	003	0	1	04	01	H4882_003_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4882	003	0	1	04	01	H4882_003_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4882	003	0	1	04	01	H4882_003_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4882	003	0	1	04	01	H4882_003_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4882	009	1	1	04	01	H4882_009_1	11			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4882	009	1	1	04	01	H4882_009_1	11			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4882	009	1	1	04	01	H4882_009_1	11			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4882	009	1	1	04	01	H4882_009_1	11			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4882	009	1	1	04	01	H4882_009_1	11			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4882	009	2	1	04	01	H4882_009_2	10			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4882	009	2	1	04	01	H4882_009_2	10			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4882	009	2	1	04	01	H4882_009_2	10			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4882	009	2	1	04	01	H4882_009_2	10			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4882	009	2	1	04	01	H4882_009_2	10			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4882	011	1	1	04	01	H4882_011_1	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4882	011	1	1	04	01	H4882_011_1	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4882	011	1	1	04	01	H4882_011_1	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4882	011	1	1	04	01	H4882_011_1	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4882	011	1	1	04	01	H4882_011_1	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4882	011	2	1	04	01	H4882_011_2	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4882	011	2	1	04	01	H4882_011_2	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4882	011	2	1	04	01	H4882_011_2	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4882	011	2	1	04	01	H4882_011_2	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4882	011	2	1	04	01	H4882_011_2	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4882	014	1	1	04	01	H4882_014_1	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4882	014	1	1	04	01	H4882_014_1	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4882	014	1	1	04	01	H4882_014_1	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4882	014	1	1	04	01	H4882_014_1	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4882	014	1	1	04	01	H4882_014_1	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4882	014	2	1	04	01	H4882_014_2	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4882	014	2	1	04	01	H4882_014_2	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4882	014	2	1	04	01	H4882_014_2	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4882	014	2	1	04	01	H4882_014_2	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4882	014	2	1	04	01	H4882_014_2	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4909	014	0	1	04	01	H4909_014_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H4909	014	0	1	04	01	H4909_014_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4909	014	0	1	04	01	H4909_014_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4909	014	0	1	04	01	H4909_014_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4909	014	0	1	04	01	H4909_014_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4909	014	0	1	04	01	H4909_014_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4909	026	0	1	04	01	H4909_026_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H4909	026	0	1	04	01	H4909_026_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4909	026	0	1	04	01	H4909_026_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H4909	026	0	1	04	01	H4909_026_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H4909	026	0	1	04	01	H4909_026_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4909	026	0	1	04	01	H4909_026_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H4939	001	0	1	02	01	H4939_001_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4939	001	0	1	02	01	H4939_001_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4939	001	0	1	02	01	H4939_001_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4939	001	0	1	02	01	H4939_001_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4939	001	0	1	02	01	H4939_001_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4939	002	0	1	02	01	H4939_002_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4939	002	0	1	02	01	H4939_002_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4939	002	0	1	02	01	H4939_002_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4939	002	0	1	02	01	H4939_002_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4939	002	0	1	02	01	H4939_002_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4939	003	0	1	02	01	H4939_003_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4939	003	0	1	02	01	H4939_003_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H4939	003	0	1	02	01	H4939_003_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4939	003	0	1	02	01	H4939_003_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4939	003	0	1	02	01	H4939_003_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4961	001	0	1	04	01	H4961_001_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H4961	001	0	1	04	01	H4961_001_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4961	001	0	1	04	01	H4961_001_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	3	2	40.00	
H4961	001	0	1	04	01	H4961_001_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	3	1		32
H4961	001	0	1	04	01	H4961_001_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4961	001	0	1	04	01	H4961_001_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H4961	003	0	1	04	01	H4961_003_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H4961	003	0	1	04	01	H4961_003_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4961	003	0	1	04	01	H4961_003_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	3	2	40.00	
H4961	003	0	1	04	01	H4961_003_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	3	1		32
H4961	003	0	1	04	01	H4961_003_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4961	003	0	1	04	01	H4961_003_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H4961	006	0	1	04	01	H4961_006_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H4961	006	0	1	04	01	H4961_006_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H4961	006	0	1	04	01	H4961_006_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	3	2	40.00	
H4961	006	0	1	04	01	H4961_006_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	3	1		32
H4961	006	0	1	04	01	H4961_006_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H4961	006	0	1	04	01	H4961_006_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H4982	001	0	1	01	01	H4982_001_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4982	001	0	1	01	01	H4982_001_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4982	001	0	1	01	01	H4982_001_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4982	001	0	1	01	01	H4982_001_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4982	001	0	1	01	01	H4982_001_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4982	002	0	1	01	01	H4982_002_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4982	002	0	1	01	01	H4982_002_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4982	002	0	1	01	01	H4982_002_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4982	002	0	1	01	01	H4982_002_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4982	002	0	1	01	01	H4982_002_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4982	003	0	1	01	01	H4982_003_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4982	003	0	1	01	01	H4982_003_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4982	003	0	1	01	01	H4982_003_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4982	003	0	1	01	01	H4982_003_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4982	003	0	1	01	01	H4982_003_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4982	004	0	1	01	01	H4982_004_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4982	004	0	1	01	01	H4982_004_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4982	004	0	1	01	01	H4982_004_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4982	004	0	1	01	01	H4982_004_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4982	004	0	1	01	01	H4982_004_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4982	007	0	1	01	01	H4982_007_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4982	007	0	1	01	01	H4982_007_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4982	007	0	1	01	01	H4982_007_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4982	007	0	1	01	01	H4982_007_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4982	007	0	1	01	01	H4982_007_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4982	022	0	1	02	01	H4982_022_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4982	022	0	1	02	01	H4982_022_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4982	022	0	1	02	01	H4982_022_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4982	022	0	1	02	01	H4982_022_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4982	022	0	1	02	01	H4982_022_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4982	025	0	1	02	01	H4982_025_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4982	025	0	1	02	01	H4982_025_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4982	025	0	1	02	01	H4982_025_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4982	025	0	1	02	01	H4982_025_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4982	025	0	1	02	01	H4982_025_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4982	026	0	1	02	01	H4982_026_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4982	026	0	1	02	01	H4982_026_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4982	026	0	1	02	01	H4982_026_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4982	026	0	1	02	01	H4982_026_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4982	026	0	1	02	01	H4982_026_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H4982	030	0	1	02	01	H4982_030_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H4982	030	0	1	02	01	H4982_030_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H4982	030	0	1	02	01	H4982_030_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H4982	030	0	1	02	01	H4982_030_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H4982	030	0	1	02	01	H4982_030_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5008	002	0	1	02	01	H5008_002_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5008	002	0	1	02	01	H5008_002_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5008	002	0	1	02	01	H5008_002_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5008	002	0	1	02	01	H5008_002_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5008	002	0	1	02	01	H5008_002_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5008	010	0	1	02	01	H5008_010_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5008	010	0	1	02	01	H5008_010_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5008	010	0	1	02	01	H5008_010_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5008	010	0	1	02	01	H5008_010_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5008	010	0	1	02	01	H5008_010_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5008	011	0	1	02	01	H5008_011_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5008	011	0	1	02	01	H5008_011_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5008	011	0	1	02	01	H5008_011_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5008	011	0	1	02	01	H5008_011_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5008	011	0	1	02	01	H5008_011_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5008	015	0	1	02	01	H5008_015_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5008	015	0	1	02	01	H5008_015_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5008	015	0	1	02	01	H5008_015_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5008	015	0	1	02	01	H5008_015_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5008	015	0	1	02	01	H5008_015_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5008	016	0	1	02	01	H5008_016_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5008	016	0	1	02	01	H5008_016_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5008	016	0	1	02	01	H5008_016_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5008	016	0	1	02	01	H5008_016_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5008	016	0	1	02	01	H5008_016_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5008	017	0	1	02	01	H5008_017_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5008	017	0	1	02	01	H5008_017_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5008	017	0	1	02	01	H5008_017_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5008	017	0	1	02	01	H5008_017_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5008	017	0	1	02	01	H5008_017_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5008	018	0	1	02	01	H5008_018_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5008	018	0	1	02	01	H5008_018_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5008	018	0	1	02	01	H5008_018_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5008	018	0	1	02	01	H5008_018_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5008	018	0	1	02	01	H5008_018_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5008	019	0	1	02	01	H5008_019_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5008	019	0	1	02	01	H5008_019_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5008	019	0	1	02	01	H5008_019_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5008	019	0	1	02	01	H5008_019_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5008	019	0	1	02	01	H5008_019_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5008	020	0	1	02	01	H5008_020_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5008	020	0	1	02	01	H5008_020_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5008	020	0	1	02	01	H5008_020_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5008	020	0	1	02	01	H5008_020_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5008	020	0	1	02	01	H5008_020_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5009	002	0	1	04	01	H5009_002_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5009	002	0	1	04	01	H5009_002_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5009	002	0	1	04	01	H5009_002_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5009	002	0	1	04	01	H5009_002_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5009	002	0	1	04	01	H5009_002_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5009	011	1	1	04	01	H5009_011_1	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5009	011	1	1	04	01	H5009_011_1	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5009	011	1	1	04	01	H5009_011_1	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5009	011	1	1	04	01	H5009_011_1	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5009	011	1	1	04	01	H5009_011_1	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5009	011	2	1	04	01	H5009_011_2	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5009	011	2	1	04	01	H5009_011_2	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5009	011	2	1	04	01	H5009_011_2	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5009	011	2	1	04	01	H5009_011_2	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5009	011	2	1	04	01	H5009_011_2	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5050	004	0	1	01	01	H5050_004_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H5050	004	0	1	01	01	H5050_004_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H5050	004	0	1	01	01	H5050_004_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H5050	004	0	1	01	01	H5050_004_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H5050	004	0	1	01	01	H5050_004_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H5050	004	0	1	01	01	H5050_004_0	4			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H5050	009	0	1	01	01	H5050_009_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H5050	009	0	1	01	01	H5050_009_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H5050	009	0	1	01	01	H5050_009_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H5050	009	0	1	01	01	H5050_009_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H5050	009	0	1	01	01	H5050_009_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H5050	009	0	1	01	01	H5050_009_0	4			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H5050	017	0	1	01	01	H5050_017_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H5050	017	0	1	01	01	H5050_017_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H5050	017	0	1	01	01	H5050_017_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H5050	017	0	1	01	01	H5050_017_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H5050	017	0	1	01	01	H5050_017_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H5050	017	0	1	01	01	H5050_017_0	4			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H5050	019	0	1	01	01	H5050_019_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H5050	019	0	1	01	01	H5050_019_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H5050	019	0	1	01	01	H5050_019_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H5050	019	0	1	01	01	H5050_019_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H5050	019	0	1	01	01	H5050_019_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H5050	019	0	1	01	01	H5050_019_0	4			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H5050	021	0	1	01	01	H5050_021_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H5050	021	0	1	01	01	H5050_021_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H5050	021	0	1	01	01	H5050_021_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H5050	021	0	1	01	01	H5050_021_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H5050	021	0	1	01	01	H5050_021_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H5050	021	0	1	01	01	H5050_021_0	4			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H5050	022	0	1	01	01	H5050_022_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H5050	022	0	1	01	01	H5050_022_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H5050	022	0	1	01	01	H5050_022_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H5050	022	0	1	01	01	H5050_022_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H5050	022	0	1	01	01	H5050_022_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H5050	022	0	1	01	01	H5050_022_0	4			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H5050	023	0	1	01	01	H5050_023_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H5050	023	0	1	01	01	H5050_023_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H5050	023	0	1	01	01	H5050_023_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H5050	023	0	1	01	01	H5050_023_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H5050	023	0	1	01	01	H5050_023_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H5050	023	0	1	01	01	H5050_023_0	4			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H5050	024	0	1	01	01	H5050_024_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H5050	024	0	1	01	01	H5050_024_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H5050	024	0	1	01	01	H5050_024_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H5050	024	0	1	01	01	H5050_024_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H5050	024	0	1	01	01	H5050_024_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H5050	024	0	1	01	01	H5050_024_0	4			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H5050	025	0	1	01	01	H5050_025_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H5050	025	0	1	01	01	H5050_025_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H5050	025	0	1	01	01	H5050_025_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H5050	025	0	1	01	01	H5050_025_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H5050	025	0	1	01	01	H5050_025_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H5050	025	0	1	01	01	H5050_025_0	4			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H5050	026	0	1	01	01	H5050_026_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H5050	026	0	1	01	01	H5050_026_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H5050	026	0	1	01	01	H5050_026_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H5050	026	0	1	01	01	H5050_026_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H5050	026	0	1	01	01	H5050_026_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H5050	026	0	1	01	01	H5050_026_0	4			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H5050	027	0	1	01	01	H5050_027_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H5050	027	0	1	01	01	H5050_027_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H5050	027	0	1	01	01	H5050_027_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H5050	027	0	1	01	01	H5050_027_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H5050	027	0	1	01	01	H5050_027_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H5050	027	0	1	01	01	H5050_027_0	4			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H5050	028	0	1	01	01	H5050_028_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H5050	028	0	1	01	01	H5050_028_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H5050	028	0	1	01	01	H5050_028_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H5050	028	0	1	01	01	H5050_028_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H5050	028	0	1	01	01	H5050_028_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H5050	028	0	1	01	01	H5050_028_0	4			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H5050	029	0	1	01	01	H5050_029_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H5050	029	0	1	01	01	H5050_029_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H5050	029	0	1	01	01	H5050_029_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H5050	029	0	1	01	01	H5050_029_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H5050	029	0	1	01	01	H5050_029_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H5050	029	0	1	01	01	H5050_029_0	4			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H5050	030	0	1	01	01	H5050_030_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H5050	030	0	1	01	01	H5050_030_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H5050	030	0	1	01	01	H5050_030_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H5050	030	0	1	01	01	H5050_030_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H5050	030	0	1	01	01	H5050_030_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H5050	030	0	1	01	01	H5050_030_0	4			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H5050	031	0	1	01	01	H5050_031_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H5050	031	0	1	01	01	H5050_031_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H5050	031	0	1	01	01	H5050_031_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H5050	031	0	1	01	01	H5050_031_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H5050	031	0	1	01	01	H5050_031_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H5050	031	0	1	01	01	H5050_031_0	4			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H5050	032	0	1	01	01	H5050_032_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H5050	032	0	1	01	01	H5050_032_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H5050	032	0	1	01	01	H5050_032_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H5050	032	0	1	01	01	H5050_032_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H5050	032	0	1	01	01	H5050_032_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H5050	032	0	1	01	01	H5050_032_0	4			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H5087	005	0	1	01	01	H5087_005_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H5087	005	0	1	01	01	H5087_005_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5087	005	0	1	01	01	H5087_005_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5087	005	0	1	01	01	H5087_005_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5087	005	0	1	01	01	H5087_005_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5087	005	0	1	01	01	H5087_005_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5087	032	0	1	01	01	H5087_032_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H5087	032	0	1	01	01	H5087_032_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5087	032	0	1	01	01	H5087_032_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5087	032	0	1	01	01	H5087_032_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5087	032	0	1	01	01	H5087_032_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5087	032	0	1	01	01	H5087_032_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5087	034	1	1	01	01	H5087_034_1	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H5087	034	1	1	01	01	H5087_034_1	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5087	034	1	1	01	01	H5087_034_1	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5087	034	1	1	01	01	H5087_034_1	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5087	034	1	1	01	01	H5087_034_1	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5087	034	1	1	01	01	H5087_034_1	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5087	034	2	1	01	01	H5087_034_2	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H5087	034	2	1	01	01	H5087_034_2	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5087	034	2	1	01	01	H5087_034_2	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5087	034	2	1	01	01	H5087_034_2	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5087	034	2	1	01	01	H5087_034_2	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5087	034	2	1	01	01	H5087_034_2	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5106	029	1	1	04	01	H5106_029_1	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5106	029	1	1	04	01	H5106_029_1	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5106	029	1	1	04	01	H5106_029_1	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5106	029	1	1	04	01	H5106_029_1	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5106	029	1	1	04	01	H5106_029_1	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5106	029	2	1	04	01	H5106_029_2	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5106	029	2	1	04	01	H5106_029_2	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5106	029	2	1	04	01	H5106_029_2	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5106	029	2	1	04	01	H5106_029_2	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5106	029	2	1	04	01	H5106_029_2	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5106	029	3	1	04	01	H5106_029_3	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5106	029	3	1	04	01	H5106_029_3	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5106	029	3	1	04	01	H5106_029_3	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5106	029	3	1	04	01	H5106_029_3	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5106	029	3	1	04	01	H5106_029_3	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5106	030	1	1	04	01	H5106_030_1	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5106	030	1	1	04	01	H5106_030_1	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5106	030	1	1	04	01	H5106_030_1	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5106	030	1	1	04	01	H5106_030_1	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5106	030	1	1	04	01	H5106_030_1	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5106	030	2	1	04	01	H5106_030_2	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5106	030	2	1	04	01	H5106_030_2	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5106	030	2	1	04	01	H5106_030_2	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5106	030	2	1	04	01	H5106_030_2	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5106	030	2	1	04	01	H5106_030_2	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5106	030	3	1	04	01	H5106_030_3	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5106	030	3	1	04	01	H5106_030_3	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5106	030	3	1	04	01	H5106_030_3	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5106	030	3	1	04	01	H5106_030_3	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5106	030	3	1	04	01	H5106_030_3	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5106	034	1	1	04	01	H5106_034_1	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5106	034	1	1	04	01	H5106_034_1	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5106	034	1	1	04	01	H5106_034_1	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5106	034	1	1	04	01	H5106_034_1	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5106	034	1	1	04	01	H5106_034_1	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5106	034	2	1	04	01	H5106_034_2	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5106	034	2	1	04	01	H5106_034_2	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5106	034	2	1	04	01	H5106_034_2	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5106	034	2	1	04	01	H5106_034_2	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5106	034	2	1	04	01	H5106_034_2	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5106	035	0	1	04	01	H5106_035_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5106	035	0	1	04	01	H5106_035_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5106	035	0	1	04	01	H5106_035_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5106	035	0	1	04	01	H5106_035_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5106	035	0	1	04	01	H5106_035_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5106	036	0	1	04	01	H5106_036_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5106	036	0	1	04	01	H5106_036_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5106	036	0	1	04	01	H5106_036_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5106	036	0	1	04	01	H5106_036_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5106	036	0	1	04	01	H5106_036_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5106	037	0	1	04	01	H5106_037_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5106	037	0	1	04	01	H5106_037_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5106	037	0	1	04	01	H5106_037_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5106	037	0	1	04	01	H5106_037_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5106	037	0	1	04	01	H5106_037_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5119	001	0	1	01	01	H5119_001_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5119	001	0	1	01	01	H5119_001_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H5119	001	0	1	01	01	H5119_001_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H5119	001	0	1	01	01	H5119_001_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5119	001	0	1	01	01	H5119_001_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5119	001	0	1	01	01	H5119_001_0	6		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5141	004	0	1	04	01	H5141_004_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5141	004	0	1	04	01	H5141_004_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5141	004	0	1	04	01	H5141_004_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5141	004	0	1	04	01	H5141_004_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5141	004	0	1	04	01	H5141_004_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5141	007	0	1	04	01	H5141_007_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5141	007	0	1	04	01	H5141_007_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5141	007	0	1	04	01	H5141_007_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5141	007	0	1	04	01	H5141_007_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5141	007	0	1	04	01	H5141_007_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5141	025	0	1	04	01	H5141_025_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5141	025	0	1	04	01	H5141_025_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5141	025	0	1	04	01	H5141_025_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5141	025	0	1	04	01	H5141_025_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5141	025	0	1	04	01	H5141_025_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5141	026	0	1	04	01	H5141_026_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5141	026	0	1	04	01	H5141_026_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5141	026	0	1	04	01	H5141_026_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5141	026	0	1	04	01	H5141_026_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5141	026	0	1	04	01	H5141_026_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5141	032	0	1	04	01	H5141_032_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5141	032	0	1	04	01	H5141_032_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5141	032	0	1	04	01	H5141_032_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5141	032	0	1	04	01	H5141_032_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5141	032	0	1	04	01	H5141_032_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5141	036	0	1	04	01	H5141_036_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5141	036	0	1	04	01	H5141_036_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5141	036	0	1	04	01	H5141_036_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5141	036	0	1	04	01	H5141_036_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5141	036	0	1	04	01	H5141_036_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5141	038	0	1	04	01	H5141_038_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5141	038	0	1	04	01	H5141_038_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5141	038	0	1	04	01	H5141_038_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5141	038	0	1	04	01	H5141_038_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5141	038	0	1	04	01	H5141_038_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5141	042	0	1	04	01	H5141_042_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5141	042	0	1	04	01	H5141_042_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5141	042	0	1	04	01	H5141_042_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5141	042	0	1	04	01	H5141_042_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5141	042	0	1	04	01	H5141_042_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5141	045	0	1	04	01	H5141_045_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5141	045	0	1	04	01	H5141_045_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5141	045	0	1	04	01	H5141_045_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5141	045	0	1	04	01	H5141_045_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5141	045	0	1	04	01	H5141_045_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5141	054	0	1	04	01	H5141_054_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5141	054	0	1	04	01	H5141_054_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5141	054	0	1	04	01	H5141_054_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5141	054	0	1	04	01	H5141_054_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5141	054	0	1	04	01	H5141_054_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5141	063	0	1	04	01	H5141_063_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5141	063	0	1	04	01	H5141_063_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5141	063	0	1	04	01	H5141_063_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5141	063	0	1	04	01	H5141_063_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5141	063	0	1	04	01	H5141_063_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5163	001	0	1	01	01	H5163_001_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5163	001	0	1	01	01	H5163_001_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	3	2	0.00	
H5163	001	0	1	01	01	H5163_001_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5163	001	0	1	01	01	H5163_001_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5163	001	0	1	01	01	H5163_001_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5163	001	0	1	01	01	H5163_001_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5163	002	0	1	01	01	H5163_002_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5163	002	0	1	01	01	H5163_002_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	3	2	0.00	
H5163	002	0	1	01	01	H5163_002_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5163	002	0	1	01	01	H5163_002_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5163	002	0	1	01	01	H5163_002_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5163	002	0	1	01	01	H5163_002_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5163	003	0	1	01	01	H5163_003_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5163	003	0	1	01	01	H5163_003_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	3	2	0.00	
H5163	003	0	1	01	01	H5163_003_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5163	003	0	1	01	01	H5163_003_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5163	003	0	1	01	01	H5163_003_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5163	003	0	1	01	01	H5163_003_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5163	004	0	1	01	01	H5163_004_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5163	004	0	1	01	01	H5163_004_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	3	2	0.00	
H5163	004	0	1	01	01	H5163_004_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5163	004	0	1	01	01	H5163_004_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5163	004	0	1	01	01	H5163_004_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5163	004	0	1	01	01	H5163_004_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5178	002	0	1	01	01	H5178_002_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5178	002	0	1	01	01	H5178_002_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5178	002	0	1	01	01	H5178_002_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5178	002	0	1	01	01	H5178_002_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5178	002	0	1	01	01	H5178_002_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5209	005	1	1	01	01	H5209_005_1	9		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5209	005	1	1	01	01	H5209_005_1	9		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5209	005	1	1	01	01	H5209_005_1	9		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5209	005	1	1	01	01	H5209_005_1	9		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5209	005	1	1	01	01	H5209_005_1	9		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5209	005	1	1	01	01	H5209_005_1	9		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5209	005	2	1	01	01	H5209_005_2	9		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5209	005	2	1	01	01	H5209_005_2	9		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5209	005	2	1	01	01	H5209_005_2	9		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5209	005	2	1	01	01	H5209_005_2	9		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5209	005	2	1	01	01	H5209_005_2	9		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5209	005	2	1	01	01	H5209_005_2	9		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5209	006	1	1	01	01	H5209_006_1	9		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5209	006	1	1	01	01	H5209_006_1	9		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5209	006	1	1	01	01	H5209_006_1	9		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5209	006	1	1	01	01	H5209_006_1	9		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5209	006	1	1	01	01	H5209_006_1	9		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5209	006	1	1	01	01	H5209_006_1	9		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5209	006	2	1	01	01	H5209_006_2	9		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5209	006	2	1	01	01	H5209_006_2	9		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5209	006	2	1	01	01	H5209_006_2	9		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5209	006	2	1	01	01	H5209_006_2	9		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5209	006	2	1	01	01	H5209_006_2	9		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5209	006	2	1	01	01	H5209_006_2	9		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5211	002	0	1	02	01	H5211_002_0	10			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5211	002	0	1	02	01	H5211_002_0	10			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5211	002	0	1	02	01	H5211_002_0	10			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5211	002	0	1	02	01	H5211_002_0	10			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5211	002	0	1	02	01	H5211_002_0	10			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5211	002	0	1	02	01	H5211_002_0	10			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5211	004	0	1	02	01	H5211_004_0	11			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5211	004	0	1	02	01	H5211_004_0	11			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5211	004	0	1	02	01	H5211_004_0	11			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5211	004	0	1	02	01	H5211_004_0	11			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5211	004	0	1	02	01	H5211_004_0	11			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5211	004	0	1	02	01	H5211_004_0	11			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5211	012	0	1	02	01	H5211_012_0	11			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5211	012	0	1	02	01	H5211_012_0	11			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5211	012	0	1	02	01	H5211_012_0	11			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5211	012	0	1	02	01	H5211_012_0	11			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5211	012	0	1	02	01	H5211_012_0	11			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5211	012	0	1	02	01	H5211_012_0	11			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5215	002	0	1	04	01	H5215_002_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5215	002	0	1	04	01	H5215_002_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5215	002	0	1	04	01	H5215_002_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5215	002	0	1	04	01	H5215_002_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5215	002	0	1	04	01	H5215_002_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5215	005	0	1	04	01	H5215_005_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5215	005	0	1	04	01	H5215_005_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5215	005	0	1	04	01	H5215_005_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5215	005	0	1	04	01	H5215_005_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5215	005	0	1	04	01	H5215_005_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5215	008	0	1	04	01	H5215_008_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5215	008	0	1	04	01	H5215_008_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5215	008	0	1	04	01	H5215_008_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5215	008	0	1	04	01	H5215_008_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5215	008	0	1	04	01	H5215_008_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5215	009	0	1	04	01	H5215_009_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5215	009	0	1	04	01	H5215_009_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5215	009	0	1	04	01	H5215_009_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5215	009	0	1	04	01	H5215_009_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5215	009	0	1	04	01	H5215_009_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5215	010	0	1	04	01	H5215_010_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5215	010	0	1	04	01	H5215_010_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5215	010	0	1	04	01	H5215_010_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5215	010	0	1	04	01	H5215_010_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5215	010	0	1	04	01	H5215_010_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5215	011	0	1	04	01	H5215_011_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5215	011	0	1	04	01	H5215_011_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5215	011	0	1	04	01	H5215_011_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5215	011	0	1	04	01	H5215_011_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5215	011	0	1	04	01	H5215_011_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5215	012	0	1	04	01	H5215_012_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5215	012	0	1	04	01	H5215_012_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5215	012	0	1	04	01	H5215_012_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5215	012	0	1	04	01	H5215_012_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5215	012	0	1	04	01	H5215_012_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	001	0	1	04	01	H5216_001_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	001	0	1	04	01	H5216_001_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	001	0	1	04	01	H5216_001_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	001	0	1	04	01	H5216_001_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	001	0	1	04	01	H5216_001_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	006	0	1	04	01	H5216_006_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	006	0	1	04	01	H5216_006_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	006	0	1	04	01	H5216_006_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	006	0	1	04	01	H5216_006_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	006	0	1	04	01	H5216_006_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	011	0	1	04	01	H5216_011_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	011	0	1	04	01	H5216_011_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	011	0	1	04	01	H5216_011_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	011	0	1	04	01	H5216_011_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	011	0	1	04	01	H5216_011_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	013	0	1	04	01	H5216_013_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	013	0	1	04	01	H5216_013_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	013	0	1	04	01	H5216_013_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	013	0	1	04	01	H5216_013_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	013	0	1	04	01	H5216_013_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	014	0	1	04	01	H5216_014_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	014	0	1	04	01	H5216_014_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	014	0	1	04	01	H5216_014_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	014	0	1	04	01	H5216_014_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	014	0	1	04	01	H5216_014_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	017	0	1	04	01	H5216_017_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	017	0	1	04	01	H5216_017_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	017	0	1	04	01	H5216_017_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	017	0	1	04	01	H5216_017_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	017	0	1	04	01	H5216_017_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	019	0	1	04	01	H5216_019_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	019	0	1	04	01	H5216_019_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	019	0	1	04	01	H5216_019_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	019	0	1	04	01	H5216_019_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	019	0	1	04	01	H5216_019_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	023	0	1	04	01	H5216_023_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	023	0	1	04	01	H5216_023_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	023	0	1	04	01	H5216_023_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	023	0	1	04	01	H5216_023_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	023	0	1	04	01	H5216_023_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	027	0	1	04	01	H5216_027_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	027	0	1	04	01	H5216_027_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	027	0	1	04	01	H5216_027_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	027	0	1	04	01	H5216_027_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	027	0	1	04	01	H5216_027_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	032	0	1	04	01	H5216_032_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	032	0	1	04	01	H5216_032_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	032	0	1	04	01	H5216_032_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	032	0	1	04	01	H5216_032_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	032	0	1	04	01	H5216_032_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	034	0	1	04	01	H5216_034_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	034	0	1	04	01	H5216_034_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	034	0	1	04	01	H5216_034_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	034	0	1	04	01	H5216_034_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	034	0	1	04	01	H5216_034_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	037	0	1	04	01	H5216_037_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	037	0	1	04	01	H5216_037_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	037	0	1	04	01	H5216_037_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	037	0	1	04	01	H5216_037_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	037	0	1	04	01	H5216_037_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	039	0	1	04	01	H5216_039_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	039	0	1	04	01	H5216_039_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	039	0	1	04	01	H5216_039_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	039	0	1	04	01	H5216_039_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	039	0	1	04	01	H5216_039_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	042	0	1	04	01	H5216_042_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	042	0	1	04	01	H5216_042_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	042	0	1	04	01	H5216_042_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	042	0	1	04	01	H5216_042_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	042	0	1	04	01	H5216_042_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	043	1	1	04	01	H5216_043_1	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	043	1	1	04	01	H5216_043_1	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	043	1	1	04	01	H5216_043_1	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	043	1	1	04	01	H5216_043_1	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	043	1	1	04	01	H5216_043_1	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	043	5	1	04	01	H5216_043_5	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	043	5	1	04	01	H5216_043_5	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	043	5	1	04	01	H5216_043_5	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	043	5	1	04	01	H5216_043_5	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	043	5	1	04	01	H5216_043_5	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	043	6	1	04	01	H5216_043_6	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	043	6	1	04	01	H5216_043_6	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	043	6	1	04	01	H5216_043_6	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	043	6	1	04	01	H5216_043_6	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	043	6	1	04	01	H5216_043_6	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	048	0	1	04	01	H5216_048_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	048	0	1	04	01	H5216_048_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	048	0	1	04	01	H5216_048_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	048	0	1	04	01	H5216_048_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	048	0	1	04	01	H5216_048_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	053	0	1	04	01	H5216_053_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	053	0	1	04	01	H5216_053_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	053	0	1	04	01	H5216_053_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	053	0	1	04	01	H5216_053_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	053	0	1	04	01	H5216_053_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	062	0	1	04	01	H5216_062_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	062	0	1	04	01	H5216_062_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	062	0	1	04	01	H5216_062_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	062	0	1	04	01	H5216_062_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	062	0	1	04	01	H5216_062_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	063	0	1	04	01	H5216_063_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	063	0	1	04	01	H5216_063_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	063	0	1	04	01	H5216_063_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	063	0	1	04	01	H5216_063_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	063	0	1	04	01	H5216_063_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	064	0	1	04	01	H5216_064_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	064	0	1	04	01	H5216_064_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	064	0	1	04	01	H5216_064_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	064	0	1	04	01	H5216_064_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	064	0	1	04	01	H5216_064_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	068	0	1	04	01	H5216_068_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	068	0	1	04	01	H5216_068_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	068	0	1	04	01	H5216_068_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	068	0	1	04	01	H5216_068_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	068	0	1	04	01	H5216_068_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	070	0	1	04	01	H5216_070_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	070	0	1	04	01	H5216_070_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	070	0	1	04	01	H5216_070_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	070	0	1	04	01	H5216_070_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	070	0	1	04	01	H5216_070_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	072	0	1	04	01	H5216_072_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	072	0	1	04	01	H5216_072_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	072	0	1	04	01	H5216_072_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	072	0	1	04	01	H5216_072_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	072	0	1	04	01	H5216_072_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	073	0	1	04	01	H5216_073_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	073	0	1	04	01	H5216_073_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	073	0	1	04	01	H5216_073_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	073	0	1	04	01	H5216_073_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	073	0	1	04	01	H5216_073_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	074	0	1	04	01	H5216_074_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	074	0	1	04	01	H5216_074_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	074	0	1	04	01	H5216_074_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	074	0	1	04	01	H5216_074_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	074	0	1	04	01	H5216_074_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	078	1	1	04	01	H5216_078_1	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	078	1	1	04	01	H5216_078_1	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	078	1	1	04	01	H5216_078_1	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	078	1	1	04	01	H5216_078_1	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	078	1	1	04	01	H5216_078_1	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	078	2	1	04	01	H5216_078_2	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	078	2	1	04	01	H5216_078_2	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	078	2	1	04	01	H5216_078_2	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	078	2	1	04	01	H5216_078_2	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	078	2	1	04	01	H5216_078_2	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	078	6	1	04	01	H5216_078_6	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	078	6	1	04	01	H5216_078_6	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	078	6	1	04	01	H5216_078_6	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	078	6	1	04	01	H5216_078_6	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	078	6	1	04	01	H5216_078_6	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	081	0	1	04	01	H5216_081_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	081	0	1	04	01	H5216_081_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	081	0	1	04	01	H5216_081_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	081	0	1	04	01	H5216_081_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	081	0	1	04	01	H5216_081_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	083	0	1	04	01	H5216_083_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	083	0	1	04	01	H5216_083_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	083	0	1	04	01	H5216_083_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	083	0	1	04	01	H5216_083_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	083	0	1	04	01	H5216_083_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	089	0	1	04	01	H5216_089_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	089	0	1	04	01	H5216_089_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	089	0	1	04	01	H5216_089_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	089	0	1	04	01	H5216_089_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	089	0	1	04	01	H5216_089_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	092	0	1	04	01	H5216_092_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	092	0	1	04	01	H5216_092_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	092	0	1	04	01	H5216_092_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	092	0	1	04	01	H5216_092_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	092	0	1	04	01	H5216_092_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	097	0	1	04	01	H5216_097_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	097	0	1	04	01	H5216_097_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	097	0	1	04	01	H5216_097_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	097	0	1	04	01	H5216_097_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	097	0	1	04	01	H5216_097_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	100	0	1	04	01	H5216_100_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	100	0	1	04	01	H5216_100_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	100	0	1	04	01	H5216_100_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	100	0	1	04	01	H5216_100_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	100	0	1	04	01	H5216_100_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	106	0	1	04	01	H5216_106_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	106	0	1	04	01	H5216_106_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	106	0	1	04	01	H5216_106_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	106	0	1	04	01	H5216_106_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	106	0	1	04	01	H5216_106_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	114	0	1	04	01	H5216_114_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	114	0	1	04	01	H5216_114_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	114	0	1	04	01	H5216_114_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	114	0	1	04	01	H5216_114_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	114	0	1	04	01	H5216_114_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	120	0	1	04	01	H5216_120_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	120	0	1	04	01	H5216_120_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	120	0	1	04	01	H5216_120_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	120	0	1	04	01	H5216_120_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	120	0	1	04	01	H5216_120_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	124	0	1	04	01	H5216_124_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	124	0	1	04	01	H5216_124_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	124	0	1	04	01	H5216_124_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	124	0	1	04	01	H5216_124_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	124	0	1	04	01	H5216_124_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	132	0	1	04	01	H5216_132_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	132	0	1	04	01	H5216_132_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	132	0	1	04	01	H5216_132_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	132	0	1	04	01	H5216_132_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	132	0	1	04	01	H5216_132_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	136	0	1	04	01	H5216_136_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	136	0	1	04	01	H5216_136_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	136	0	1	04	01	H5216_136_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	136	0	1	04	01	H5216_136_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	136	0	1	04	01	H5216_136_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	138	0	1	04	01	H5216_138_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	138	0	1	04	01	H5216_138_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	138	0	1	04	01	H5216_138_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	138	0	1	04	01	H5216_138_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	138	0	1	04	01	H5216_138_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	141	0	1	04	01	H5216_141_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	141	0	1	04	01	H5216_141_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	141	0	1	04	01	H5216_141_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	141	0	1	04	01	H5216_141_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	141	0	1	04	01	H5216_141_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	144	0	1	04	01	H5216_144_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	144	0	1	04	01	H5216_144_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	144	0	1	04	01	H5216_144_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	144	0	1	04	01	H5216_144_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	144	0	1	04	01	H5216_144_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	154	0	1	04	01	H5216_154_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	154	0	1	04	01	H5216_154_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	154	0	1	04	01	H5216_154_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	154	0	1	04	01	H5216_154_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	154	0	1	04	01	H5216_154_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	164	0	1	04	01	H5216_164_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	164	0	1	04	01	H5216_164_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	164	0	1	04	01	H5216_164_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	164	0	1	04	01	H5216_164_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	164	0	1	04	01	H5216_164_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	168	0	1	04	01	H5216_168_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	168	0	1	04	01	H5216_168_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	168	0	1	04	01	H5216_168_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	168	0	1	04	01	H5216_168_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	168	0	1	04	01	H5216_168_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	175	0	1	04	01	H5216_175_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	175	0	1	04	01	H5216_175_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	175	0	1	04	01	H5216_175_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	175	0	1	04	01	H5216_175_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	175	0	1	04	01	H5216_175_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	188	0	1	04	01	H5216_188_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	188	0	1	04	01	H5216_188_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	188	0	1	04	01	H5216_188_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	188	0	1	04	01	H5216_188_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	188	0	1	04	01	H5216_188_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	192	0	1	04	01	H5216_192_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	192	0	1	04	01	H5216_192_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	192	0	1	04	01	H5216_192_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	192	0	1	04	01	H5216_192_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	192	0	1	04	01	H5216_192_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	194	0	1	04	01	H5216_194_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	194	0	1	04	01	H5216_194_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	194	0	1	04	01	H5216_194_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	194	0	1	04	01	H5216_194_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	194	0	1	04	01	H5216_194_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	196	1	1	04	01	H5216_196_1	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	196	1	1	04	01	H5216_196_1	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	196	1	1	04	01	H5216_196_1	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	196	1	1	04	01	H5216_196_1	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	196	1	1	04	01	H5216_196_1	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	196	2	1	04	01	H5216_196_2	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	196	2	1	04	01	H5216_196_2	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	196	2	1	04	01	H5216_196_2	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	196	2	1	04	01	H5216_196_2	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	196	2	1	04	01	H5216_196_2	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	203	1	1	04	01	H5216_203_1	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	203	1	1	04	01	H5216_203_1	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	203	1	1	04	01	H5216_203_1	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	203	1	1	04	01	H5216_203_1	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	203	1	1	04	01	H5216_203_1	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	203	2	1	04	01	H5216_203_2	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	203	2	1	04	01	H5216_203_2	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	203	2	1	04	01	H5216_203_2	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	203	2	1	04	01	H5216_203_2	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	203	2	1	04	01	H5216_203_2	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	205	0	1	04	01	H5216_205_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	205	0	1	04	01	H5216_205_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	205	0	1	04	01	H5216_205_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	205	0	1	04	01	H5216_205_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	205	0	1	04	01	H5216_205_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	207	0	1	04	01	H5216_207_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	207	0	1	04	01	H5216_207_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	207	0	1	04	01	H5216_207_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	207	0	1	04	01	H5216_207_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	207	0	1	04	01	H5216_207_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	211	0	1	04	01	H5216_211_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	211	0	1	04	01	H5216_211_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	211	0	1	04	01	H5216_211_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	211	0	1	04	01	H5216_211_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	211	0	1	04	01	H5216_211_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	219	0	1	04	01	H5216_219_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	219	0	1	04	01	H5216_219_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	219	0	1	04	01	H5216_219_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	219	0	1	04	01	H5216_219_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	219	0	1	04	01	H5216_219_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	220	0	1	04	01	H5216_220_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	220	0	1	04	01	H5216_220_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	220	0	1	04	01	H5216_220_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	220	0	1	04	01	H5216_220_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	220	0	1	04	01	H5216_220_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	223	0	1	04	01	H5216_223_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	223	0	1	04	01	H5216_223_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	223	0	1	04	01	H5216_223_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	223	0	1	04	01	H5216_223_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	223	0	1	04	01	H5216_223_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	224	0	1	04	01	H5216_224_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	224	0	1	04	01	H5216_224_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	224	0	1	04	01	H5216_224_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	224	0	1	04	01	H5216_224_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	224	0	1	04	01	H5216_224_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	226	0	1	04	01	H5216_226_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	226	0	1	04	01	H5216_226_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	226	0	1	04	01	H5216_226_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	226	0	1	04	01	H5216_226_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	226	0	1	04	01	H5216_226_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	227	0	1	04	01	H5216_227_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	227	0	1	04	01	H5216_227_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	227	0	1	04	01	H5216_227_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	227	0	1	04	01	H5216_227_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	227	0	1	04	01	H5216_227_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	228	0	1	04	01	H5216_228_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	228	0	1	04	01	H5216_228_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	228	0	1	04	01	H5216_228_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	228	0	1	04	01	H5216_228_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	228	0	1	04	01	H5216_228_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	229	0	1	04	01	H5216_229_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	229	0	1	04	01	H5216_229_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	229	0	1	04	01	H5216_229_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	229	0	1	04	01	H5216_229_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	229	0	1	04	01	H5216_229_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	231	0	1	04	01	H5216_231_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	231	0	1	04	01	H5216_231_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	231	0	1	04	01	H5216_231_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	231	0	1	04	01	H5216_231_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	231	0	1	04	01	H5216_231_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	242	0	1	04	01	H5216_242_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	242	0	1	04	01	H5216_242_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	242	0	1	04	01	H5216_242_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	242	0	1	04	01	H5216_242_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	242	0	1	04	01	H5216_242_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	244	0	1	04	01	H5216_244_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H5216	244	0	1	04	01	H5216_244_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5216	244	0	1	04	01	H5216_244_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5216	244	0	1	04	01	H5216_244_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5216	244	0	1	04	01	H5216_244_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5216	244	0	1	04	01	H5216_244_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5216	246	0	1	04	01	H5216_246_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H5216	246	0	1	04	01	H5216_246_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5216	246	0	1	04	01	H5216_246_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5216	246	0	1	04	01	H5216_246_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5216	246	0	1	04	01	H5216_246_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5216	246	0	1	04	01	H5216_246_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5216	249	0	1	04	01	H5216_249_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	249	0	1	04	01	H5216_249_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	249	0	1	04	01	H5216_249_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	249	0	1	04	01	H5216_249_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	249	0	1	04	01	H5216_249_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	251	0	1	04	01	H5216_251_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	251	0	1	04	01	H5216_251_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	251	0	1	04	01	H5216_251_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	251	0	1	04	01	H5216_251_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	251	0	1	04	01	H5216_251_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	252	0	1	04	01	H5216_252_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	252	0	1	04	01	H5216_252_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	252	0	1	04	01	H5216_252_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	252	0	1	04	01	H5216_252_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	252	0	1	04	01	H5216_252_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	253	0	1	04	01	H5216_253_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	253	0	1	04	01	H5216_253_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	253	0	1	04	01	H5216_253_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	253	0	1	04	01	H5216_253_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	253	0	1	04	01	H5216_253_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	261	0	1	04	01	H5216_261_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	261	0	1	04	01	H5216_261_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	261	0	1	04	01	H5216_261_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	261	0	1	04	01	H5216_261_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	261	0	1	04	01	H5216_261_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	263	0	1	04	01	H5216_263_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	263	0	1	04	01	H5216_263_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	263	0	1	04	01	H5216_263_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	263	0	1	04	01	H5216_263_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	263	0	1	04	01	H5216_263_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	264	0	1	04	01	H5216_264_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	264	0	1	04	01	H5216_264_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	264	0	1	04	01	H5216_264_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	264	0	1	04	01	H5216_264_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	264	0	1	04	01	H5216_264_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	265	0	1	04	01	H5216_265_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	265	0	1	04	01	H5216_265_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	265	0	1	04	01	H5216_265_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	265	0	1	04	01	H5216_265_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	265	0	1	04	01	H5216_265_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	266	0	1	04	01	H5216_266_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	266	0	1	04	01	H5216_266_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	266	0	1	04	01	H5216_266_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	266	0	1	04	01	H5216_266_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	266	0	1	04	01	H5216_266_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	267	0	1	04	01	H5216_267_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	267	0	1	04	01	H5216_267_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	267	0	1	04	01	H5216_267_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	267	0	1	04	01	H5216_267_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	267	0	1	04	01	H5216_267_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	268	0	1	04	01	H5216_268_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	268	0	1	04	01	H5216_268_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	268	0	1	04	01	H5216_268_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	268	0	1	04	01	H5216_268_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	268	0	1	04	01	H5216_268_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	269	0	1	04	01	H5216_269_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	269	0	1	04	01	H5216_269_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	269	0	1	04	01	H5216_269_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	269	0	1	04	01	H5216_269_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	269	0	1	04	01	H5216_269_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	271	0	1	04	01	H5216_271_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	271	0	1	04	01	H5216_271_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	271	0	1	04	01	H5216_271_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	271	0	1	04	01	H5216_271_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	271	0	1	04	01	H5216_271_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	275	0	1	04	01	H5216_275_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	275	0	1	04	01	H5216_275_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	275	0	1	04	01	H5216_275_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	275	0	1	04	01	H5216_275_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	275	0	1	04	01	H5216_275_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	277	0	1	04	01	H5216_277_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	277	0	1	04	01	H5216_277_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	277	0	1	04	01	H5216_277_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	277	0	1	04	01	H5216_277_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	277	0	1	04	01	H5216_277_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	280	1	1	04	01	H5216_280_1	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	280	1	1	04	01	H5216_280_1	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	280	1	1	04	01	H5216_280_1	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	280	1	1	04	01	H5216_280_1	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	280	1	1	04	01	H5216_280_1	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	280	2	1	04	01	H5216_280_2	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	280	2	1	04	01	H5216_280_2	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	280	2	1	04	01	H5216_280_2	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	280	2	1	04	01	H5216_280_2	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	280	2	1	04	01	H5216_280_2	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	281	0	1	04	01	H5216_281_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	281	0	1	04	01	H5216_281_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	281	0	1	04	01	H5216_281_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	281	0	1	04	01	H5216_281_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	281	0	1	04	01	H5216_281_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	283	0	1	04	01	H5216_283_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	283	0	1	04	01	H5216_283_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	283	0	1	04	01	H5216_283_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	283	0	1	04	01	H5216_283_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	283	0	1	04	01	H5216_283_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	284	0	1	04	01	H5216_284_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	284	0	1	04	01	H5216_284_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	284	0	1	04	01	H5216_284_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	284	0	1	04	01	H5216_284_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	284	0	1	04	01	H5216_284_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	285	0	1	04	01	H5216_285_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	285	0	1	04	01	H5216_285_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	285	0	1	04	01	H5216_285_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	285	0	1	04	01	H5216_285_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	285	0	1	04	01	H5216_285_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	287	0	1	04	01	H5216_287_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	287	0	1	04	01	H5216_287_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	287	0	1	04	01	H5216_287_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	287	0	1	04	01	H5216_287_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	287	0	1	04	01	H5216_287_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	288	0	1	04	01	H5216_288_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	288	0	1	04	01	H5216_288_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	288	0	1	04	01	H5216_288_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	288	0	1	04	01	H5216_288_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	288	0	1	04	01	H5216_288_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	289	0	1	04	01	H5216_289_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	289	0	1	04	01	H5216_289_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	289	0	1	04	01	H5216_289_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	289	0	1	04	01	H5216_289_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	289	0	1	04	01	H5216_289_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	291	0	1	04	01	H5216_291_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	291	0	1	04	01	H5216_291_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	291	0	1	04	01	H5216_291_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	291	0	1	04	01	H5216_291_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	291	0	1	04	01	H5216_291_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	292	0	1	04	01	H5216_292_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	292	0	1	04	01	H5216_292_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	292	0	1	04	01	H5216_292_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	292	0	1	04	01	H5216_292_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	292	0	1	04	01	H5216_292_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	296	0	1	04	01	H5216_296_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	296	0	1	04	01	H5216_296_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	296	0	1	04	01	H5216_296_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	296	0	1	04	01	H5216_296_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	296	0	1	04	01	H5216_296_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	298	0	1	04	01	H5216_298_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	298	0	1	04	01	H5216_298_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	298	0	1	04	01	H5216_298_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	298	0	1	04	01	H5216_298_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	298	0	1	04	01	H5216_298_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	300	0	1	04	01	H5216_300_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	300	0	1	04	01	H5216_300_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	300	0	1	04	01	H5216_300_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	300	0	1	04	01	H5216_300_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	300	0	1	04	01	H5216_300_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	302	0	1	04	01	H5216_302_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	302	0	1	04	01	H5216_302_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	302	0	1	04	01	H5216_302_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	302	0	1	04	01	H5216_302_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	302	0	1	04	01	H5216_302_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	304	0	1	04	01	H5216_304_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	304	0	1	04	01	H5216_304_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	304	0	1	04	01	H5216_304_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	304	0	1	04	01	H5216_304_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	304	0	1	04	01	H5216_304_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	305	0	1	04	01	H5216_305_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	305	0	1	04	01	H5216_305_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	305	0	1	04	01	H5216_305_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	305	0	1	04	01	H5216_305_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	305	0	1	04	01	H5216_305_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	306	0	1	04	01	H5216_306_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	306	0	1	04	01	H5216_306_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	306	0	1	04	01	H5216_306_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	306	0	1	04	01	H5216_306_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	306	0	1	04	01	H5216_306_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	307	0	1	04	01	H5216_307_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	307	0	1	04	01	H5216_307_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	307	0	1	04	01	H5216_307_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	307	0	1	04	01	H5216_307_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	307	0	1	04	01	H5216_307_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	308	0	1	04	01	H5216_308_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	308	0	1	04	01	H5216_308_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	308	0	1	04	01	H5216_308_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	308	0	1	04	01	H5216_308_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	308	0	1	04	01	H5216_308_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	309	0	1	04	01	H5216_309_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	309	0	1	04	01	H5216_309_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	309	0	1	04	01	H5216_309_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	309	0	1	04	01	H5216_309_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	309	0	1	04	01	H5216_309_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	311	0	1	04	01	H5216_311_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	311	0	1	04	01	H5216_311_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	311	0	1	04	01	H5216_311_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	311	0	1	04	01	H5216_311_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	311	0	1	04	01	H5216_311_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	313	0	1	04	01	H5216_313_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	313	0	1	04	01	H5216_313_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	313	0	1	04	01	H5216_313_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	313	0	1	04	01	H5216_313_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	313	0	1	04	01	H5216_313_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	314	0	1	04	01	H5216_314_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	314	0	1	04	01	H5216_314_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	314	0	1	04	01	H5216_314_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	314	0	1	04	01	H5216_314_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	314	0	1	04	01	H5216_314_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	316	1	1	04	01	H5216_316_1	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	316	1	1	04	01	H5216_316_1	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	316	1	1	04	01	H5216_316_1	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	316	1	1	04	01	H5216_316_1	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	316	1	1	04	01	H5216_316_1	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	316	3	1	04	01	H5216_316_3	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	316	3	1	04	01	H5216_316_3	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	316	3	1	04	01	H5216_316_3	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	316	3	1	04	01	H5216_316_3	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	316	3	1	04	01	H5216_316_3	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	317	0	1	04	01	H5216_317_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	317	0	1	04	01	H5216_317_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	317	0	1	04	01	H5216_317_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	317	0	1	04	01	H5216_317_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	317	0	1	04	01	H5216_317_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	318	1	1	04	01	H5216_318_1	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	318	1	1	04	01	H5216_318_1	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	318	1	1	04	01	H5216_318_1	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	318	1	1	04	01	H5216_318_1	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	318	1	1	04	01	H5216_318_1	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	318	2	1	04	01	H5216_318_2	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	318	2	1	04	01	H5216_318_2	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	318	2	1	04	01	H5216_318_2	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	318	2	1	04	01	H5216_318_2	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	318	2	1	04	01	H5216_318_2	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	318	3	1	04	01	H5216_318_3	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	318	3	1	04	01	H5216_318_3	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	318	3	1	04	01	H5216_318_3	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	318	3	1	04	01	H5216_318_3	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	318	3	1	04	01	H5216_318_3	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	319	0	1	04	01	H5216_319_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	319	0	1	04	01	H5216_319_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	319	0	1	04	01	H5216_319_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	319	0	1	04	01	H5216_319_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	319	0	1	04	01	H5216_319_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	322	0	1	04	01	H5216_322_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	322	0	1	04	01	H5216_322_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	322	0	1	04	01	H5216_322_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	322	0	1	04	01	H5216_322_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	322	0	1	04	01	H5216_322_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	325	0	1	04	01	H5216_325_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	325	0	1	04	01	H5216_325_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	325	0	1	04	01	H5216_325_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	325	0	1	04	01	H5216_325_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	325	0	1	04	01	H5216_325_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	326	0	1	04	01	H5216_326_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	326	0	1	04	01	H5216_326_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	326	0	1	04	01	H5216_326_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	326	0	1	04	01	H5216_326_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	326	0	1	04	01	H5216_326_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	327	0	1	04	01	H5216_327_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	327	0	1	04	01	H5216_327_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	327	0	1	04	01	H5216_327_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	327	0	1	04	01	H5216_327_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	327	0	1	04	01	H5216_327_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	328	0	1	04	01	H5216_328_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	328	0	1	04	01	H5216_328_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	328	0	1	04	01	H5216_328_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	328	0	1	04	01	H5216_328_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	328	0	1	04	01	H5216_328_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	330	0	1	04	01	H5216_330_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	330	0	1	04	01	H5216_330_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	330	0	1	04	01	H5216_330_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	330	0	1	04	01	H5216_330_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	330	0	1	04	01	H5216_330_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	331	0	1	04	01	H5216_331_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	331	0	1	04	01	H5216_331_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	331	0	1	04	01	H5216_331_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	331	0	1	04	01	H5216_331_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	331	0	1	04	01	H5216_331_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	332	0	1	04	01	H5216_332_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	332	0	1	04	01	H5216_332_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	332	0	1	04	01	H5216_332_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	332	0	1	04	01	H5216_332_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	332	0	1	04	01	H5216_332_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	333	0	1	04	01	H5216_333_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	333	0	1	04	01	H5216_333_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	333	0	1	04	01	H5216_333_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	333	0	1	04	01	H5216_333_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	333	0	1	04	01	H5216_333_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	334	0	1	04	01	H5216_334_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H5216	334	0	1	04	01	H5216_334_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5216	334	0	1	04	01	H5216_334_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5216	334	0	1	04	01	H5216_334_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5216	334	0	1	04	01	H5216_334_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5216	334	0	1	04	01	H5216_334_0	3			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5216	337	1	1	04	01	H5216_337_1	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	337	1	1	04	01	H5216_337_1	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	337	1	1	04	01	H5216_337_1	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	337	1	1	04	01	H5216_337_1	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	337	1	1	04	01	H5216_337_1	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	337	2	1	04	01	H5216_337_2	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	337	2	1	04	01	H5216_337_2	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	337	2	1	04	01	H5216_337_2	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	337	2	1	04	01	H5216_337_2	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	337	2	1	04	01	H5216_337_2	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	337	3	1	04	01	H5216_337_3	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	337	3	1	04	01	H5216_337_3	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	337	3	1	04	01	H5216_337_3	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	337	3	1	04	01	H5216_337_3	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	337	3	1	04	01	H5216_337_3	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	339	0	1	04	01	H5216_339_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	339	0	1	04	01	H5216_339_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	339	0	1	04	01	H5216_339_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	339	0	1	04	01	H5216_339_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	339	0	1	04	01	H5216_339_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	340	0	1	04	01	H5216_340_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	340	0	1	04	01	H5216_340_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	340	0	1	04	01	H5216_340_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	340	0	1	04	01	H5216_340_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	340	0	1	04	01	H5216_340_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	345	0	1	04	01	H5216_345_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	345	0	1	04	01	H5216_345_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	345	0	1	04	01	H5216_345_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	345	0	1	04	01	H5216_345_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	345	0	1	04	01	H5216_345_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	347	0	1	04	01	H5216_347_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	347	0	1	04	01	H5216_347_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	347	0	1	04	01	H5216_347_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	347	0	1	04	01	H5216_347_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	347	0	1	04	01	H5216_347_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	350	0	1	04	01	H5216_350_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	350	0	1	04	01	H5216_350_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	350	0	1	04	01	H5216_350_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	350	0	1	04	01	H5216_350_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	350	0	1	04	01	H5216_350_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	351	0	1	04	01	H5216_351_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	351	0	1	04	01	H5216_351_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	351	0	1	04	01	H5216_351_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	351	0	1	04	01	H5216_351_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	351	0	1	04	01	H5216_351_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	352	0	1	04	01	H5216_352_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	352	0	1	04	01	H5216_352_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	352	0	1	04	01	H5216_352_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	352	0	1	04	01	H5216_352_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	352	0	1	04	01	H5216_352_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	353	0	1	04	01	H5216_353_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	353	0	1	04	01	H5216_353_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	353	0	1	04	01	H5216_353_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	353	0	1	04	01	H5216_353_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	353	0	1	04	01	H5216_353_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	358	0	1	04	01	H5216_358_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	358	0	1	04	01	H5216_358_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	358	0	1	04	01	H5216_358_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	358	0	1	04	01	H5216_358_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	358	0	1	04	01	H5216_358_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	359	0	1	04	01	H5216_359_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	359	0	1	04	01	H5216_359_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	359	0	1	04	01	H5216_359_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	359	0	1	04	01	H5216_359_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	359	0	1	04	01	H5216_359_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	360	0	1	04	01	H5216_360_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	360	0	1	04	01	H5216_360_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	360	0	1	04	01	H5216_360_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	360	0	1	04	01	H5216_360_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	360	0	1	04	01	H5216_360_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	361	0	1	04	01	H5216_361_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	361	0	1	04	01	H5216_361_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	361	0	1	04	01	H5216_361_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	361	0	1	04	01	H5216_361_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	361	0	1	04	01	H5216_361_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	363	0	1	04	01	H5216_363_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	363	0	1	04	01	H5216_363_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	363	0	1	04	01	H5216_363_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	363	0	1	04	01	H5216_363_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	363	0	1	04	01	H5216_363_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	366	0	1	04	01	H5216_366_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5216	366	0	1	04	01	H5216_366_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5216	366	0	1	04	01	H5216_366_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5216	366	0	1	04	01	H5216_366_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5216	366	0	1	04	01	H5216_366_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5216	366	0	1	04	01	H5216_366_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5216	367	0	1	04	01	H5216_367_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	367	0	1	04	01	H5216_367_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	367	0	1	04	01	H5216_367_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	367	0	1	04	01	H5216_367_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	367	0	1	04	01	H5216_367_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	368	0	1	04	01	H5216_368_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	368	0	1	04	01	H5216_368_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	368	0	1	04	01	H5216_368_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	368	0	1	04	01	H5216_368_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	368	0	1	04	01	H5216_368_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	369	0	1	04	01	H5216_369_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	369	0	1	04	01	H5216_369_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	369	0	1	04	01	H5216_369_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	369	0	1	04	01	H5216_369_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	369	0	1	04	01	H5216_369_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	370	0	1	04	01	H5216_370_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	370	0	1	04	01	H5216_370_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	370	0	1	04	01	H5216_370_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	370	0	1	04	01	H5216_370_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	370	0	1	04	01	H5216_370_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	371	0	1	04	01	H5216_371_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	371	0	1	04	01	H5216_371_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	371	0	1	04	01	H5216_371_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	371	0	1	04	01	H5216_371_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	371	0	1	04	01	H5216_371_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	372	0	1	04	01	H5216_372_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5216	372	0	1	04	01	H5216_372_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5216	372	0	1	04	01	H5216_372_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5216	372	0	1	04	01	H5216_372_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5216	372	0	1	04	01	H5216_372_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5216	372	0	1	04	01	H5216_372_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5216	375	0	1	04	01	H5216_375_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5216	375	0	1	04	01	H5216_375_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5216	375	0	1	04	01	H5216_375_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5216	375	0	1	04	01	H5216_375_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5216	375	0	1	04	01	H5216_375_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5216	375	0	1	04	01	H5216_375_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5216	376	0	1	04	01	H5216_376_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	376	0	1	04	01	H5216_376_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	376	0	1	04	01	H5216_376_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	376	0	1	04	01	H5216_376_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	376	0	1	04	01	H5216_376_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	377	0	1	04	01	H5216_377_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	377	0	1	04	01	H5216_377_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	377	0	1	04	01	H5216_377_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	377	0	1	04	01	H5216_377_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	377	0	1	04	01	H5216_377_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	382	0	1	04	01	H5216_382_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	382	0	1	04	01	H5216_382_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	382	0	1	04	01	H5216_382_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	382	0	1	04	01	H5216_382_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	382	0	1	04	01	H5216_382_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	383	0	1	04	01	H5216_383_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	383	0	1	04	01	H5216_383_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	383	0	1	04	01	H5216_383_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	383	0	1	04	01	H5216_383_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	383	0	1	04	01	H5216_383_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	384	0	1	04	01	H5216_384_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	384	0	1	04	01	H5216_384_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	384	0	1	04	01	H5216_384_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	384	0	1	04	01	H5216_384_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	384	0	1	04	01	H5216_384_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	385	0	1	04	01	H5216_385_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	385	0	1	04	01	H5216_385_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	385	0	1	04	01	H5216_385_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	385	0	1	04	01	H5216_385_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	385	0	1	04	01	H5216_385_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	387	1	1	04	01	H5216_387_1	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	387	1	1	04	01	H5216_387_1	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	387	1	1	04	01	H5216_387_1	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	387	1	1	04	01	H5216_387_1	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	387	1	1	04	01	H5216_387_1	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	387	2	1	04	01	H5216_387_2	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	387	2	1	04	01	H5216_387_2	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	387	2	1	04	01	H5216_387_2	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	387	2	1	04	01	H5216_387_2	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	387	2	1	04	01	H5216_387_2	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	388	0	1	04	01	H5216_388_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	388	0	1	04	01	H5216_388_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	388	0	1	04	01	H5216_388_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	388	0	1	04	01	H5216_388_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	388	0	1	04	01	H5216_388_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	389	0	1	04	01	H5216_389_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	389	0	1	04	01	H5216_389_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	389	0	1	04	01	H5216_389_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	389	0	1	04	01	H5216_389_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	389	0	1	04	01	H5216_389_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	390	0	1	04	01	H5216_390_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	390	0	1	04	01	H5216_390_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	390	0	1	04	01	H5216_390_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	390	0	1	04	01	H5216_390_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	390	0	1	04	01	H5216_390_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	391	0	1	04	01	H5216_391_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	391	0	1	04	01	H5216_391_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	391	0	1	04	01	H5216_391_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	391	0	1	04	01	H5216_391_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	391	0	1	04	01	H5216_391_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	393	0	1	04	01	H5216_393_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	393	0	1	04	01	H5216_393_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	393	0	1	04	01	H5216_393_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	393	0	1	04	01	H5216_393_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	393	0	1	04	01	H5216_393_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	394	0	1	04	01	H5216_394_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	394	0	1	04	01	H5216_394_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	394	0	1	04	01	H5216_394_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	394	0	1	04	01	H5216_394_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	394	0	1	04	01	H5216_394_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	395	0	1	04	01	H5216_395_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	395	0	1	04	01	H5216_395_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	395	0	1	04	01	H5216_395_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	395	0	1	04	01	H5216_395_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	395	0	1	04	01	H5216_395_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	396	0	1	04	01	H5216_396_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	396	0	1	04	01	H5216_396_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	396	0	1	04	01	H5216_396_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	396	0	1	04	01	H5216_396_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	396	0	1	04	01	H5216_396_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	399	0	1	04	01	H5216_399_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	399	0	1	04	01	H5216_399_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	399	0	1	04	01	H5216_399_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	399	0	1	04	01	H5216_399_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	399	0	1	04	01	H5216_399_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	403	0	1	04	01	H5216_403_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	403	0	1	04	01	H5216_403_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	403	0	1	04	01	H5216_403_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	403	0	1	04	01	H5216_403_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	403	0	1	04	01	H5216_403_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	404	0	1	04	01	H5216_404_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	404	0	1	04	01	H5216_404_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	404	0	1	04	01	H5216_404_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	404	0	1	04	01	H5216_404_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	404	0	1	04	01	H5216_404_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	405	0	1	04	01	H5216_405_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	405	0	1	04	01	H5216_405_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	405	0	1	04	01	H5216_405_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	405	0	1	04	01	H5216_405_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	405	0	1	04	01	H5216_405_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	406	0	1	04	01	H5216_406_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	406	0	1	04	01	H5216_406_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	406	0	1	04	01	H5216_406_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	406	0	1	04	01	H5216_406_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	406	0	1	04	01	H5216_406_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	407	0	1	04	01	H5216_407_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	407	0	1	04	01	H5216_407_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	407	0	1	04	01	H5216_407_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	407	0	1	04	01	H5216_407_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	407	0	1	04	01	H5216_407_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	408	0	1	04	01	H5216_408_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	408	0	1	04	01	H5216_408_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	408	0	1	04	01	H5216_408_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	408	0	1	04	01	H5216_408_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	408	0	1	04	01	H5216_408_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	409	0	1	04	01	H5216_409_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	409	0	1	04	01	H5216_409_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	409	0	1	04	01	H5216_409_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	409	0	1	04	01	H5216_409_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	409	0	1	04	01	H5216_409_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	410	0	1	04	01	H5216_410_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	410	0	1	04	01	H5216_410_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	410	0	1	04	01	H5216_410_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	410	0	1	04	01	H5216_410_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	410	0	1	04	01	H5216_410_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	411	0	1	04	01	H5216_411_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	411	0	1	04	01	H5216_411_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	411	0	1	04	01	H5216_411_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	411	0	1	04	01	H5216_411_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	411	0	1	04	01	H5216_411_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	412	0	1	04	01	H5216_412_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	412	0	1	04	01	H5216_412_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	412	0	1	04	01	H5216_412_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	412	0	1	04	01	H5216_412_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	412	0	1	04	01	H5216_412_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	414	0	1	04	01	H5216_414_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H5216	414	0	1	04	01	H5216_414_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5216	414	0	1	04	01	H5216_414_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5216	414	0	1	04	01	H5216_414_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5216	414	0	1	04	01	H5216_414_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5216	414	0	1	04	01	H5216_414_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5216	416	0	1	04	01	H5216_416_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	416	0	1	04	01	H5216_416_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	416	0	1	04	01	H5216_416_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	416	0	1	04	01	H5216_416_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	416	0	1	04	01	H5216_416_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	417	0	1	04	01	H5216_417_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	417	0	1	04	01	H5216_417_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	417	0	1	04	01	H5216_417_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	417	0	1	04	01	H5216_417_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	417	0	1	04	01	H5216_417_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	420	0	1	04	01	H5216_420_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	420	0	1	04	01	H5216_420_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	420	0	1	04	01	H5216_420_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	420	0	1	04	01	H5216_420_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	420	0	1	04	01	H5216_420_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	421	0	1	04	01	H5216_421_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	421	0	1	04	01	H5216_421_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	421	0	1	04	01	H5216_421_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	421	0	1	04	01	H5216_421_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	421	0	1	04	01	H5216_421_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	423	0	1	04	01	H5216_423_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	423	0	1	04	01	H5216_423_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	423	0	1	04	01	H5216_423_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	423	0	1	04	01	H5216_423_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	423	0	1	04	01	H5216_423_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	424	0	1	04	01	H5216_424_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	424	0	1	04	01	H5216_424_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	424	0	1	04	01	H5216_424_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	424	0	1	04	01	H5216_424_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	424	0	1	04	01	H5216_424_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	425	0	1	04	01	H5216_425_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	425	0	1	04	01	H5216_425_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	425	0	1	04	01	H5216_425_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	425	0	1	04	01	H5216_425_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	425	0	1	04	01	H5216_425_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	426	0	1	04	01	H5216_426_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	426	0	1	04	01	H5216_426_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	426	0	1	04	01	H5216_426_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	426	0	1	04	01	H5216_426_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	426	0	1	04	01	H5216_426_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	428	1	1	04	01	H5216_428_1	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	428	1	1	04	01	H5216_428_1	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	428	1	1	04	01	H5216_428_1	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	428	1	1	04	01	H5216_428_1	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	428	1	1	04	01	H5216_428_1	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	428	2	1	04	01	H5216_428_2	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	428	2	1	04	01	H5216_428_2	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	428	2	1	04	01	H5216_428_2	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	428	2	1	04	01	H5216_428_2	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	428	2	1	04	01	H5216_428_2	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	428	3	1	04	01	H5216_428_3	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	428	3	1	04	01	H5216_428_3	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	428	3	1	04	01	H5216_428_3	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	428	3	1	04	01	H5216_428_3	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	428	3	1	04	01	H5216_428_3	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	428	5	1	04	01	H5216_428_5	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	428	5	1	04	01	H5216_428_5	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	428	5	1	04	01	H5216_428_5	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	428	5	1	04	01	H5216_428_5	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	428	5	1	04	01	H5216_428_5	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	429	0	1	04	01	H5216_429_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	429	0	1	04	01	H5216_429_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	429	0	1	04	01	H5216_429_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	429	0	1	04	01	H5216_429_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	429	0	1	04	01	H5216_429_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	430	0	1	04	01	H5216_430_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	430	0	1	04	01	H5216_430_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	430	0	1	04	01	H5216_430_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	430	0	1	04	01	H5216_430_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	430	0	1	04	01	H5216_430_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	431	0	1	04	01	H5216_431_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	431	0	1	04	01	H5216_431_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	431	0	1	04	01	H5216_431_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	431	0	1	04	01	H5216_431_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	431	0	1	04	01	H5216_431_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	432	0	1	04	01	H5216_432_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	432	0	1	04	01	H5216_432_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	432	0	1	04	01	H5216_432_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	432	0	1	04	01	H5216_432_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	432	0	1	04	01	H5216_432_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	433	0	1	04	01	H5216_433_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	433	0	1	04	01	H5216_433_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	433	0	1	04	01	H5216_433_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	433	0	1	04	01	H5216_433_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	433	0	1	04	01	H5216_433_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	435	1	1	04	01	H5216_435_1	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	435	1	1	04	01	H5216_435_1	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	435	1	1	04	01	H5216_435_1	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	435	1	1	04	01	H5216_435_1	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	435	1	1	04	01	H5216_435_1	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	435	2	1	04	01	H5216_435_2	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	435	2	1	04	01	H5216_435_2	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	435	2	1	04	01	H5216_435_2	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	435	2	1	04	01	H5216_435_2	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	435	2	1	04	01	H5216_435_2	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	435	3	1	04	01	H5216_435_3	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	435	3	1	04	01	H5216_435_3	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	435	3	1	04	01	H5216_435_3	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	435	3	1	04	01	H5216_435_3	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	435	3	1	04	01	H5216_435_3	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	443	0	1	04	01	H5216_443_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H5216	443	0	1	04	01	H5216_443_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5216	443	0	1	04	01	H5216_443_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5216	443	0	1	04	01	H5216_443_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5216	443	0	1	04	01	H5216_443_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5216	443	0	1	04	01	H5216_443_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5216	444	0	1	04	01	H5216_444_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	444	0	1	04	01	H5216_444_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	444	0	1	04	01	H5216_444_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	444	0	1	04	01	H5216_444_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	444	0	1	04	01	H5216_444_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	448	0	1	04	01	H5216_448_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	448	0	1	04	01	H5216_448_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	448	0	1	04	01	H5216_448_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	448	0	1	04	01	H5216_448_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	448	0	1	04	01	H5216_448_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	449	0	1	04	01	H5216_449_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	449	0	1	04	01	H5216_449_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	449	0	1	04	01	H5216_449_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	449	0	1	04	01	H5216_449_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	449	0	1	04	01	H5216_449_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	450	0	1	04	01	H5216_450_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	450	0	1	04	01	H5216_450_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	450	0	1	04	01	H5216_450_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	450	0	1	04	01	H5216_450_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	450	0	1	04	01	H5216_450_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	451	0	1	04	01	H5216_451_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	451	0	1	04	01	H5216_451_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	451	0	1	04	01	H5216_451_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	451	0	1	04	01	H5216_451_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	451	0	1	04	01	H5216_451_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	452	0	1	04	01	H5216_452_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	452	0	1	04	01	H5216_452_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	452	0	1	04	01	H5216_452_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	452	0	1	04	01	H5216_452_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	452	0	1	04	01	H5216_452_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	453	0	1	04	01	H5216_453_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	453	0	1	04	01	H5216_453_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	453	0	1	04	01	H5216_453_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	453	0	1	04	01	H5216_453_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	453	0	1	04	01	H5216_453_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	456	1	1	04	01	H5216_456_1	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	456	1	1	04	01	H5216_456_1	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	456	1	1	04	01	H5216_456_1	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	456	1	1	04	01	H5216_456_1	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	456	1	1	04	01	H5216_456_1	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	456	2	1	04	01	H5216_456_2	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	456	2	1	04	01	H5216_456_2	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	456	2	1	04	01	H5216_456_2	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	456	2	1	04	01	H5216_456_2	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	456	2	1	04	01	H5216_456_2	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	457	1	1	04	01	H5216_457_1	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	457	1	1	04	01	H5216_457_1	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	457	1	1	04	01	H5216_457_1	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	457	1	1	04	01	H5216_457_1	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	457	1	1	04	01	H5216_457_1	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	457	2	1	04	01	H5216_457_2	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	457	2	1	04	01	H5216_457_2	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	457	2	1	04	01	H5216_457_2	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	457	2	1	04	01	H5216_457_2	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	457	2	1	04	01	H5216_457_2	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	459	0	1	04	01	H5216_459_0	3		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	459	0	1	04	01	H5216_459_0	3		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	459	0	1	04	01	H5216_459_0	3		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	459	0	1	04	01	H5216_459_0	3		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	459	0	1	04	01	H5216_459_0	3		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	461	0	1	04	01	H5216_461_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	461	0	1	04	01	H5216_461_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	461	0	1	04	01	H5216_461_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	461	0	1	04	01	H5216_461_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	461	0	1	04	01	H5216_461_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	463	0	1	04	01	H5216_463_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	463	0	1	04	01	H5216_463_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	463	0	1	04	01	H5216_463_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	463	0	1	04	01	H5216_463_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	463	0	1	04	01	H5216_463_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	464	0	1	04	01	H5216_464_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	464	0	1	04	01	H5216_464_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	464	0	1	04	01	H5216_464_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	464	0	1	04	01	H5216_464_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	464	0	1	04	01	H5216_464_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	465	0	1	04	01	H5216_465_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	465	0	1	04	01	H5216_465_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	465	0	1	04	01	H5216_465_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	465	0	1	04	01	H5216_465_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	465	0	1	04	01	H5216_465_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	466	0	1	04	01	H5216_466_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	466	0	1	04	01	H5216_466_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	466	0	1	04	01	H5216_466_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	466	0	1	04	01	H5216_466_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	466	0	1	04	01	H5216_466_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	468	0	1	04	01	H5216_468_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5216	468	0	1	04	01	H5216_468_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	468	0	1	04	01	H5216_468_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	468	0	1	04	01	H5216_468_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	468	0	1	04	01	H5216_468_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	469	0	1	04	01	H5216_469_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	469	0	1	04	01	H5216_469_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	469	0	1	04	01	H5216_469_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	469	0	1	04	01	H5216_469_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	469	0	1	04	01	H5216_469_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5216	470	0	1	04	01	H5216_470_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5216	470	0	1	04	01	H5216_470_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5216	470	0	1	04	01	H5216_470_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5216	470	0	1	04	01	H5216_470_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5216	470	0	1	04	01	H5216_470_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5232	001	0	1	04	01	H5232_001_0	18			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5232	001	0	1	04	01	H5232_001_0	18			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5232	001	0	1	04	01	H5232_001_0	18			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5232	001	0	1	04	01	H5232_001_0	18			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5232	001	0	1	04	01	H5232_001_0	18			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5244	001	0	1	01	01	H5244_001_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5244	001	0	1	01	01	H5244_001_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5244	001	0	1	01	01	H5244_001_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5244	001	0	1	01	01	H5244_001_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5244	001	0	1	01	01	H5244_001_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5244	002	0	1	01	01	H5244_002_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5244	002	0	1	01	01	H5244_002_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5244	002	0	1	01	01	H5244_002_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5244	002	0	1	01	01	H5244_002_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5244	002	0	1	01	01	H5244_002_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5244	004	0	1	01	01	H5244_004_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5244	004	0	1	01	01	H5244_004_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5244	004	0	1	01	01	H5244_004_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5244	004	0	1	01	01	H5244_004_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5244	004	0	1	01	01	H5244_004_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5244	005	0	1	01	01	H5244_005_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5244	005	0	1	01	01	H5244_005_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5244	005	0	1	01	01	H5244_005_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5244	005	0	1	01	01	H5244_005_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5244	005	0	1	01	01	H5244_005_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	004	0	1	02	01	H5253_004_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	004	0	1	02	01	H5253_004_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	5.00	
H5253	004	0	1	02	01	H5253_004_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	004	0	1	02	01	H5253_004_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	004	0	1	02	01	H5253_004_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	011	0	1	02	01	H5253_011_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	011	0	1	02	01	H5253_011_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H5253	011	0	1	02	01	H5253_011_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	011	0	1	02	01	H5253_011_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	011	0	1	02	01	H5253_011_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	024	0	1	02	01	H5253_024_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	024	0	1	02	01	H5253_024_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5253	024	0	1	02	01	H5253_024_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	024	0	1	02	01	H5253_024_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	024	0	1	02	01	H5253_024_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	030	0	1	02	01	H5253_030_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	030	0	1	02	01	H5253_030_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H5253	030	0	1	02	01	H5253_030_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	030	0	1	02	01	H5253_030_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	030	0	1	02	01	H5253_030_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	033	0	1	02	01	H5253_033_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	033	0	1	02	01	H5253_033_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H5253	033	0	1	02	01	H5253_033_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	033	0	1	02	01	H5253_033_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	033	0	1	02	01	H5253_033_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	034	0	1	02	01	H5253_034_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	034	0	1	02	01	H5253_034_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H5253	034	0	1	02	01	H5253_034_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	034	0	1	02	01	H5253_034_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	034	0	1	02	01	H5253_034_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	035	0	1	02	01	H5253_035_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	035	0	1	02	01	H5253_035_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H5253	035	0	1	02	01	H5253_035_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	035	0	1	02	01	H5253_035_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	035	0	1	02	01	H5253_035_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	036	0	1	02	01	H5253_036_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	036	0	1	02	01	H5253_036_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H5253	036	0	1	02	01	H5253_036_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	036	0	1	02	01	H5253_036_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	036	0	1	02	01	H5253_036_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	037	0	1	02	01	H5253_037_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	037	0	1	02	01	H5253_037_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	5.00	
H5253	037	0	1	02	01	H5253_037_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	037	0	1	02	01	H5253_037_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	037	0	1	02	01	H5253_037_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	038	0	1	02	01	H5253_038_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	038	0	1	02	01	H5253_038_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H5253	038	0	1	02	01	H5253_038_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	038	0	1	02	01	H5253_038_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	038	0	1	02	01	H5253_038_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	039	0	1	02	01	H5253_039_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	039	0	1	02	01	H5253_039_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H5253	039	0	1	02	01	H5253_039_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	039	0	1	02	01	H5253_039_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	039	0	1	02	01	H5253_039_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	041	0	1	02	01	H5253_041_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	041	0	1	02	01	H5253_041_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5253	041	0	1	02	01	H5253_041_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	041	0	1	02	01	H5253_041_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	041	0	1	02	01	H5253_041_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	047	0	1	02	01	H5253_047_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	047	0	1	02	01	H5253_047_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H5253	047	0	1	02	01	H5253_047_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	047	0	1	02	01	H5253_047_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	047	0	1	02	01	H5253_047_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	048	0	1	02	01	H5253_048_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	048	0	1	02	01	H5253_048_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	5.00	
H5253	048	0	1	02	01	H5253_048_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	048	0	1	02	01	H5253_048_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	048	0	1	02	01	H5253_048_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	051	0	1	02	01	H5253_051_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	051	0	1	02	01	H5253_051_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H5253	051	0	1	02	01	H5253_051_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	051	0	1	02	01	H5253_051_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	051	0	1	02	01	H5253_051_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	059	0	1	01	01	H5253_059_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	0.00	
H5253	059	0	1	01	01	H5253_059_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5253	059	0	1	01	01	H5253_059_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	059	0	1	01	01	H5253_059_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	059	0	1	01	01	H5253_059_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	062	0	1	02	01	H5253_062_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	062	0	1	02	01	H5253_062_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H5253	062	0	1	02	01	H5253_062_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	062	0	1	02	01	H5253_062_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	062	0	1	02	01	H5253_062_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	064	0	1	02	01	H5253_064_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	064	0	1	02	01	H5253_064_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H5253	064	0	1	02	01	H5253_064_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	064	0	1	02	01	H5253_064_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	064	0	1	02	01	H5253_064_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	072	0	1	02	01	H5253_072_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	072	0	1	02	01	H5253_072_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H5253	072	0	1	02	01	H5253_072_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	072	0	1	02	01	H5253_072_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	072	0	1	02	01	H5253_072_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	079	0	1	02	01	H5253_079_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	079	0	1	02	01	H5253_079_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H5253	079	0	1	02	01	H5253_079_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	079	0	1	02	01	H5253_079_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	079	0	1	02	01	H5253_079_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	080	0	1	02	01	H5253_080_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	080	0	1	02	01	H5253_080_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H5253	080	0	1	02	01	H5253_080_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	080	0	1	02	01	H5253_080_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	080	0	1	02	01	H5253_080_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	081	0	1	02	01	H5253_081_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	081	0	1	02	01	H5253_081_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H5253	081	0	1	02	01	H5253_081_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	081	0	1	02	01	H5253_081_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	081	0	1	02	01	H5253_081_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	082	0	1	02	01	H5253_082_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	082	0	1	02	01	H5253_082_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H5253	082	0	1	02	01	H5253_082_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	082	0	1	02	01	H5253_082_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	082	0	1	02	01	H5253_082_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	084	0	1	02	01	H5253_084_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	084	0	1	02	01	H5253_084_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H5253	084	0	1	02	01	H5253_084_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	084	0	1	02	01	H5253_084_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	084	0	1	02	01	H5253_084_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	087	0	1	02	01	H5253_087_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	087	0	1	02	01	H5253_087_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H5253	087	0	1	02	01	H5253_087_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	087	0	1	02	01	H5253_087_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	087	0	1	02	01	H5253_087_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	088	0	1	02	01	H5253_088_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	088	0	1	02	01	H5253_088_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H5253	088	0	1	02	01	H5253_088_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	088	0	1	02	01	H5253_088_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	088	0	1	02	01	H5253_088_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	089	0	1	02	01	H5253_089_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	089	0	1	02	01	H5253_089_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H5253	089	0	1	02	01	H5253_089_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	089	0	1	02	01	H5253_089_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	089	0	1	02	01	H5253_089_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	097	0	1	02	01	H5253_097_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	097	0	1	02	01	H5253_097_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H5253	097	0	1	02	01	H5253_097_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	097	0	1	02	01	H5253_097_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	097	0	1	02	01	H5253_097_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	099	0	1	02	01	H5253_099_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	099	0	1	02	01	H5253_099_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H5253	099	0	1	02	01	H5253_099_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	099	0	1	02	01	H5253_099_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	099	0	1	02	01	H5253_099_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	100	0	1	02	01	H5253_100_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	100	0	1	02	01	H5253_100_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H5253	100	0	1	02	01	H5253_100_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	100	0	1	02	01	H5253_100_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	100	0	1	02	01	H5253_100_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	103	0	1	02	01	H5253_103_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	103	0	1	02	01	H5253_103_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H5253	103	0	1	02	01	H5253_103_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	103	0	1	02	01	H5253_103_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	103	0	1	02	01	H5253_103_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	104	0	1	02	01	H5253_104_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	104	0	1	02	01	H5253_104_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H5253	104	0	1	02	01	H5253_104_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	104	0	1	02	01	H5253_104_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	104	0	1	02	01	H5253_104_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	105	0	1	02	01	H5253_105_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	105	0	1	02	01	H5253_105_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	7.00	
H5253	105	0	1	02	01	H5253_105_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	105	0	1	02	01	H5253_105_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	105	0	1	02	01	H5253_105_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	108	1	1	02	01	H5253_108_1	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	108	1	1	02	01	H5253_108_1	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H5253	108	1	1	02	01	H5253_108_1	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	108	1	1	02	01	H5253_108_1	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	108	1	1	02	01	H5253_108_1	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	108	2	1	02	01	H5253_108_2	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	108	2	1	02	01	H5253_108_2	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H5253	108	2	1	02	01	H5253_108_2	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	108	2	1	02	01	H5253_108_2	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	108	2	1	02	01	H5253_108_2	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	108	3	1	02	01	H5253_108_3	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	108	3	1	02	01	H5253_108_3	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H5253	108	3	1	02	01	H5253_108_3	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	108	3	1	02	01	H5253_108_3	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	108	3	1	02	01	H5253_108_3	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	109	1	1	02	01	H5253_109_1	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	109	1	1	02	01	H5253_109_1	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H5253	109	1	1	02	01	H5253_109_1	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	109	1	1	02	01	H5253_109_1	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	109	1	1	02	01	H5253_109_1	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	109	2	1	02	01	H5253_109_2	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	109	2	1	02	01	H5253_109_2	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H5253	109	2	1	02	01	H5253_109_2	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	109	2	1	02	01	H5253_109_2	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	109	2	1	02	01	H5253_109_2	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	109	4	1	02	01	H5253_109_4	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	109	4	1	02	01	H5253_109_4	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H5253	109	4	1	02	01	H5253_109_4	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	109	4	1	02	01	H5253_109_4	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	109	4	1	02	01	H5253_109_4	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	110	0	1	02	01	H5253_110_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	110	0	1	02	01	H5253_110_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H5253	110	0	1	02	01	H5253_110_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	110	0	1	02	01	H5253_110_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	110	0	1	02	01	H5253_110_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	111	1	1	02	01	H5253_111_1	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	111	1	1	02	01	H5253_111_1	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H5253	111	1	1	02	01	H5253_111_1	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	111	1	1	02	01	H5253_111_1	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	111	1	1	02	01	H5253_111_1	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	111	2	1	02	01	H5253_111_2	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	111	2	1	02	01	H5253_111_2	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H5253	111	2	1	02	01	H5253_111_2	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	111	2	1	02	01	H5253_111_2	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	111	2	1	02	01	H5253_111_2	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	112	1	1	02	01	H5253_112_1	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	112	1	1	02	01	H5253_112_1	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H5253	112	1	1	02	01	H5253_112_1	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	112	1	1	02	01	H5253_112_1	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	112	1	1	02	01	H5253_112_1	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	112	2	1	02	01	H5253_112_2	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	112	2	1	02	01	H5253_112_2	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H5253	112	2	1	02	01	H5253_112_2	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	112	2	1	02	01	H5253_112_2	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	112	2	1	02	01	H5253_112_2	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	116	0	1	02	01	H5253_116_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	116	0	1	02	01	H5253_116_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5253	116	0	1	02	01	H5253_116_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	116	0	1	02	01	H5253_116_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	116	0	1	02	01	H5253_116_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	117	0	1	02	01	H5253_117_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	117	0	1	02	01	H5253_117_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	5.00	
H5253	117	0	1	02	01	H5253_117_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	117	0	1	02	01	H5253_117_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	117	0	1	02	01	H5253_117_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	119	0	1	02	01	H5253_119_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	119	0	1	02	01	H5253_119_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H5253	119	0	1	02	01	H5253_119_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	119	0	1	02	01	H5253_119_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	119	0	1	02	01	H5253_119_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	120	0	1	02	01	H5253_120_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	120	0	1	02	01	H5253_120_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H5253	120	0	1	02	01	H5253_120_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	120	0	1	02	01	H5253_120_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	120	0	1	02	01	H5253_120_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	121	0	1	02	01	H5253_121_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	121	0	1	02	01	H5253_121_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H5253	121	0	1	02	01	H5253_121_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	121	0	1	02	01	H5253_121_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	121	0	1	02	01	H5253_121_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	122	0	1	01	01	H5253_122_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	0.00	
H5253	122	0	1	01	01	H5253_122_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5253	122	0	1	01	01	H5253_122_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	122	0	1	01	01	H5253_122_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	122	0	1	01	01	H5253_122_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	124	1	1	02	01	H5253_124_1	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	124	1	1	02	01	H5253_124_1	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	5.00	
H5253	124	1	1	02	01	H5253_124_1	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	124	1	1	02	01	H5253_124_1	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	124	1	1	02	01	H5253_124_1	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	124	2	1	02	01	H5253_124_2	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	124	2	1	02	01	H5253_124_2	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	5.00	
H5253	124	2	1	02	01	H5253_124_2	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	124	2	1	02	01	H5253_124_2	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	124	2	1	02	01	H5253_124_2	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	125	1	1	02	01	H5253_125_1	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	125	1	1	02	01	H5253_125_1	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H5253	125	1	1	02	01	H5253_125_1	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	125	1	1	02	01	H5253_125_1	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	125	1	1	02	01	H5253_125_1	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	125	2	1	02	01	H5253_125_2	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	125	2	1	02	01	H5253_125_2	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H5253	125	2	1	02	01	H5253_125_2	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	125	2	1	02	01	H5253_125_2	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	125	2	1	02	01	H5253_125_2	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	126	1	1	02	01	H5253_126_1	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	126	1	1	02	01	H5253_126_1	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H5253	126	1	1	02	01	H5253_126_1	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	126	1	1	02	01	H5253_126_1	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	126	1	1	02	01	H5253_126_1	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	126	2	1	02	01	H5253_126_2	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	126	2	1	02	01	H5253_126_2	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H5253	126	2	1	02	01	H5253_126_2	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	126	2	1	02	01	H5253_126_2	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	126	2	1	02	01	H5253_126_2	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	127	0	1	02	01	H5253_127_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	127	0	1	02	01	H5253_127_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H5253	127	0	1	02	01	H5253_127_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	127	0	1	02	01	H5253_127_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	127	0	1	02	01	H5253_127_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	128	0	1	02	01	H5253_128_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	128	0	1	02	01	H5253_128_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H5253	128	0	1	02	01	H5253_128_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	128	0	1	02	01	H5253_128_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	128	0	1	02	01	H5253_128_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	130	0	1	02	01	H5253_130_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	130	0	1	02	01	H5253_130_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H5253	130	0	1	02	01	H5253_130_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	130	0	1	02	01	H5253_130_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	130	0	1	02	01	H5253_130_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	131	0	1	02	01	H5253_131_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	131	0	1	02	01	H5253_131_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H5253	131	0	1	02	01	H5253_131_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	131	0	1	02	01	H5253_131_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	131	0	1	02	01	H5253_131_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	132	0	1	02	01	H5253_132_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	132	0	1	02	01	H5253_132_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H5253	132	0	1	02	01	H5253_132_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	132	0	1	02	01	H5253_132_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	132	0	1	02	01	H5253_132_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	133	0	1	02	01	H5253_133_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	133	0	1	02	01	H5253_133_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H5253	133	0	1	02	01	H5253_133_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	133	0	1	02	01	H5253_133_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	133	0	1	02	01	H5253_133_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	134	0	1	02	01	H5253_134_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	134	0	1	02	01	H5253_134_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H5253	134	0	1	02	01	H5253_134_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	134	0	1	02	01	H5253_134_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	134	0	1	02	01	H5253_134_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	135	0	1	02	01	H5253_135_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	135	0	1	02	01	H5253_135_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H5253	135	0	1	02	01	H5253_135_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	135	0	1	02	01	H5253_135_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	135	0	1	02	01	H5253_135_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	141	0	1	02	01	H5253_141_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	141	0	1	02	01	H5253_141_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H5253	141	0	1	02	01	H5253_141_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	141	0	1	02	01	H5253_141_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	141	0	1	02	01	H5253_141_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	142	0	1	02	01	H5253_142_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	142	0	1	02	01	H5253_142_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	5.00	
H5253	142	0	1	02	01	H5253_142_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	142	0	1	02	01	H5253_142_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	142	0	1	02	01	H5253_142_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	144	1	1	02	01	H5253_144_1	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	144	1	1	02	01	H5253_144_1	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H5253	144	1	1	02	01	H5253_144_1	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	144	1	1	02	01	H5253_144_1	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	144	1	1	02	01	H5253_144_1	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	144	2	1	02	01	H5253_144_2	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	144	2	1	02	01	H5253_144_2	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H5253	144	2	1	02	01	H5253_144_2	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	144	2	1	02	01	H5253_144_2	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	144	2	1	02	01	H5253_144_2	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	145	0	1	02	01	H5253_145_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	145	0	1	02	01	H5253_145_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	5.00	
H5253	145	0	1	02	01	H5253_145_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	145	0	1	02	01	H5253_145_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	145	0	1	02	01	H5253_145_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	146	0	1	02	01	H5253_146_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	146	0	1	02	01	H5253_146_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H5253	146	0	1	02	01	H5253_146_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	146	0	1	02	01	H5253_146_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	146	0	1	02	01	H5253_146_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	147	0	1	02	01	H5253_147_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	147	0	1	02	01	H5253_147_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H5253	147	0	1	02	01	H5253_147_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	147	0	1	02	01	H5253_147_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	147	0	1	02	01	H5253_147_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	148	0	1	02	01	H5253_148_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	148	0	1	02	01	H5253_148_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H5253	148	0	1	02	01	H5253_148_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	148	0	1	02	01	H5253_148_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	148	0	1	02	01	H5253_148_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	150	0	1	02	01	H5253_150_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	150	0	1	02	01	H5253_150_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H5253	150	0	1	02	01	H5253_150_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	150	0	1	02	01	H5253_150_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	150	0	1	02	01	H5253_150_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	154	0	1	02	01	H5253_154_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	154	0	1	02	01	H5253_154_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	5.00	
H5253	154	0	1	02	01	H5253_154_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	154	0	1	02	01	H5253_154_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	154	0	1	02	01	H5253_154_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	155	0	1	02	01	H5253_155_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	155	0	1	02	01	H5253_155_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H5253	155	0	1	02	01	H5253_155_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	155	0	1	02	01	H5253_155_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	155	0	1	02	01	H5253_155_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	157	1	1	02	01	H5253_157_1	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	157	1	1	02	01	H5253_157_1	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H5253	157	1	1	02	01	H5253_157_1	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	157	1	1	02	01	H5253_157_1	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	157	1	1	02	01	H5253_157_1	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	157	2	1	02	01	H5253_157_2	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	157	2	1	02	01	H5253_157_2	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H5253	157	2	1	02	01	H5253_157_2	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	157	2	1	02	01	H5253_157_2	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	157	2	1	02	01	H5253_157_2	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	159	0	1	02	01	H5253_159_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	159	0	1	02	01	H5253_159_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H5253	159	0	1	02	01	H5253_159_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	159	0	1	02	01	H5253_159_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	159	0	1	02	01	H5253_159_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	161	0	1	02	01	H5253_161_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	161	0	1	02	01	H5253_161_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H5253	161	0	1	02	01	H5253_161_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	161	0	1	02	01	H5253_161_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	161	0	1	02	01	H5253_161_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	162	1	1	02	01	H5253_162_1	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	162	1	1	02	01	H5253_162_1	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H5253	162	1	1	02	01	H5253_162_1	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	162	1	1	02	01	H5253_162_1	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	162	1	1	02	01	H5253_162_1	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	162	2	1	02	01	H5253_162_2	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	162	2	1	02	01	H5253_162_2	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H5253	162	2	1	02	01	H5253_162_2	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	162	2	1	02	01	H5253_162_2	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	162	2	1	02	01	H5253_162_2	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	168	0	1	02	01	H5253_168_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	168	0	1	02	01	H5253_168_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H5253	168	0	1	02	01	H5253_168_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	168	0	1	02	01	H5253_168_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	168	0	1	02	01	H5253_168_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	169	0	1	02	01	H5253_169_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	169	0	1	02	01	H5253_169_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H5253	169	0	1	02	01	H5253_169_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	169	0	1	02	01	H5253_169_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	169	0	1	02	01	H5253_169_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	171	0	1	02	01	H5253_171_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	171	0	1	02	01	H5253_171_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	5.00	
H5253	171	0	1	02	01	H5253_171_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	171	0	1	02	01	H5253_171_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	171	0	1	02	01	H5253_171_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	172	0	1	02	01	H5253_172_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	172	0	1	02	01	H5253_172_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H5253	172	0	1	02	01	H5253_172_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	172	0	1	02	01	H5253_172_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	172	0	1	02	01	H5253_172_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	173	0	1	02	01	H5253_173_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	173	0	1	02	01	H5253_173_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H5253	173	0	1	02	01	H5253_173_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	173	0	1	02	01	H5253_173_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	173	0	1	02	01	H5253_173_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	174	0	1	02	01	H5253_174_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	174	0	1	02	01	H5253_174_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H5253	174	0	1	02	01	H5253_174_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	174	0	1	02	01	H5253_174_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	174	0	1	02	01	H5253_174_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	175	0	1	02	01	H5253_175_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	175	0	1	02	01	H5253_175_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	5.00	
H5253	175	0	1	02	01	H5253_175_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	175	0	1	02	01	H5253_175_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	175	0	1	02	01	H5253_175_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	176	0	1	02	01	H5253_176_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	176	0	1	02	01	H5253_176_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H5253	176	0	1	02	01	H5253_176_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	176	0	1	02	01	H5253_176_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	176	0	1	02	01	H5253_176_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	178	0	1	02	01	H5253_178_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	178	0	1	02	01	H5253_178_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H5253	178	0	1	02	01	H5253_178_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	178	0	1	02	01	H5253_178_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	178	0	1	02	01	H5253_178_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	179	0	1	02	01	H5253_179_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	179	0	1	02	01	H5253_179_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H5253	179	0	1	02	01	H5253_179_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	179	0	1	02	01	H5253_179_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	179	0	1	02	01	H5253_179_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	180	0	1	02	01	H5253_180_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	180	0	1	02	01	H5253_180_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H5253	180	0	1	02	01	H5253_180_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	180	0	1	02	01	H5253_180_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	180	0	1	02	01	H5253_180_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	182	0	1	02	01	H5253_182_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	182	0	1	02	01	H5253_182_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H5253	182	0	1	02	01	H5253_182_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	182	0	1	02	01	H5253_182_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	182	0	1	02	01	H5253_182_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	183	0	1	02	01	H5253_183_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	183	0	1	02	01	H5253_183_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H5253	183	0	1	02	01	H5253_183_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	183	0	1	02	01	H5253_183_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	183	0	1	02	01	H5253_183_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	184	0	1	02	01	H5253_184_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	184	0	1	02	01	H5253_184_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5253	184	0	1	02	01	H5253_184_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	184	0	1	02	01	H5253_184_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	184	0	1	02	01	H5253_184_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	185	0	1	02	01	H5253_185_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	185	0	1	02	01	H5253_185_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H5253	185	0	1	02	01	H5253_185_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	185	0	1	02	01	H5253_185_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	185	0	1	02	01	H5253_185_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	186	0	1	02	01	H5253_186_0	11			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	186	0	1	02	01	H5253_186_0	11			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H5253	186	0	1	02	01	H5253_186_0	11			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	186	0	1	02	01	H5253_186_0	11			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	186	0	1	02	01	H5253_186_0	11			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	187	0	1	02	01	H5253_187_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	187	0	1	02	01	H5253_187_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	5.00	
H5253	187	0	1	02	01	H5253_187_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	187	0	1	02	01	H5253_187_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	187	0	1	02	01	H5253_187_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	188	0	1	02	01	H5253_188_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	188	0	1	02	01	H5253_188_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	5.00	
H5253	188	0	1	02	01	H5253_188_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	188	0	1	02	01	H5253_188_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	188	0	1	02	01	H5253_188_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	189	0	1	02	01	H5253_189_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	189	0	1	02	01	H5253_189_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	5.00	
H5253	189	0	1	02	01	H5253_189_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	189	0	1	02	01	H5253_189_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	189	0	1	02	01	H5253_189_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	190	0	1	02	01	H5253_190_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	190	0	1	02	01	H5253_190_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H5253	190	0	1	02	01	H5253_190_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	190	0	1	02	01	H5253_190_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	190	0	1	02	01	H5253_190_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	192	0	1	02	01	H5253_192_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	192	0	1	02	01	H5253_192_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H5253	192	0	1	02	01	H5253_192_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	192	0	1	02	01	H5253_192_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	192	0	1	02	01	H5253_192_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	193	1	1	02	01	H5253_193_1	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	193	1	1	02	01	H5253_193_1	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H5253	193	1	1	02	01	H5253_193_1	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	193	1	1	02	01	H5253_193_1	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	193	1	1	02	01	H5253_193_1	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	193	2	1	02	01	H5253_193_2	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	193	2	1	02	01	H5253_193_2	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H5253	193	2	1	02	01	H5253_193_2	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	193	2	1	02	01	H5253_193_2	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	193	2	1	02	01	H5253_193_2	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	195	0	1	02	01	H5253_195_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	195	0	1	02	01	H5253_195_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H5253	195	0	1	02	01	H5253_195_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	195	0	1	02	01	H5253_195_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	195	0	1	02	01	H5253_195_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	196	0	1	02	01	H5253_196_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	196	0	1	02	01	H5253_196_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H5253	196	0	1	02	01	H5253_196_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	196	0	1	02	01	H5253_196_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	196	0	1	02	01	H5253_196_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	197	0	1	02	01	H5253_197_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	197	0	1	02	01	H5253_197_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H5253	197	0	1	02	01	H5253_197_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	197	0	1	02	01	H5253_197_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	197	0	1	02	01	H5253_197_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	198	0	1	02	01	H5253_198_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	198	0	1	02	01	H5253_198_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H5253	198	0	1	02	01	H5253_198_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	198	0	1	02	01	H5253_198_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	198	0	1	02	01	H5253_198_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	199	0	1	02	01	H5253_199_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	199	0	1	02	01	H5253_199_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H5253	199	0	1	02	01	H5253_199_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	199	0	1	02	01	H5253_199_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	199	0	1	02	01	H5253_199_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	201	0	1	02	01	H5253_201_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	201	0	1	02	01	H5253_201_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H5253	201	0	1	02	01	H5253_201_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	201	0	1	02	01	H5253_201_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	201	0	1	02	01	H5253_201_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	202	0	1	02	01	H5253_202_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	202	0	1	02	01	H5253_202_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H5253	202	0	1	02	01	H5253_202_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	202	0	1	02	01	H5253_202_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	202	0	1	02	01	H5253_202_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	203	0	1	02	01	H5253_203_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	203	0	1	02	01	H5253_203_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	5.00	
H5253	203	0	1	02	01	H5253_203_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	203	0	1	02	01	H5253_203_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	203	0	1	02	01	H5253_203_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	204	0	1	02	01	H5253_204_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	204	0	1	02	01	H5253_204_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H5253	204	0	1	02	01	H5253_204_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	204	0	1	02	01	H5253_204_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	204	0	1	02	01	H5253_204_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	206	0	1	02	01	H5253_206_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	206	0	1	02	01	H5253_206_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H5253	206	0	1	02	01	H5253_206_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	206	0	1	02	01	H5253_206_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	206	0	1	02	01	H5253_206_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	207	0	1	02	01	H5253_207_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	207	0	1	02	01	H5253_207_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H5253	207	0	1	02	01	H5253_207_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	207	0	1	02	01	H5253_207_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	207	0	1	02	01	H5253_207_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	208	0	1	02	01	H5253_208_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	208	0	1	02	01	H5253_208_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H5253	208	0	1	02	01	H5253_208_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	208	0	1	02	01	H5253_208_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	208	0	1	02	01	H5253_208_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5253	209	0	1	02	01	H5253_209_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5253	209	0	1	02	01	H5253_209_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H5253	209	0	1	02	01	H5253_209_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5253	209	0	1	02	01	H5253_209_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5253	209	0	1	02	01	H5253_209_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5262	001	0	1	01	01	H5262_001_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5262	001	0	1	01	01	H5262_001_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H5262	001	0	1	01	01	H5262_001_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5262	001	0	1	01	01	H5262_001_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5262	001	0	1	01	01	H5262_001_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5262	001	0	1	01	01	H5262_001_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5262	003	0	1	01	01	H5262_003_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5262	003	0	1	01	01	H5262_003_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H5262	003	0	1	01	01	H5262_003_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5262	003	0	1	01	01	H5262_003_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5262	003	0	1	01	01	H5262_003_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5262	003	0	1	01	01	H5262_003_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5262	007	0	1	01	01	H5262_007_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5262	007	0	1	01	01	H5262_007_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H5262	007	0	1	01	01	H5262_007_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5262	007	0	1	01	01	H5262_007_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5262	007	0	1	01	01	H5262_007_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5262	007	0	1	01	01	H5262_007_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5262	008	0	1	01	01	H5262_008_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5262	008	0	1	01	01	H5262_008_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H5262	008	0	1	01	01	H5262_008_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5262	008	0	1	01	01	H5262_008_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5262	008	0	1	01	01	H5262_008_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5262	008	0	1	01	01	H5262_008_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5262	021	0	1	01	01	H5262_021_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5262	021	0	1	01	01	H5262_021_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H5262	021	0	1	01	01	H5262_021_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5262	021	0	1	01	01	H5262_021_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5262	021	0	1	01	01	H5262_021_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5262	021	0	1	01	01	H5262_021_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5262	023	0	1	01	01	H5262_023_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5262	023	0	1	01	01	H5262_023_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H5262	023	0	1	01	01	H5262_023_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5262	023	0	1	01	01	H5262_023_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5262	023	0	1	01	01	H5262_023_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5262	023	0	1	01	01	H5262_023_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5262	029	0	1	01	01	H5262_029_0	5		N	Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5262	029	0	1	01	01	H5262_029_0	5		N	Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H5262	029	0	1	01	01	H5262_029_0	5		N	Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5262	029	0	1	01	01	H5262_029_0	5		N	Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5262	029	0	1	01	01	H5262_029_0	5		N	Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5262	029	0	1	01	01	H5262_029_0	5		N	Select Care Drugs	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5262	030	0	1	01	01	H5262_030_0	5		N	Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5262	030	0	1	01	01	H5262_030_0	5		N	Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H5262	030	0	1	01	01	H5262_030_0	5		N	Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5262	030	0	1	01	01	H5262_030_0	5		N	Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5262	030	0	1	01	01	H5262_030_0	5		N	Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5262	030	0	1	01	01	H5262_030_0	5		N	Select Care Drugs	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5262	032	0	1	01	01	H5262_032_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5262	032	0	1	01	01	H5262_032_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H5262	032	0	1	01	01	H5262_032_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5262	032	0	1	01	01	H5262_032_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5262	032	0	1	01	01	H5262_032_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5262	032	0	1	01	01	H5262_032_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5262	033	0	1	01	01	H5262_033_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5262	033	0	1	01	01	H5262_033_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H5262	033	0	1	01	01	H5262_033_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5262	033	0	1	01	01	H5262_033_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5262	033	0	1	01	01	H5262_033_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5262	033	0	1	01	01	H5262_033_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5272	001	0	1	01	01	H5272_001_0	7		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5272	001	0	1	01	01	H5272_001_0	7		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5272	001	0	1	01	01	H5272_001_0	7		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5272	001	0	1	01	01	H5272_001_0	7		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5272	001	0	1	01	01	H5272_001_0	7		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5272	001	0	1	01	01	H5272_001_0	7		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5273	001	0	1	01	01	H5273_001_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	01	3	2	0.00	
H5273	001	0	1	01	01	H5273_001_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	01	3	2	0.00	
H5273	001	0	1	01	01	H5273_001_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H5273	001	0	1	01	01	H5273_001_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H5273	001	0	1	01	01	H5273_001_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H5273	001	0	1	01	01	H5273_001_0	7			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	11	1	2	0.00	
H5294	010	0	1	01	01	H5294_010_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5294	010	0	1	01	01	H5294_010_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5294	010	0	1	01	01	H5294_010_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5294	010	0	1	01	01	H5294_010_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5294	010	0	1	01	01	H5294_010_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5294	010	0	1	01	01	H5294_010_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5294	011	0	1	01	01	H5294_011_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H5294	011	0	1	01	01	H5294_011_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5294	011	0	1	01	01	H5294_011_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5294	011	0	1	01	01	H5294_011_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5294	011	0	1	01	01	H5294_011_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5294	011	0	1	01	01	H5294_011_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5294	013	0	1	01	01	H5294_013_0	8			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5294	013	0	1	01	01	H5294_013_0	8			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5294	013	0	1	01	01	H5294_013_0	8			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5294	013	0	1	01	01	H5294_013_0	8			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5294	013	0	1	01	01	H5294_013_0	8			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5294	013	0	1	01	01	H5294_013_0	8			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5294	015	0	1	01	01	H5294_015_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5294	015	0	1	01	01	H5294_015_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5294	015	0	1	01	01	H5294_015_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5294	015	0	1	01	01	H5294_015_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5294	015	0	1	01	01	H5294_015_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5294	015	0	1	01	01	H5294_015_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5294	016	0	1	01	01	H5294_016_0	8			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5294	016	0	1	01	01	H5294_016_0	8			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5294	016	0	1	01	01	H5294_016_0	8			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5294	016	0	1	01	01	H5294_016_0	8			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5294	016	0	1	01	01	H5294_016_0	8			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5294	016	0	1	01	01	H5294_016_0	8			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5294	017	0	1	01	01	H5294_017_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H5294	017	0	1	01	01	H5294_017_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5294	017	0	1	01	01	H5294_017_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5294	017	0	1	01	01	H5294_017_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5294	017	0	1	01	01	H5294_017_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5294	017	0	1	01	01	H5294_017_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5294	018	0	1	01	01	H5294_018_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H5294	018	0	1	01	01	H5294_018_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5294	018	0	1	01	01	H5294_018_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5294	018	0	1	01	01	H5294_018_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5294	018	0	1	01	01	H5294_018_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5294	018	0	1	01	01	H5294_018_0	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5294	019	0	1	01	01	H5294_019_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H5294	019	0	1	01	01	H5294_019_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5294	019	0	1	01	01	H5294_019_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5294	019	0	1	01	01	H5294_019_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5294	019	0	1	01	01	H5294_019_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5294	019	0	1	01	01	H5294_019_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5294	021	0	1	01	01	H5294_021_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5294	021	0	1	01	01	H5294_021_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5294	021	0	1	01	01	H5294_021_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5294	021	0	1	01	01	H5294_021_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5294	021	0	1	01	01	H5294_021_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5294	021	0	1	01	01	H5294_021_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5294	022	0	1	01	01	H5294_022_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5294	022	0	1	01	01	H5294_022_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5294	022	0	1	01	01	H5294_022_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5294	022	0	1	01	01	H5294_022_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5294	022	0	1	01	01	H5294_022_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5294	022	0	1	01	01	H5294_022_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5294	023	0	1	01	01	H5294_023_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5294	023	0	1	01	01	H5294_023_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5294	023	0	1	01	01	H5294_023_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5294	023	0	1	01	01	H5294_023_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5294	023	0	1	01	01	H5294_023_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5294	023	0	1	01	01	H5294_023_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5294	024	0	1	01	01	H5294_024_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5294	024	0	1	01	01	H5294_024_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5294	024	0	1	01	01	H5294_024_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5294	024	0	1	01	01	H5294_024_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5294	024	0	1	01	01	H5294_024_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5294	024	0	1	01	01	H5294_024_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5294	025	0	1	01	01	H5294_025_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5294	025	0	1	01	01	H5294_025_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5294	025	0	1	01	01	H5294_025_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5294	025	0	1	01	01	H5294_025_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5294	025	0	1	01	01	H5294_025_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5294	025	0	1	01	01	H5294_025_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5296	003	0	1	01	01	H5296_003_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5296	003	0	1	01	01	H5296_003_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5296	003	0	1	01	01	H5296_003_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	3	2	45.00	
H5296	003	0	1	01	01	H5296_003_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	3	1		40
H5296	003	0	1	01	01	H5296_003_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5296	003	0	1	01	01	H5296_003_0	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5296	004	0	1	02	01	H5296_004_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5296	004	0	1	02	01	H5296_004_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5296	004	0	1	02	01	H5296_004_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5296	004	0	1	02	01	H5296_004_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5296	004	0	1	02	01	H5296_004_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5296	004	0	1	02	01	H5296_004_0	6		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5296	006	0	1	01	01	H5296_006_0	10			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5296	006	0	1	01	01	H5296_006_0	10			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5296	006	0	1	01	01	H5296_006_0	10			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	3	2	45.00	
H5296	006	0	1	01	01	H5296_006_0	10			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	3	1		40
H5296	006	0	1	01	01	H5296_006_0	10			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5296	006	0	1	01	01	H5296_006_0	10			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5296	007	0	1	01	01	H5296_007_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5296	007	0	1	01	01	H5296_007_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5296	007	0	1	01	01	H5296_007_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	3	2	40.00	
H5296	007	0	1	01	01	H5296_007_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	3	1		32
H5296	007	0	1	01	01	H5296_007_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5296	007	0	1	01	01	H5296_007_0	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5296	008	0	1	01	01	H5296_008_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5296	008	0	1	01	01	H5296_008_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5296	008	0	1	01	01	H5296_008_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	3	2	45.00	
H5296	008	0	1	01	01	H5296_008_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	3	1		32
H5296	008	0	1	01	01	H5296_008_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5296	008	0	1	01	01	H5296_008_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5296	009	0	1	02	01	H5296_009_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5296	009	0	1	02	01	H5296_009_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5296	009	0	1	02	01	H5296_009_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5296	009	0	1	02	01	H5296_009_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5296	009	0	1	02	01	H5296_009_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5296	009	0	1	02	01	H5296_009_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5296	010	0	1	01	01	H5296_010_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5296	010	0	1	01	01	H5296_010_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5296	010	0	1	01	01	H5296_010_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	3	2	45.00	
H5296	010	0	1	01	01	H5296_010_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	3	1		40
H5296	010	0	1	01	01	H5296_010_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5296	010	0	1	01	01	H5296_010_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5296	011	0	1	01	01	H5296_011_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5296	011	0	1	01	01	H5296_011_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5296	011	0	1	01	01	H5296_011_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	3	2	30.00	
H5296	011	0	1	01	01	H5296_011_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	3	1		40
H5296	011	0	1	01	01	H5296_011_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5296	011	0	1	01	01	H5296_011_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5299	001	0	1	01	01	H5299_001_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5299	001	0	1	01	01	H5299_001_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	5.00	
H5299	001	0	1	01	01	H5299_001_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5299	001	0	1	01	01	H5299_001_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5299	001	0	1	01	01	H5299_001_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5299	002	0	1	01	01	H5299_002_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5299	002	0	1	01	01	H5299_002_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H5299	002	0	1	01	01	H5299_002_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5299	002	0	1	01	01	H5299_002_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5299	002	0	1	01	01	H5299_002_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5299	006	0	1	01	01	H5299_006_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5299	006	0	1	01	01	H5299_006_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5299	006	0	1	01	01	H5299_006_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5299	006	0	1	01	01	H5299_006_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5299	006	0	1	01	01	H5299_006_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5299	006	0	1	01	01	H5299_006_0	7		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H5299	009	0	1	01	01	H5299_009_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5299	009	0	1	01	01	H5299_009_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5299	009	0	1	01	01	H5299_009_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5299	009	0	1	01	01	H5299_009_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5299	009	0	1	01	01	H5299_009_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5299	009	0	1	01	01	H5299_009_0	7		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H5299	012	0	1	01	01	H5299_012_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5299	012	0	1	01	01	H5299_012_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H5299	012	0	1	01	01	H5299_012_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5299	012	0	1	01	01	H5299_012_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5299	012	0	1	01	01	H5299_012_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5299	013	0	1	01	01	H5299_013_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5299	013	0	1	01	01	H5299_013_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5299	013	0	1	01	01	H5299_013_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5299	013	0	1	01	01	H5299_013_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5299	013	0	1	01	01	H5299_013_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5299	013	0	1	01	01	H5299_013_0	6		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H5299	014	0	1	01	01	H5299_014_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5299	014	0	1	01	01	H5299_014_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5299	014	0	1	01	01	H5299_014_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5299	014	0	1	01	01	H5299_014_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5299	014	0	1	01	01	H5299_014_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5299	014	0	1	01	01	H5299_014_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5299	015	0	1	01	01	H5299_015_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5299	015	0	1	01	01	H5299_015_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5299	015	0	1	01	01	H5299_015_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5299	015	0	1	01	01	H5299_015_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5299	015	0	1	01	01	H5299_015_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5299	015	0	1	01	01	H5299_015_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5299	016	0	1	01	01	H5299_016_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5299	016	0	1	01	01	H5299_016_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5299	016	0	1	01	01	H5299_016_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5299	016	0	1	01	01	H5299_016_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5299	016	0	1	01	01	H5299_016_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5299	016	0	1	01	01	H5299_016_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5299	017	0	1	01	01	H5299_017_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5299	017	0	1	01	01	H5299_017_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5299	017	0	1	01	01	H5299_017_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5299	017	0	1	01	01	H5299_017_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5299	017	0	1	01	01	H5299_017_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5299	017	0	1	01	01	H5299_017_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5299	018	0	1	01	01	H5299_018_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5299	018	0	1	01	01	H5299_018_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5299	018	0	1	01	01	H5299_018_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5299	018	0	1	01	01	H5299_018_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5299	018	0	1	01	01	H5299_018_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5299	018	0	1	01	01	H5299_018_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5302	012	0	1	01	01	H5302_012_0	2		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5302	012	0	1	01	01	H5302_012_0	2		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5302	012	0	1	01	01	H5302_012_0	2		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5302	012	0	1	01	01	H5302_012_0	2		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5302	012	0	1	01	01	H5302_012_0	2		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5302	020	0	1	01	01	H5302_020_0	2		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5302	020	0	1	01	01	H5302_020_0	2		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5302	020	0	1	01	01	H5302_020_0	2		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5302	020	0	1	01	01	H5302_020_0	2		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5302	020	0	1	01	01	H5302_020_0	2		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5302	022	0	1	01	01	H5302_022_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5302	022	0	1	01	01	H5302_022_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5302	022	0	1	01	01	H5302_022_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5302	022	0	1	01	01	H5302_022_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5302	022	0	1	01	01	H5302_022_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5302	023	0	1	01	01	H5302_023_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5302	023	0	1	01	01	H5302_023_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5302	023	0	1	01	01	H5302_023_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5302	023	0	1	01	01	H5302_023_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5302	023	0	1	01	01	H5302_023_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5302	024	0	1	01	01	H5302_024_0	2		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5302	024	0	1	01	01	H5302_024_0	2		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5302	024	0	1	01	01	H5302_024_0	2		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5302	024	0	1	01	01	H5302_024_0	2		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5302	024	0	1	01	01	H5302_024_0	2		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5302	026	0	1	01	01	H5302_026_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5302	026	0	1	01	01	H5302_026_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5302	026	0	1	01	01	H5302_026_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5302	026	0	1	01	01	H5302_026_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5302	026	0	1	01	01	H5302_026_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5322	025	0	1	02	01	H5322_025_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5322	025	0	1	02	01	H5322_025_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5322	025	0	1	02	01	H5322_025_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5322	025	0	1	02	01	H5322_025_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5322	025	0	1	02	01	H5322_025_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5322	026	0	1	02	01	H5322_026_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5322	026	0	1	02	01	H5322_026_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5322	026	0	1	02	01	H5322_026_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5322	026	0	1	02	01	H5322_026_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5322	026	0	1	02	01	H5322_026_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5322	028	0	1	02	01	H5322_028_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	0.00	
H5322	028	0	1	02	01	H5322_028_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5322	028	0	1	02	01	H5322_028_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5322	028	0	1	02	01	H5322_028_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5322	028	0	1	02	01	H5322_028_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5322	029	0	1	02	01	H5322_029_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5322	029	0	1	02	01	H5322_029_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5322	029	0	1	02	01	H5322_029_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5322	029	0	1	02	01	H5322_029_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5322	029	0	1	02	01	H5322_029_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5322	031	0	1	02	01	H5322_031_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5322	031	0	1	02	01	H5322_031_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5322	031	0	1	02	01	H5322_031_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5322	031	0	1	02	01	H5322_031_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5322	031	0	1	02	01	H5322_031_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5322	033	0	1	02	01	H5322_033_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5322	033	0	1	02	01	H5322_033_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5322	033	0	1	02	01	H5322_033_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5322	033	0	1	02	01	H5322_033_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5322	033	0	1	02	01	H5322_033_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5322	034	0	1	02	01	H5322_034_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	0.00	
H5322	034	0	1	02	01	H5322_034_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5322	034	0	1	02	01	H5322_034_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5322	034	0	1	02	01	H5322_034_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5322	034	0	1	02	01	H5322_034_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5322	038	0	1	02	01	H5322_038_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5322	038	0	1	02	01	H5322_038_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5322	038	0	1	02	01	H5322_038_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5322	038	0	1	02	01	H5322_038_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5322	038	0	1	02	01	H5322_038_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5322	040	0	1	02	01	H5322_040_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5322	040	0	1	02	01	H5322_040_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H5322	040	0	1	02	01	H5322_040_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5322	040	0	1	02	01	H5322_040_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5322	040	0	1	02	01	H5322_040_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5322	044	0	1	02	01	H5322_044_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5322	044	0	1	02	01	H5322_044_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H5322	044	0	1	02	01	H5322_044_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5322	044	0	1	02	01	H5322_044_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5322	044	0	1	02	01	H5322_044_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5322	046	0	1	02	01	H5322_046_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5322	046	0	1	02	01	H5322_046_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5322	046	0	1	02	01	H5322_046_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5322	046	0	1	02	01	H5322_046_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5322	046	0	1	02	01	H5322_046_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5322	047	1	1	02	01	H5322_047_1	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5322	047	1	1	02	01	H5322_047_1	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H5322	047	1	1	02	01	H5322_047_1	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5322	047	1	1	02	01	H5322_047_1	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5322	047	1	1	02	01	H5322_047_1	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5322	047	2	1	02	01	H5322_047_2	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5322	047	2	1	02	01	H5322_047_2	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H5322	047	2	1	02	01	H5322_047_2	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5322	047	2	1	02	01	H5322_047_2	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5322	047	2	1	02	01	H5322_047_2	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5322	049	1	1	02	01	H5322_049_1	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5322	049	1	1	02	01	H5322_049_1	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5322	049	1	1	02	01	H5322_049_1	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5322	049	1	1	02	01	H5322_049_1	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5322	049	1	1	02	01	H5322_049_1	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5322	049	2	1	02	01	H5322_049_2	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5322	049	2	1	02	01	H5322_049_2	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5322	049	2	1	02	01	H5322_049_2	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5322	049	2	1	02	01	H5322_049_2	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5322	049	2	1	02	01	H5322_049_2	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5322	050	1	1	02	01	H5322_050_1	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5322	050	1	1	02	01	H5322_050_1	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5322	050	1	1	02	01	H5322_050_1	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5322	050	1	1	02	01	H5322_050_1	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5322	050	1	1	02	01	H5322_050_1	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5322	050	2	1	02	01	H5322_050_2	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5322	050	2	1	02	01	H5322_050_2	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5322	050	2	1	02	01	H5322_050_2	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5322	050	2	1	02	01	H5322_050_2	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5322	050	2	1	02	01	H5322_050_2	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5325	003	0	1	01	01	H5325_003_0	2		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5325	003	0	1	01	01	H5325_003_0	2		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5325	003	0	1	01	01	H5325_003_0	2		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5325	003	0	1	01	01	H5325_003_0	2		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5325	003	0	1	01	01	H5325_003_0	2		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5325	004	0	1	01	01	H5325_004_0	2		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5325	004	0	1	01	01	H5325_004_0	2		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5325	004	0	1	01	01	H5325_004_0	2		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5325	004	0	1	01	01	H5325_004_0	2		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5325	004	0	1	01	01	H5325_004_0	2		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5325	005	0	1	01	01	H5325_005_0	2		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5325	005	0	1	01	01	H5325_005_0	2		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5325	005	0	1	01	01	H5325_005_0	2		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5325	005	0	1	01	01	H5325_005_0	2		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5325	005	0	1	01	01	H5325_005_0	2		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5325	006	0	1	01	01	H5325_006_0	2		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5325	006	0	1	01	01	H5325_006_0	2		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5325	006	0	1	01	01	H5325_006_0	2		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5325	006	0	1	01	01	H5325_006_0	2		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5325	006	0	1	01	01	H5325_006_0	2		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5325	007	0	1	01	01	H5325_007_0	3		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5325	007	0	1	01	01	H5325_007_0	3		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5325	007	0	1	01	01	H5325_007_0	3		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5325	007	0	1	01	01	H5325_007_0	3		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5325	007	0	1	01	01	H5325_007_0	3		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5325	011	0	1	01	01	H5325_011_0	2		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5325	011	0	1	01	01	H5325_011_0	2		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5325	011	0	1	01	01	H5325_011_0	2		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5325	011	0	1	01	01	H5325_011_0	2		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5325	011	0	1	01	01	H5325_011_0	2		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5325	012	0	1	01	01	H5325_012_0	2		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5325	012	0	1	01	01	H5325_012_0	2		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5325	012	0	1	01	01	H5325_012_0	2		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5325	012	0	1	01	01	H5325_012_0	2		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5325	012	0	1	01	01	H5325_012_0	2		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5325	013	0	1	01	01	H5325_013_0	2		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5325	013	0	1	01	01	H5325_013_0	2		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5325	013	0	1	01	01	H5325_013_0	2		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5325	013	0	1	01	01	H5325_013_0	2		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5325	013	0	1	01	01	H5325_013_0	2		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5325	014	0	1	01	01	H5325_014_0	2		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5325	014	0	1	01	01	H5325_014_0	2		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5325	014	0	1	01	01	H5325_014_0	2		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5325	014	0	1	01	01	H5325_014_0	2		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5325	014	0	1	01	01	H5325_014_0	2		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5325	015	0	1	01	01	H5325_015_0	2		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5325	015	0	1	01	01	H5325_015_0	2		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5325	015	0	1	01	01	H5325_015_0	2		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5325	015	0	1	01	01	H5325_015_0	2		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5325	015	0	1	01	01	H5325_015_0	2		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5361	001	0	1	04	01	H5361_001_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5361	001	0	1	04	01	H5361_001_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5361	001	0	1	04	01	H5361_001_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5361	001	0	1	04	01	H5361_001_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5361	001	0	1	04	01	H5361_001_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5361	002	0	1	04	01	H5361_002_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5361	002	0	1	04	01	H5361_002_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5361	002	0	1	04	01	H5361_002_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5361	002	0	1	04	01	H5361_002_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5361	002	0	1	04	01	H5361_002_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5361	004	0	1	04	01	H5361_004_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5361	004	0	1	04	01	H5361_004_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5361	004	0	1	04	01	H5361_004_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5361	004	0	1	04	01	H5361_004_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5361	004	0	1	04	01	H5361_004_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5377	002	0	1	02	01	H5377_002_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5377	002	0	1	02	01	H5377_002_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5377	002	0	1	02	01	H5377_002_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5377	002	0	1	02	01	H5377_002_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5377	002	0	1	02	01	H5377_002_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5377	003	0	1	01	01	H5377_003_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5377	003	0	1	01	01	H5377_003_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5377	003	0	1	01	01	H5377_003_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5377	003	0	1	01	01	H5377_003_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5377	003	0	1	01	01	H5377_003_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5386	003	0	1	01	01	H5386_003_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5386	003	0	1	01	01	H5386_003_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5386	003	0	1	01	01	H5386_003_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5386	003	0	1	01	01	H5386_003_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5386	003	0	1	01	01	H5386_003_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5386	003	0	1	01	01	H5386_003_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5386	004	0	1	01	01	H5386_004_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5386	004	0	1	01	01	H5386_004_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5386	004	0	1	01	01	H5386_004_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5386	004	0	1	01	01	H5386_004_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5386	004	0	1	01	01	H5386_004_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5386	004	0	1	01	01	H5386_004_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5386	005	0	1	01	01	H5386_005_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5386	005	0	1	01	01	H5386_005_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5386	005	0	1	01	01	H5386_005_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5386	005	0	1	01	01	H5386_005_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5386	005	0	1	01	01	H5386_005_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5386	005	0	1	01	01	H5386_005_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5386	006	0	1	01	01	H5386_006_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5386	006	0	1	01	01	H5386_006_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5386	006	0	1	01	01	H5386_006_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5386	006	0	1	01	01	H5386_006_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5386	006	0	1	01	01	H5386_006_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5386	006	0	1	01	01	H5386_006_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5397	001	0	1	01	01	H5397_001_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5397	001	0	1	01	01	H5397_001_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	1.00	
H5397	001	0	1	01	01	H5397_001_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5397	001	0	1	01	01	H5397_001_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5397	001	0	1	01	01	H5397_001_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5397	002	0	1	01	01	H5397_002_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5397	002	0	1	01	01	H5397_002_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H5397	002	0	1	01	01	H5397_002_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5397	002	0	1	01	01	H5397_002_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5397	002	0	1	01	01	H5397_002_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5397	003	0	1	01	01	H5397_003_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5397	003	0	1	01	01	H5397_003_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5397	003	0	1	01	01	H5397_003_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5397	003	0	1	01	01	H5397_003_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5397	003	0	1	01	01	H5397_003_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5397	003	0	1	01	01	H5397_003_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5397	004	0	1	01	01	H5397_004_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5397	004	0	1	01	01	H5397_004_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H5397	004	0	1	01	01	H5397_004_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5397	004	0	1	01	01	H5397_004_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5397	004	0	1	01	01	H5397_004_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5397	005	0	1	01	01	H5397_005_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5397	005	0	1	01	01	H5397_005_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H5397	005	0	1	01	01	H5397_005_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5397	005	0	1	01	01	H5397_005_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5397	005	0	1	01	01	H5397_005_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5410	013	0	1	01	01	H5410_013_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5410	013	0	1	01	01	H5410_013_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5410	013	0	1	01	01	H5410_013_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5410	013	0	1	01	01	H5410_013_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5410	013	0	1	01	01	H5410_013_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5410	018	0	1	01	01	H5410_018_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H5410	018	0	1	01	01	H5410_018_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5410	018	0	1	01	01	H5410_018_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5410	018	0	1	01	01	H5410_018_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5410	018	0	1	01	01	H5410_018_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5410	024	0	1	01	01	H5410_024_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H5410	024	0	1	01	01	H5410_024_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5410	024	0	1	01	01	H5410_024_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5410	024	0	1	01	01	H5410_024_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5410	024	0	1	01	01	H5410_024_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5410	025	0	1	01	01	H5410_025_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5410	025	0	1	01	01	H5410_025_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5410	025	0	1	01	01	H5410_025_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5410	025	0	1	01	01	H5410_025_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5410	025	0	1	01	01	H5410_025_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5410	026	0	1	01	01	H5410_026_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H5410	026	0	1	01	01	H5410_026_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5410	026	0	1	01	01	H5410_026_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5410	026	0	1	01	01	H5410_026_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5410	026	0	1	01	01	H5410_026_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5410	031	0	1	01	01	H5410_031_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5410	031	0	1	01	01	H5410_031_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5410	031	0	1	01	01	H5410_031_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5410	031	0	1	01	01	H5410_031_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5410	031	0	1	01	01	H5410_031_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5410	032	0	1	01	01	H5410_032_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5410	032	0	1	01	01	H5410_032_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5410	032	0	1	01	01	H5410_032_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5410	032	0	1	01	01	H5410_032_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5410	032	0	1	01	01	H5410_032_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5410	042	0	1	01	01	H5410_042_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5410	042	0	1	01	01	H5410_042_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5410	042	0	1	01	01	H5410_042_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5410	042	0	1	01	01	H5410_042_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5410	042	0	1	01	01	H5410_042_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5410	045	0	1	01	01	H5410_045_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5410	045	0	1	01	01	H5410_045_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5410	045	0	1	01	01	H5410_045_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5410	045	0	1	01	01	H5410_045_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5410	045	0	1	01	01	H5410_045_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5410	046	0	1	01	01	H5410_046_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5410	046	0	1	01	01	H5410_046_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5410	046	0	1	01	01	H5410_046_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5410	046	0	1	01	01	H5410_046_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5410	046	0	1	01	01	H5410_046_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5410	047	0	1	01	01	H5410_047_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5410	047	0	1	01	01	H5410_047_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5410	047	0	1	01	01	H5410_047_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5410	047	0	1	01	01	H5410_047_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5410	047	0	1	01	01	H5410_047_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5410	055	0	1	01	01	H5410_055_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5410	055	0	1	01	01	H5410_055_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5410	055	0	1	01	01	H5410_055_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5410	055	0	1	01	01	H5410_055_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5410	055	0	1	01	01	H5410_055_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5410	056	0	1	01	01	H5410_056_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5410	056	0	1	01	01	H5410_056_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5410	056	0	1	01	01	H5410_056_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5410	056	0	1	01	01	H5410_056_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5410	056	0	1	01	01	H5410_056_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5410	059	0	1	01	01	H5410_059_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H5410	059	0	1	01	01	H5410_059_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5410	059	0	1	01	01	H5410_059_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5410	059	0	1	01	01	H5410_059_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5410	059	0	1	01	01	H5410_059_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5410	060	0	1	01	01	H5410_060_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H5410	060	0	1	01	01	H5410_060_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5410	060	0	1	01	01	H5410_060_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5410	060	0	1	01	01	H5410_060_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5410	060	0	1	01	01	H5410_060_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5420	001	0	1	01	01	H5420_001_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5420	001	0	1	01	01	H5420_001_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H5420	001	0	1	01	01	H5420_001_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5420	001	0	1	01	01	H5420_001_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5420	001	0	1	01	01	H5420_001_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5420	003	0	1	01	01	H5420_003_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5420	003	0	1	01	01	H5420_003_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H5420	003	0	1	01	01	H5420_003_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5420	003	0	1	01	01	H5420_003_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5420	003	0	1	01	01	H5420_003_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5420	006	0	1	01	01	H5420_006_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5420	006	0	1	01	01	H5420_006_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5420	006	0	1	01	01	H5420_006_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5420	006	0	1	01	01	H5420_006_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5420	006	0	1	01	01	H5420_006_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5420	014	0	1	01	01	H5420_014_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5420	014	0	1	01	01	H5420_014_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H5420	014	0	1	01	01	H5420_014_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5420	014	0	1	01	01	H5420_014_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5420	014	0	1	01	01	H5420_014_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5420	015	0	1	01	01	H5420_015_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5420	015	0	1	01	01	H5420_015_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5420	015	0	1	01	01	H5420_015_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5420	015	0	1	01	01	H5420_015_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5420	015	0	1	01	01	H5420_015_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5420	016	0	1	02	01	H5420_016_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5420	016	0	1	02	01	H5420_016_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5420	016	0	1	02	01	H5420_016_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5420	016	0	1	02	01	H5420_016_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5420	016	0	1	02	01	H5420_016_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5422	011	0	1	02	01	H5422_011_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5422	011	0	1	02	01	H5422_011_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5422	011	0	1	02	01	H5422_011_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5422	011	0	1	02	01	H5422_011_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5422	011	0	1	02	01	H5422_011_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5422	011	0	1	02	01	H5422_011_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5422	013	0	1	02	01	H5422_013_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5422	013	0	1	02	01	H5422_013_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5422	013	0	1	02	01	H5422_013_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5422	013	0	1	02	01	H5422_013_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5422	013	0	1	02	01	H5422_013_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5422	013	0	1	02	01	H5422_013_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5422	015	0	1	02	01	H5422_015_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H5422	015	0	1	02	01	H5422_015_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5422	015	0	1	02	01	H5422_015_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5422	015	0	1	02	01	H5422_015_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5422	015	0	1	02	01	H5422_015_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5422	015	0	1	02	01	H5422_015_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5422	018	0	1	01	01	H5422_018_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5422	018	0	1	01	01	H5422_018_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5422	018	0	1	01	01	H5422_018_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5422	018	0	1	01	01	H5422_018_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5422	018	0	1	01	01	H5422_018_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5422	018	0	1	01	01	H5422_018_0	4		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5422	019	0	1	01	01	H5422_019_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5422	019	0	1	01	01	H5422_019_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5422	019	0	1	01	01	H5422_019_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5422	019	0	1	01	01	H5422_019_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5422	019	0	1	01	01	H5422_019_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5422	019	0	1	01	01	H5422_019_0	5		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5425	001	0	1	01	01	H5425_001_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5425	001	0	1	01	01	H5425_001_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5425	001	0	1	01	01	H5425_001_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5425	001	0	1	01	01	H5425_001_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5425	001	0	1	01	01	H5425_001_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5425	005	0	1	01	01	H5425_005_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5425	005	0	1	01	01	H5425_005_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5425	005	0	1	01	01	H5425_005_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5425	005	0	1	01	01	H5425_005_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5425	005	0	1	01	01	H5425_005_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5425	006	0	1	01	01	H5425_006_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5425	006	0	1	01	01	H5425_006_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5425	006	0	1	01	01	H5425_006_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5425	006	0	1	01	01	H5425_006_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5425	006	0	1	01	01	H5425_006_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5425	007	0	1	01	01	H5425_007_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5425	007	0	1	01	01	H5425_007_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5425	007	0	1	01	01	H5425_007_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5425	007	0	1	01	01	H5425_007_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5425	007	0	1	01	01	H5425_007_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5425	008	0	1	01	01	H5425_008_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5425	008	0	1	01	01	H5425_008_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5425	008	0	1	01	01	H5425_008_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5425	008	0	1	01	01	H5425_008_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5425	008	0	1	01	01	H5425_008_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5425	009	0	1	01	01	H5425_009_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5425	009	0	1	01	01	H5425_009_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5425	009	0	1	01	01	H5425_009_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5425	009	0	1	01	01	H5425_009_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5425	009	0	1	01	01	H5425_009_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5425	019	0	1	01	01	H5425_019_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5425	019	0	1	01	01	H5425_019_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5425	019	0	1	01	01	H5425_019_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5425	019	0	1	01	01	H5425_019_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5425	019	0	1	01	01	H5425_019_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5425	034	0	1	01	01	H5425_034_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5425	034	0	1	01	01	H5425_034_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5425	034	0	1	01	01	H5425_034_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5425	034	0	1	01	01	H5425_034_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5425	034	0	1	01	01	H5425_034_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5425	065	0	1	01	01	H5425_065_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5425	065	0	1	01	01	H5425_065_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5425	065	0	1	01	01	H5425_065_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5425	065	0	1	01	01	H5425_065_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5425	065	0	1	01	01	H5425_065_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5425	069	0	1	01	01	H5425_069_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5425	069	0	1	01	01	H5425_069_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5425	069	0	1	01	01	H5425_069_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5425	069	0	1	01	01	H5425_069_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5425	069	0	1	01	01	H5425_069_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5425	070	0	1	01	01	H5425_070_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5425	070	0	1	01	01	H5425_070_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5425	070	0	1	01	01	H5425_070_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5425	070	0	1	01	01	H5425_070_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5425	070	0	1	01	01	H5425_070_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5425	075	0	1	01	01	H5425_075_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5425	075	0	1	01	01	H5425_075_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5425	075	0	1	01	01	H5425_075_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5425	075	0	1	01	01	H5425_075_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5425	075	0	1	01	01	H5425_075_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5425	076	0	1	01	01	H5425_076_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5425	076	0	1	01	01	H5425_076_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5425	076	0	1	01	01	H5425_076_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5425	076	0	1	01	01	H5425_076_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5425	076	0	1	01	01	H5425_076_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5425	082	0	1	01	01	H5425_082_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5425	082	0	1	01	01	H5425_082_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5425	082	0	1	01	01	H5425_082_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5425	082	0	1	01	01	H5425_082_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5425	082	0	1	01	01	H5425_082_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5425	084	0	1	01	01	H5425_084_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5425	084	0	1	01	01	H5425_084_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5425	084	0	1	01	01	H5425_084_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5425	084	0	1	01	01	H5425_084_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5425	084	0	1	01	01	H5425_084_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5425	085	0	1	01	01	H5425_085_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5425	085	0	1	01	01	H5425_085_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5425	085	0	1	01	01	H5425_085_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5425	085	0	1	01	01	H5425_085_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5425	085	0	1	01	01	H5425_085_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5425	086	0	1	01	01	H5425_086_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5425	086	0	1	01	01	H5425_086_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5425	086	0	1	01	01	H5425_086_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5425	086	0	1	01	01	H5425_086_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5425	086	0	1	01	01	H5425_086_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5425	087	0	1	01	01	H5425_087_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5425	087	0	1	01	01	H5425_087_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5425	087	0	1	01	01	H5425_087_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5425	087	0	1	01	01	H5425_087_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5425	087	0	1	01	01	H5425_087_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5425	091	0	1	02	01	H5425_091_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5425	091	0	1	02	01	H5425_091_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5425	091	0	1	02	01	H5425_091_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5425	091	0	1	02	01	H5425_091_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5425	091	0	1	02	01	H5425_091_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5425	092	0	1	01	01	H5425_092_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5425	092	0	1	01	01	H5425_092_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5425	092	0	1	01	01	H5425_092_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5425	092	0	1	01	01	H5425_092_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5425	092	0	1	01	01	H5425_092_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5425	096	0	1	01	01	H5425_096_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5425	096	0	1	01	01	H5425_096_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5425	096	0	1	01	01	H5425_096_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5425	096	0	1	01	01	H5425_096_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5425	096	0	1	01	01	H5425_096_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5425	097	0	1	01	01	H5425_097_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5425	097	0	1	01	01	H5425_097_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5425	097	0	1	01	01	H5425_097_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5425	097	0	1	01	01	H5425_097_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5425	097	0	1	01	01	H5425_097_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5425	098	0	1	01	01	H5425_098_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5425	098	0	1	01	01	H5425_098_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5425	098	0	1	01	01	H5425_098_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5425	098	0	1	01	01	H5425_098_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5425	098	0	1	01	01	H5425_098_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5425	100	0	1	01	01	H5425_100_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5425	100	0	1	01	01	H5425_100_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5425	100	0	1	01	01	H5425_100_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5425	100	0	1	01	01	H5425_100_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5425	100	0	1	01	01	H5425_100_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5425	101	0	1	01	01	H5425_101_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5425	101	0	1	01	01	H5425_101_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5425	101	0	1	01	01	H5425_101_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5425	101	0	1	01	01	H5425_101_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5425	101	0	1	01	01	H5425_101_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5425	102	0	1	01	01	H5425_102_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5425	102	0	1	01	01	H5425_102_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5425	102	0	1	01	01	H5425_102_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5425	102	0	1	01	01	H5425_102_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5425	102	0	1	01	01	H5425_102_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5425	104	0	1	01	01	H5425_104_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5425	104	0	1	01	01	H5425_104_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5425	104	0	1	01	01	H5425_104_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5425	104	0	1	01	01	H5425_104_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5425	104	0	1	01	01	H5425_104_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5425	105	0	1	01	01	H5425_105_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5425	105	0	1	01	01	H5425_105_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5425	105	0	1	01	01	H5425_105_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5425	105	0	1	01	01	H5425_105_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5425	105	0	1	01	01	H5425_105_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5425	106	0	1	01	01	H5425_106_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5425	106	0	1	01	01	H5425_106_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5425	106	0	1	01	01	H5425_106_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5425	106	0	1	01	01	H5425_106_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5425	106	0	1	01	01	H5425_106_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5425	107	0	1	01	01	H5425_107_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5425	107	0	1	01	01	H5425_107_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5425	107	0	1	01	01	H5425_107_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5425	107	0	1	01	01	H5425_107_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5425	107	0	1	01	01	H5425_107_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5425	108	0	1	01	01	H5425_108_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5425	108	0	1	01	01	H5425_108_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5425	108	0	1	01	01	H5425_108_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5425	108	0	1	01	01	H5425_108_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5425	108	0	1	01	01	H5425_108_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5425	109	0	1	01	01	H5425_109_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5425	109	0	1	01	01	H5425_109_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5425	109	0	1	01	01	H5425_109_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5425	109	0	1	01	01	H5425_109_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5425	109	0	1	01	01	H5425_109_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5425	110	0	1	01	01	H5425_110_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5425	110	0	1	01	01	H5425_110_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5425	110	0	1	01	01	H5425_110_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5425	110	0	1	01	01	H5425_110_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5425	110	0	1	01	01	H5425_110_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5425	118	0	1	01	01	H5425_118_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5425	118	0	1	01	01	H5425_118_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5425	118	0	1	01	01	H5425_118_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5425	118	0	1	01	01	H5425_118_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5425	118	0	1	01	01	H5425_118_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5425	119	0	1	01	01	H5425_119_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5425	119	0	1	01	01	H5425_119_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5425	119	0	1	01	01	H5425_119_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5425	119	0	1	01	01	H5425_119_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5425	119	0	1	01	01	H5425_119_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5425	120	0	1	01	01	H5425_120_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5425	120	0	1	01	01	H5425_120_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5425	120	0	1	01	01	H5425_120_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5425	120	0	1	01	01	H5425_120_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5425	120	0	1	01	01	H5425_120_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5425	121	0	1	01	01	H5425_121_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5425	121	0	1	01	01	H5425_121_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5425	121	0	1	01	01	H5425_121_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5425	121	0	1	01	01	H5425_121_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5425	121	0	1	01	01	H5425_121_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5425	123	0	1	01	01	H5425_123_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5425	123	0	1	01	01	H5425_123_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5425	123	0	1	01	01	H5425_123_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5425	123	0	1	01	01	H5425_123_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5425	123	0	1	01	01	H5425_123_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5425	124	0	1	01	01	H5425_124_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5425	124	0	1	01	01	H5425_124_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5425	124	0	1	01	01	H5425_124_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5425	124	0	1	01	01	H5425_124_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5425	124	0	1	01	01	H5425_124_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5425	125	0	1	01	01	H5425_125_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5425	125	0	1	01	01	H5425_125_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5425	125	0	1	01	01	H5425_125_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5425	125	0	1	01	01	H5425_125_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5425	125	0	1	01	01	H5425_125_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5425	126	0	1	01	01	H5425_126_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5425	126	0	1	01	01	H5425_126_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5425	126	0	1	01	01	H5425_126_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5425	126	0	1	01	01	H5425_126_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5425	126	0	1	01	01	H5425_126_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5425	127	0	1	01	01	H5425_127_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5425	127	0	1	01	01	H5425_127_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5425	127	0	1	01	01	H5425_127_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5425	127	0	1	01	01	H5425_127_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5425	127	0	1	01	01	H5425_127_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5425	128	0	1	01	01	H5425_128_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5425	128	0	1	01	01	H5425_128_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5425	128	0	1	01	01	H5425_128_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5425	128	0	1	01	01	H5425_128_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5425	128	0	1	01	01	H5425_128_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5425	129	0	1	01	01	H5425_129_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5425	129	0	1	01	01	H5425_129_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5425	129	0	1	01	01	H5425_129_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5425	129	0	1	01	01	H5425_129_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5425	129	0	1	01	01	H5425_129_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5425	130	0	1	01	01	H5425_130_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5425	130	0	1	01	01	H5425_130_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5425	130	0	1	01	01	H5425_130_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5425	130	0	1	01	01	H5425_130_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5425	130	0	1	01	01	H5425_130_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5425	131	0	1	01	01	H5425_131_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5425	131	0	1	01	01	H5425_131_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5425	131	0	1	01	01	H5425_131_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5425	131	0	1	01	01	H5425_131_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5425	131	0	1	01	01	H5425_131_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5425	132	0	1	02	01	H5425_132_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5425	132	0	1	02	01	H5425_132_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5425	132	0	1	02	01	H5425_132_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5425	132	0	1	02	01	H5425_132_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5425	132	0	1	02	01	H5425_132_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5425	133	0	1	01	01	H5425_133_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5425	133	0	1	01	01	H5425_133_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5425	133	0	1	01	01	H5425_133_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5425	133	0	1	01	01	H5425_133_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5425	133	0	1	01	01	H5425_133_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5425	134	0	1	01	01	H5425_134_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5425	134	0	1	01	01	H5425_134_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5425	134	0	1	01	01	H5425_134_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5425	134	0	1	01	01	H5425_134_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5425	134	0	1	01	01	H5425_134_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5425	135	0	1	01	01	H5425_135_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5425	135	0	1	01	01	H5425_135_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5425	135	0	1	01	01	H5425_135_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5425	135	0	1	01	01	H5425_135_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5425	135	0	1	01	01	H5425_135_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5427	059	0	1	01	01	H5427_059_0	5			Preferred Generic	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5427	059	0	1	01	01	H5427_059_0	5			Preferred Brand	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	47.00	
H5427	059	0	1	01	01	H5427_059_0	5			Non-Preferred Drug	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	3	2	100.00	
H5427	059	0	1	01	01	H5427_059_0	5			Specialty Tier	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5427	060	0	1	01	01	H5427_060_0	6			Preferred Generic	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5427	060	0	1	01	01	H5427_060_0	6			Preferred Brand	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	47.00	
H5427	060	0	1	01	01	H5427_060_0	6			Non-Preferred Drug	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	3	2	100.00	
H5427	060	0	1	01	01	H5427_060_0	6			Specialty Tier	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5427	070	0	1	01	01	H5427_070_0	6			Preferred Generic	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	1	2	11	3	2	0.00	
H5427	070	0	1	01	01	H5427_070_0	6			Preferred Brand	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	2	2	11	3	2	10.00	
H5427	070	0	1	01	01	H5427_070_0	6			Non-Preferred Drug	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	3	2	11	3	2	65.00	
H5427	070	0	1	01	01	H5427_070_0	6			Specialty Tier	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	4	2	11	1	2	0.00	
H5427	070	0	1	01	01	H5427_070_0	6			Select Diabetic Drugs	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	5	2	11	1	2	0.00	
H5427	072	0	1	01	01	H5427_072_0	6			Preferred Generic	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	1	2	11	3	2	0.00	
H5427	072	0	1	01	01	H5427_072_0	6			Preferred Brand	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	2	2	11	3	2	20.00	
H5427	072	0	1	01	01	H5427_072_0	6			Non-Preferred Drug	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	3	2	11	3	2	70.00	
H5427	072	0	1	01	01	H5427_072_0	6			Specialty Tier	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	4	2	11	1	2	0.00	
H5427	072	0	1	01	01	H5427_072_0	6			Select Diabetic Drugs	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	5	2	11	1	2	0.00	
H5427	077	0	1	01	01	H5427_077_0	6			Preferred Generic	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5427	077	0	1	01	01	H5427_077_0	6			Preferred Brand	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	20.00	
H5427	077	0	1	01	01	H5427_077_0	6			Non-Preferred Drug	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	3	2	70.00	
H5427	077	0	1	01	01	H5427_077_0	6			Specialty Tier	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5427	078	0	1	01	01	H5427_078_0	7		N	Preferred Generic	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5427	078	0	1	01	01	H5427_078_0	7		N	Preferred Brand	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5427	078	0	1	01	01	H5427_078_0	7		N	Non-Preferred Drug	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5427	078	0	1	01	01	H5427_078_0	7		N	Specialty Tier	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5427	078	0	1	01	01	H5427_078_0	7		N	Supplemental Drugs	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	2	2	0.00	
H5427	082	0	1	01	01	H5427_082_0	5			Preferred Generic	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	1	2	11	3	2	0.00	
H5427	082	0	1	01	01	H5427_082_0	5			Preferred Brand	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	2	2	11	3	2	30.00	
H5427	082	0	1	01	01	H5427_082_0	5			Non-Preferred Drug	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	3	2	11	3	2	85.00	
H5427	082	0	1	01	01	H5427_082_0	5			Specialty Tier	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	4	2	11	1	2	0.00	
H5427	082	0	1	01	01	H5427_082_0	5			Select Diabetic Drugs	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	5	2	11	1	2	0.00	
H5427	083	0	1	01	01	H5427_083_0	5			Preferred Generic	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5427	083	0	1	01	01	H5427_083_0	5			Preferred Brand	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	30.00	
H5427	083	0	1	01	01	H5427_083_0	5			Non-Preferred Drug	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	3	2	85.00	
H5427	083	0	1	01	01	H5427_083_0	5			Specialty Tier	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5427	087	0	1	01	01	H5427_087_0	7		N	Preferred Generic	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5427	087	0	1	01	01	H5427_087_0	7		N	Preferred Brand	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5427	087	0	1	01	01	H5427_087_0	7		N	Non-Preferred Drug	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5427	087	0	1	01	01	H5427_087_0	7		N	Specialty Tier	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5427	087	0	1	01	01	H5427_087_0	7		N	Supplemental Drugs	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	2	2	0.00	
H5427	088	0	1	01	01	H5427_088_0	5			Preferred Generic	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5427	088	0	1	01	01	H5427_088_0	5			Preferred Brand	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	30.00	
H5427	088	0	1	01	01	H5427_088_0	5			Non-Preferred Drug	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	3	2	80.00	
H5427	088	0	1	01	01	H5427_088_0	5			Specialty Tier	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5427	089	0	1	01	01	H5427_089_0	5			Preferred Generic	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5427	089	0	1	01	01	H5427_089_0	5			Preferred Brand	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	30.00	
H5427	089	0	1	01	01	H5427_089_0	5			Non-Preferred Drug	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	3	2	80.00	
H5427	089	0	1	01	01	H5427_089_0	5			Specialty Tier	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5427	091	0	1	01	01	H5427_091_0	5			Preferred Generic	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5427	091	0	1	01	01	H5427_091_0	5			Preferred Brand	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	10.00	
H5427	091	0	1	01	01	H5427_091_0	5			Non-Preferred Drug	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	3	2	55.00	
H5427	091	0	1	01	01	H5427_091_0	5			Specialty Tier	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5427	093	0	1	01	01	H5427_093_0	4			Preferred Generic	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5427	093	0	1	01	01	H5427_093_0	4			Preferred Brand	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	10.00	
H5427	093	0	1	01	01	H5427_093_0	4			Non-Preferred Drug	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	3	2	55.00	
H5427	093	0	1	01	01	H5427_093_0	4			Specialty Tier	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5427	094	0	1	01	01	H5427_094_0	5			Preferred Generic	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5427	094	0	1	01	01	H5427_094_0	5			Preferred Brand	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	30.00	
H5427	094	0	1	01	01	H5427_094_0	5			Non-Preferred Drug	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	3	2	80.00	
H5427	094	0	1	01	01	H5427_094_0	5			Specialty Tier	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5427	096	0	1	01	01	H5427_096_0	5			Preferred Generic	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5427	096	0	1	01	01	H5427_096_0	5			Preferred Brand	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	10.00	
H5427	096	0	1	01	01	H5427_096_0	5			Non-Preferred Drug	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	3	2	55.00	
H5427	096	0	1	01	01	H5427_096_0	5			Specialty Tier	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5427	099	0	1	01	01	H5427_099_0	6			Preferred Generic	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	1	2	11	3	2	0.00	
H5427	099	0	1	01	01	H5427_099_0	6			Preferred Brand	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	2	2	11	3	2	30.00	
H5427	099	0	1	01	01	H5427_099_0	6			Non-Preferred Drug	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	3	2	11	3	2	70.00	
H5427	099	0	1	01	01	H5427_099_0	6			Specialty Tier	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	4	2	11	1	2	0.00	
H5427	099	0	1	01	01	H5427_099_0	6			Select Diabetic Drugs	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	5	2	11	1	2	0.00	
H5427	102	0	1	01	01	H5427_102_0	5			Preferred Generic	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5427	102	0	1	01	01	H5427_102_0	5			Preferred Brand	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	10.00	
H5427	102	0	1	01	01	H5427_102_0	5			Non-Preferred Drug	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	3	2	55.00	
H5427	102	0	1	01	01	H5427_102_0	5			Specialty Tier	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5427	103	0	1	01	01	H5427_103_0	5			Preferred Generic	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5427	103	0	1	01	01	H5427_103_0	5			Preferred Brand	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	35.00	
H5427	103	0	1	01	01	H5427_103_0	5			Non-Preferred Drug	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	3	2	90.00	
H5427	103	0	1	01	01	H5427_103_0	5			Specialty Tier	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5427	105	0	1	01	01	H5427_105_0	5			Preferred Generic	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5427	105	0	1	01	01	H5427_105_0	5			Preferred Brand	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	10.00	
H5427	105	0	1	01	01	H5427_105_0	5			Non-Preferred Drug	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	3	2	55.00	
H5427	105	0	1	01	01	H5427_105_0	5			Specialty Tier	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5427	106	0	1	01	01	H5427_106_0	5			Preferred Generic	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5427	106	0	1	01	01	H5427_106_0	5			Preferred Brand	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	30.00	
H5427	106	0	1	01	01	H5427_106_0	5			Non-Preferred Drug	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	3	2	85.00	
H5427	106	0	1	01	01	H5427_106_0	5			Specialty Tier	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5427	107	0	1	01	01	H5427_107_0	5			Preferred Generic	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5427	107	0	1	01	01	H5427_107_0	5			Preferred Brand	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	35.00	
H5427	107	0	1	01	01	H5427_107_0	5			Non-Preferred Drug	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	3	2	70.00	
H5427	107	0	1	01	01	H5427_107_0	5			Specialty Tier	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5427	108	0	1	01	01	H5427_108_0	6			Preferred Generic	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	1	2	11	3	2	0.00	
H5427	108	0	1	01	01	H5427_108_0	6			Preferred Brand	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	2	2	11	3	2	30.00	
H5427	108	0	1	01	01	H5427_108_0	6			Non-Preferred Drug	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	3	2	11	3	2	85.00	
H5427	108	0	1	01	01	H5427_108_0	6			Specialty Tier	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	4	2	11	1	2	0.00	
H5427	108	0	1	01	01	H5427_108_0	6			Select Diabetic Drugs	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	5	2	11	1	2	0.00	
H5427	112	0	1	02	01	H5427_112_0	5			Preferred Generic	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5427	112	0	1	02	01	H5427_112_0	5			Preferred Brand	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	10.00	
H5427	112	0	1	02	01	H5427_112_0	5			Non-Preferred Drug	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	3	2	55.00	
H5427	112	0	1	02	01	H5427_112_0	5			Specialty Tier	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5427	113	0	1	02	01	H5427_113_0	5			Preferred Generic	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5427	113	0	1	02	01	H5427_113_0	5			Preferred Brand	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	10.00	
H5427	113	0	1	02	01	H5427_113_0	5			Non-Preferred Drug	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	3	2	55.00	
H5427	113	0	1	02	01	H5427_113_0	5			Specialty Tier	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5431	001	0	1	01	01	H5431_001_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5431	001	0	1	01	01	H5431_001_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5431	001	0	1	01	01	H5431_001_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5431	001	0	1	01	01	H5431_001_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5431	001	0	1	01	01	H5431_001_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5431	001	0	1	01	01	H5431_001_0	4			Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5431	006	0	1	01	01	H5431_006_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5431	006	0	1	01	01	H5431_006_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5431	006	0	1	01	01	H5431_006_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5431	006	0	1	01	01	H5431_006_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5431	006	0	1	01	01	H5431_006_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5431	006	0	1	01	01	H5431_006_0	5			Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5431	012	0	1	01	01	H5431_012_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5431	012	0	1	01	01	H5431_012_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5431	012	0	1	01	01	H5431_012_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5431	012	0	1	01	01	H5431_012_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5431	012	0	1	01	01	H5431_012_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5431	012	0	1	01	01	H5431_012_0	5			Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5431	013	0	1	01	01	H5431_013_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5431	013	0	1	01	01	H5431_013_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5431	013	0	1	01	01	H5431_013_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5431	013	0	1	01	01	H5431_013_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5431	013	0	1	01	01	H5431_013_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5431	013	0	1	01	01	H5431_013_0	4			Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5431	016	0	1	01	01	H5431_016_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5431	016	0	1	01	01	H5431_016_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5431	016	0	1	01	01	H5431_016_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5431	016	0	1	01	01	H5431_016_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5431	016	0	1	01	01	H5431_016_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5431	016	0	1	01	01	H5431_016_0	6		N	Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5431	017	0	1	01	01	H5431_017_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5431	017	0	1	01	01	H5431_017_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5431	017	0	1	01	01	H5431_017_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5431	017	0	1	01	01	H5431_017_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5431	017	0	1	01	01	H5431_017_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5431	017	0	1	01	01	H5431_017_0	4			Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5431	018	0	1	01	01	H5431_018_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5431	018	0	1	01	01	H5431_018_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5431	018	0	1	01	01	H5431_018_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5431	018	0	1	01	01	H5431_018_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5431	018	0	1	01	01	H5431_018_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5431	018	0	1	01	01	H5431_018_0	4			Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5431	019	0	1	01	01	H5431_019_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5431	019	0	1	01	01	H5431_019_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5431	019	0	1	01	01	H5431_019_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5431	019	0	1	01	01	H5431_019_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5431	019	0	1	01	01	H5431_019_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5431	019	0	1	01	01	H5431_019_0	6		N	Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5431	020	0	1	01	01	H5431_020_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5431	020	0	1	01	01	H5431_020_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5431	020	0	1	01	01	H5431_020_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5431	020	0	1	01	01	H5431_020_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5431	020	0	1	01	01	H5431_020_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5431	020	0	1	01	01	H5431_020_0	4			Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5431	021	0	1	01	01	H5431_021_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5431	021	0	1	01	01	H5431_021_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5431	021	0	1	01	01	H5431_021_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5431	021	0	1	01	01	H5431_021_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5431	021	0	1	01	01	H5431_021_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5431	021	0	1	01	01	H5431_021_0	5			Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5431	022	0	1	01	01	H5431_022_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5431	022	0	1	01	01	H5431_022_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5431	022	0	1	01	01	H5431_022_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5431	022	0	1	01	01	H5431_022_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5431	022	0	1	01	01	H5431_022_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5431	022	0	1	01	01	H5431_022_0	5			Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5431	025	0	1	01	01	H5431_025_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5431	025	0	1	01	01	H5431_025_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5431	025	0	1	01	01	H5431_025_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5431	025	0	1	01	01	H5431_025_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5431	025	0	1	01	01	H5431_025_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5431	025	0	1	01	01	H5431_025_0	6		N	Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5431	026	0	1	01	01	H5431_026_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5431	026	0	1	01	01	H5431_026_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5431	026	0	1	01	01	H5431_026_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5431	026	0	1	01	01	H5431_026_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5431	026	0	1	01	01	H5431_026_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5431	026	0	1	01	01	H5431_026_0	6		N	Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5433	001	0	1	01	01	H5433_001_0	4		N	Generic	4	Generic, Brand	1	2	01	3	2	0.00	
H5433	001	0	1	01	01	H5433_001_0	4		N	Brand	4	Generic, Brand	2	2	10	1	2	0.00	
H5434	002	0	1	04	01	H5434_002_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5434	002	0	1	04	01	H5434_002_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H5434	002	0	1	04	01	H5434_002_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5434	002	0	1	04	01	H5434_002_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5434	002	0	1	04	01	H5434_002_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5434	002	0	1	04	01	H5434_002_0	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5434	023	0	1	04	01	H5434_023_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5434	023	0	1	04	01	H5434_023_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H5434	023	0	1	04	01	H5434_023_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5434	023	0	1	04	01	H5434_023_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5434	023	0	1	04	01	H5434_023_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5434	023	0	1	04	01	H5434_023_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5434	024	0	1	04	01	H5434_024_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5434	024	0	1	04	01	H5434_024_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H5434	024	0	1	04	01	H5434_024_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5434	024	0	1	04	01	H5434_024_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5434	024	0	1	04	01	H5434_024_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5434	024	0	1	04	01	H5434_024_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5434	025	0	1	04	01	H5434_025_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5434	025	0	1	04	01	H5434_025_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H5434	025	0	1	04	01	H5434_025_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5434	025	0	1	04	01	H5434_025_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5434	025	0	1	04	01	H5434_025_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5434	025	0	1	04	01	H5434_025_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5434	026	0	1	04	01	H5434_026_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5434	026	0	1	04	01	H5434_026_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H5434	026	0	1	04	01	H5434_026_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5434	026	0	1	04	01	H5434_026_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5434	026	0	1	04	01	H5434_026_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5434	026	0	1	04	01	H5434_026_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5434	030	0	1	04	01	H5434_030_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5434	030	0	1	04	01	H5434_030_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H5434	030	0	1	04	01	H5434_030_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5434	030	0	1	04	01	H5434_030_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5434	030	0	1	04	01	H5434_030_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5434	030	0	1	04	01	H5434_030_0	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5434	031	0	1	04	01	H5434_031_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5434	031	0	1	04	01	H5434_031_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H5434	031	0	1	04	01	H5434_031_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5434	031	0	1	04	01	H5434_031_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5434	031	0	1	04	01	H5434_031_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5434	031	0	1	04	01	H5434_031_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5434	034	0	1	04	01	H5434_034_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5434	034	0	1	04	01	H5434_034_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H5434	034	0	1	04	01	H5434_034_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5434	034	0	1	04	01	H5434_034_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5434	034	0	1	04	01	H5434_034_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5434	034	0	1	04	01	H5434_034_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5434	035	0	1	04	01	H5434_035_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5434	035	0	1	04	01	H5434_035_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H5434	035	0	1	04	01	H5434_035_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5434	035	0	1	04	01	H5434_035_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5434	035	0	1	04	01	H5434_035_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5434	035	0	1	04	01	H5434_035_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5434	036	0	1	04	01	H5434_036_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5434	036	0	1	04	01	H5434_036_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H5434	036	0	1	04	01	H5434_036_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5434	036	0	1	04	01	H5434_036_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5434	036	0	1	04	01	H5434_036_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5434	036	0	1	04	01	H5434_036_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5434	045	0	1	04	01	H5434_045_0	10			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5434	045	0	1	04	01	H5434_045_0	10			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H5434	045	0	1	04	01	H5434_045_0	10			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5434	045	0	1	04	01	H5434_045_0	10			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5434	045	0	1	04	01	H5434_045_0	10			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5434	045	0	1	04	01	H5434_045_0	10			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5435	024	0	1	09	04	H5435_024_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5435	024	0	1	09	04	H5435_024_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H5435	024	0	1	09	04	H5435_024_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5435	024	0	1	09	04	H5435_024_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5435	024	0	1	09	04	H5435_024_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5439	011	0	1	04	01	H5439_011_0	12			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H5439	011	0	1	04	01	H5439_011_0	12			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5439	011	0	1	04	01	H5439_011_0	12			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5439	011	0	1	04	01	H5439_011_0	12			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5439	011	0	1	04	01	H5439_011_0	12			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5439	011	0	1	04	01	H5439_011_0	12			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5439	015	0	1	04	01	H5439_015_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H5439	015	0	1	04	01	H5439_015_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5439	015	0	1	04	01	H5439_015_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5439	015	0	1	04	01	H5439_015_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5439	015	0	1	04	01	H5439_015_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5439	015	0	1	04	01	H5439_015_0	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5439	019	0	1	04	01	H5439_019_0	10			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H5439	019	0	1	04	01	H5439_019_0	10			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5439	019	0	1	04	01	H5439_019_0	10			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5439	019	0	1	04	01	H5439_019_0	10			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5439	019	0	1	04	01	H5439_019_0	10			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5439	019	0	1	04	01	H5439_019_0	10			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5439	022	1	1	04	01	H5439_022_1	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H5439	022	1	1	04	01	H5439_022_1	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5439	022	1	1	04	01	H5439_022_1	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5439	022	1	1	04	01	H5439_022_1	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5439	022	1	1	04	01	H5439_022_1	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5439	022	1	1	04	01	H5439_022_1	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5439	022	2	1	04	01	H5439_022_2	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H5439	022	2	1	04	01	H5439_022_2	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5439	022	2	1	04	01	H5439_022_2	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5439	022	2	1	04	01	H5439_022_2	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5439	022	2	1	04	01	H5439_022_2	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5439	022	2	1	04	01	H5439_022_2	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5439	022	3	1	04	01	H5439_022_3	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H5439	022	3	1	04	01	H5439_022_3	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5439	022	3	1	04	01	H5439_022_3	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5439	022	3	1	04	01	H5439_022_3	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5439	022	3	1	04	01	H5439_022_3	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5439	022	3	1	04	01	H5439_022_3	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5447	001	0	1	01	01	H5447_001_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5447	001	0	1	01	01	H5447_001_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5447	001	0	1	01	01	H5447_001_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H5447	001	0	1	01	01	H5447_001_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5447	001	0	1	01	01	H5447_001_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5447	002	0	1	01	01	H5447_002_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5447	002	0	1	01	01	H5447_002_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5447	002	0	1	01	01	H5447_002_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H5447	002	0	1	01	01	H5447_002_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5447	002	0	1	01	01	H5447_002_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5453	001	0	1	04	01	H5453_001_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5453	001	0	1	04	01	H5453_001_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H5453	001	0	1	04	01	H5453_001_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5453	001	0	1	04	01	H5453_001_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5453	001	0	1	04	01	H5453_001_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5453	002	0	1	04	01	H5453_002_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5453	002	0	1	04	01	H5453_002_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H5453	002	0	1	04	01	H5453_002_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5453	002	0	1	04	01	H5453_002_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5453	002	0	1	04	01	H5453_002_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5453	004	0	1	04	01	H5453_004_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5453	004	0	1	04	01	H5453_004_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H5453	004	0	1	04	01	H5453_004_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5453	004	0	1	04	01	H5453_004_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5453	004	0	1	04	01	H5453_004_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5453	005	0	1	04	01	H5453_005_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5453	005	0	1	04	01	H5453_005_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H5453	005	0	1	04	01	H5453_005_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5453	005	0	1	04	01	H5453_005_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5453	005	0	1	04	01	H5453_005_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5453	010	0	1	04	01	H5453_010_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5453	010	0	1	04	01	H5453_010_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H5453	010	0	1	04	01	H5453_010_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5453	010	0	1	04	01	H5453_010_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5453	010	0	1	04	01	H5453_010_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5453	011	0	1	04	01	H5453_011_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5453	011	0	1	04	01	H5453_011_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H5453	011	0	1	04	01	H5453_011_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5453	011	0	1	04	01	H5453_011_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5453	011	0	1	04	01	H5453_011_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5453	015	0	1	04	01	H5453_015_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5453	015	0	1	04	01	H5453_015_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5453	015	0	1	04	01	H5453_015_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5453	015	0	1	04	01	H5453_015_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5453	015	0	1	04	01	H5453_015_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5453	015	0	1	04	01	H5453_015_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5453	016	0	1	04	01	H5453_016_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5453	016	0	1	04	01	H5453_016_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5453	016	0	1	04	01	H5453_016_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5453	016	0	1	04	01	H5453_016_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5453	016	0	1	04	01	H5453_016_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5453	016	0	1	04	01	H5453_016_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5453	017	0	1	04	01	H5453_017_0	7			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5453	017	0	1	04	01	H5453_017_0	7			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5453	017	0	1	04	01	H5453_017_0	7			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5453	017	0	1	04	01	H5453_017_0	7			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5453	017	0	1	04	01	H5453_017_0	7			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5453	017	0	1	04	01	H5453_017_0	7			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5453	018	0	1	04	01	H5453_018_0	7			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5453	018	0	1	04	01	H5453_018_0	7			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5453	018	0	1	04	01	H5453_018_0	7			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5453	018	0	1	04	01	H5453_018_0	7			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5453	018	0	1	04	01	H5453_018_0	7			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5453	018	0	1	04	01	H5453_018_0	7			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5454	001	0	1	01	01	H5454_001_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5454	001	0	1	01	01	H5454_001_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H5454	001	0	1	01	01	H5454_001_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5454	001	0	1	01	01	H5454_001_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5454	001	0	1	01	01	H5454_001_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5454	001	0	1	01	01	H5454_001_0	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5454	002	0	1	01	01	H5454_002_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5454	002	0	1	01	01	H5454_002_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H5454	002	0	1	01	01	H5454_002_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5454	002	0	1	01	01	H5454_002_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5454	002	0	1	01	01	H5454_002_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5454	002	0	1	01	01	H5454_002_0	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5454	005	0	1	01	01	H5454_005_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5454	005	0	1	01	01	H5454_005_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H5454	005	0	1	01	01	H5454_005_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5454	005	0	1	01	01	H5454_005_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5454	005	0	1	01	01	H5454_005_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5454	005	0	1	01	01	H5454_005_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5454	006	0	1	01	01	H5454_006_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5454	006	0	1	01	01	H5454_006_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H5454	006	0	1	01	01	H5454_006_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5454	006	0	1	01	01	H5454_006_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5454	006	0	1	01	01	H5454_006_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5454	006	0	1	01	01	H5454_006_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5471	064	0	1	01	01	H5471_064_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5471	064	0	1	01	01	H5471_064_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5471	064	0	1	01	01	H5471_064_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5471	064	0	1	01	01	H5471_064_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5471	064	0	1	01	01	H5471_064_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5471	064	0	1	01	01	H5471_064_0	7		N	Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5471	065	0	1	01	01	H5471_065_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5471	065	0	1	01	01	H5471_065_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5471	065	0	1	01	01	H5471_065_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5471	065	0	1	01	01	H5471_065_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5471	065	0	1	01	01	H5471_065_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5471	065	0	1	01	01	H5471_065_0	5			Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5471	066	0	1	01	01	H5471_066_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5471	066	0	1	01	01	H5471_066_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5471	066	0	1	01	01	H5471_066_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5471	066	0	1	01	01	H5471_066_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5471	066	0	1	01	01	H5471_066_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5471	066	0	1	01	01	H5471_066_0	7		N	Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5471	069	0	1	01	01	H5471_069_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5471	069	0	1	01	01	H5471_069_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5471	069	0	1	01	01	H5471_069_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5471	069	0	1	01	01	H5471_069_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5471	069	0	1	01	01	H5471_069_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5471	069	0	1	01	01	H5471_069_0	6			Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5471	070	0	1	01	01	H5471_070_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5471	070	0	1	01	01	H5471_070_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5471	070	0	1	01	01	H5471_070_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5471	070	0	1	01	01	H5471_070_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5471	070	0	1	01	01	H5471_070_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5471	070	0	1	01	01	H5471_070_0	6			Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5471	071	0	1	01	01	H5471_071_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5471	071	0	1	01	01	H5471_071_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5471	071	0	1	01	01	H5471_071_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5471	071	0	1	01	01	H5471_071_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5471	071	0	1	01	01	H5471_071_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5471	071	0	1	01	01	H5471_071_0	5			Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5471	072	0	1	01	01	H5471_072_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5471	072	0	1	01	01	H5471_072_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5471	072	0	1	01	01	H5471_072_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5471	072	0	1	01	01	H5471_072_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5471	072	0	1	01	01	H5471_072_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5471	072	0	1	01	01	H5471_072_0	7		N	Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5471	073	0	1	01	01	H5471_073_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5471	073	0	1	01	01	H5471_073_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5471	073	0	1	01	01	H5471_073_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5471	073	0	1	01	01	H5471_073_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5471	073	0	1	01	01	H5471_073_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5471	073	0	1	01	01	H5471_073_0	5			Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5471	074	0	1	01	01	H5471_074_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5471	074	0	1	01	01	H5471_074_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5471	074	0	1	01	01	H5471_074_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5471	074	0	1	01	01	H5471_074_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5471	074	0	1	01	01	H5471_074_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5471	074	0	1	01	01	H5471_074_0	5			Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5471	075	0	1	01	01	H5471_075_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5471	075	0	1	01	01	H5471_075_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5471	075	0	1	01	01	H5471_075_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5471	075	0	1	01	01	H5471_075_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5471	075	0	1	01	01	H5471_075_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5471	075	0	1	01	01	H5471_075_0	6			Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5471	076	0	1	01	01	H5471_076_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5471	076	0	1	01	01	H5471_076_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5471	076	0	1	01	01	H5471_076_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5471	076	0	1	01	01	H5471_076_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5471	076	0	1	01	01	H5471_076_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5471	076	0	1	01	01	H5471_076_0	7		N	Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5471	077	0	1	01	01	H5471_077_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5471	077	0	1	01	01	H5471_077_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5471	077	0	1	01	01	H5471_077_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5471	077	0	1	01	01	H5471_077_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5471	077	0	1	01	01	H5471_077_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5471	077	0	1	01	01	H5471_077_0	5			Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5471	078	0	1	01	01	H5471_078_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5471	078	0	1	01	01	H5471_078_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5471	078	0	1	01	01	H5471_078_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5471	078	0	1	01	01	H5471_078_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5471	078	0	1	01	01	H5471_078_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5471	078	0	1	01	01	H5471_078_0	5			Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5471	080	0	1	01	01	H5471_080_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5471	080	0	1	01	01	H5471_080_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5471	080	0	1	01	01	H5471_080_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5471	080	0	1	01	01	H5471_080_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5471	080	0	1	01	01	H5471_080_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5471	080	0	1	01	01	H5471_080_0	6			Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5471	082	0	1	01	01	H5471_082_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5471	082	0	1	01	01	H5471_082_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5471	082	0	1	01	01	H5471_082_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5471	082	0	1	01	01	H5471_082_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5471	082	0	1	01	01	H5471_082_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5471	082	0	1	01	01	H5471_082_0	7		N	Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5471	084	0	1	01	01	H5471_084_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5471	084	0	1	01	01	H5471_084_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5471	084	0	1	01	01	H5471_084_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5471	084	0	1	01	01	H5471_084_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5471	084	0	1	01	01	H5471_084_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5471	084	0	1	01	01	H5471_084_0	7		N	Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5471	110	0	1	01	01	H5471_110_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5471	110	0	1	01	01	H5471_110_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5471	110	0	1	01	01	H5471_110_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5471	110	0	1	01	01	H5471_110_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5471	110	0	1	01	01	H5471_110_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5471	110	0	1	01	01	H5471_110_0	5			Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5471	111	0	1	01	01	H5471_111_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5471	111	0	1	01	01	H5471_111_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5471	111	0	1	01	01	H5471_111_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5471	111	0	1	01	01	H5471_111_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5471	111	0	1	01	01	H5471_111_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5471	111	0	1	01	01	H5471_111_0	7		N	Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5471	112	0	1	01	01	H5471_112_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5471	112	0	1	01	01	H5471_112_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5471	112	0	1	01	01	H5471_112_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5471	112	0	1	01	01	H5471_112_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5471	112	0	1	01	01	H5471_112_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5471	112	0	1	01	01	H5471_112_0	5			Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5471	113	0	1	01	01	H5471_113_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5471	113	0	1	01	01	H5471_113_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5471	113	0	1	01	01	H5471_113_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5471	113	0	1	01	01	H5471_113_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5471	113	0	1	01	01	H5471_113_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5471	113	0	1	01	01	H5471_113_0	5			Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5471	114	0	1	01	01	H5471_114_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5471	114	0	1	01	01	H5471_114_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5471	114	0	1	01	01	H5471_114_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5471	114	0	1	01	01	H5471_114_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5471	114	0	1	01	01	H5471_114_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5471	114	0	1	01	01	H5471_114_0	5			Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5471	115	0	1	01	01	H5471_115_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5471	115	0	1	01	01	H5471_115_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5471	115	0	1	01	01	H5471_115_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5471	115	0	1	01	01	H5471_115_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5471	115	0	1	01	01	H5471_115_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5471	115	0	1	01	01	H5471_115_0	7		N	Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5471	116	0	1	01	01	H5471_116_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5471	116	0	1	01	01	H5471_116_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5471	116	0	1	01	01	H5471_116_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5471	116	0	1	01	01	H5471_116_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5471	116	0	1	01	01	H5471_116_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5471	116	0	1	01	01	H5471_116_0	6			Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5471	117	0	1	01	01	H5471_117_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5471	117	0	1	01	01	H5471_117_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5471	117	0	1	01	01	H5471_117_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5471	117	0	1	01	01	H5471_117_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5471	117	0	1	01	01	H5471_117_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5471	117	0	1	01	01	H5471_117_0	5			Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5471	118	0	1	01	01	H5471_118_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5471	118	0	1	01	01	H5471_118_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5471	118	0	1	01	01	H5471_118_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5471	118	0	1	01	01	H5471_118_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5471	118	0	1	01	01	H5471_118_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5471	118	0	1	01	01	H5471_118_0	7		N	Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5471	119	0	1	01	01	H5471_119_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5471	119	0	1	01	01	H5471_119_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5471	119	0	1	01	01	H5471_119_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5471	119	0	1	01	01	H5471_119_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5471	119	0	1	01	01	H5471_119_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5471	119	0	1	01	01	H5471_119_0	6			Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5471	120	0	1	01	01	H5471_120_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5471	120	0	1	01	01	H5471_120_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5471	120	0	1	01	01	H5471_120_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5471	120	0	1	01	01	H5471_120_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5471	120	0	1	01	01	H5471_120_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5471	120	0	1	01	01	H5471_120_0	5			Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5471	121	0	1	01	01	H5471_121_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5471	121	0	1	01	01	H5471_121_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5471	121	0	1	01	01	H5471_121_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5471	121	0	1	01	01	H5471_121_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5471	121	0	1	01	01	H5471_121_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5471	121	0	1	01	01	H5471_121_0	7		N	Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5471	122	0	1	01	01	H5471_122_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5471	122	0	1	01	01	H5471_122_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5471	122	0	1	01	01	H5471_122_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5471	122	0	1	01	01	H5471_122_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5471	122	0	1	01	01	H5471_122_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5471	122	0	1	01	01	H5471_122_0	6			Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5471	123	0	1	01	01	H5471_123_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5471	123	0	1	01	01	H5471_123_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5471	123	0	1	01	01	H5471_123_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5471	123	0	1	01	01	H5471_123_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5471	123	0	1	01	01	H5471_123_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5471	123	0	1	01	01	H5471_123_0	5			Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5471	124	0	1	01	01	H5471_124_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5471	124	0	1	01	01	H5471_124_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5471	124	0	1	01	01	H5471_124_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5471	124	0	1	01	01	H5471_124_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5471	124	0	1	01	01	H5471_124_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5471	124	0	1	01	01	H5471_124_0	5			Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5471	125	0	1	01	01	H5471_125_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5471	125	0	1	01	01	H5471_125_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5471	125	0	1	01	01	H5471_125_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5471	125	0	1	01	01	H5471_125_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5471	125	0	1	01	01	H5471_125_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5471	125	0	1	01	01	H5471_125_0	7		N	Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5471	126	0	1	01	01	H5471_126_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5471	126	0	1	01	01	H5471_126_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5471	126	0	1	01	01	H5471_126_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5471	126	0	1	01	01	H5471_126_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5471	126	0	1	01	01	H5471_126_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5471	126	0	1	01	01	H5471_126_0	6			Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5471	127	0	1	01	01	H5471_127_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5471	127	0	1	01	01	H5471_127_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5471	127	0	1	01	01	H5471_127_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5471	127	0	1	01	01	H5471_127_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5471	127	0	1	01	01	H5471_127_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5471	127	0	1	01	01	H5471_127_0	7		N	Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5471	128	0	1	01	01	H5471_128_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5471	128	0	1	01	01	H5471_128_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5471	128	0	1	01	01	H5471_128_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5471	128	0	1	01	01	H5471_128_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5471	128	0	1	01	01	H5471_128_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5471	128	0	1	01	01	H5471_128_0	7		N	Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5471	129	0	1	01	01	H5471_129_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5471	129	0	1	01	01	H5471_129_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5471	129	0	1	01	01	H5471_129_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5471	129	0	1	01	01	H5471_129_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5471	129	0	1	01	01	H5471_129_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5471	129	0	1	01	01	H5471_129_0	7		N	Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5471	130	0	1	01	01	H5471_130_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5471	130	0	1	01	01	H5471_130_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5471	130	0	1	01	01	H5471_130_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5471	130	0	1	01	01	H5471_130_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5471	130	0	1	01	01	H5471_130_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5471	130	0	1	01	01	H5471_130_0	7		N	Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5471	131	0	1	01	01	H5471_131_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5471	131	0	1	01	01	H5471_131_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5471	131	0	1	01	01	H5471_131_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5471	131	0	1	01	01	H5471_131_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5471	131	0	1	01	01	H5471_131_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5471	131	0	1	01	01	H5471_131_0	7		N	Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5471	132	0	1	01	01	H5471_132_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5471	132	0	1	01	01	H5471_132_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5471	132	0	1	01	01	H5471_132_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5471	132	0	1	01	01	H5471_132_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5471	132	0	1	01	01	H5471_132_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5471	132	0	1	01	01	H5471_132_0	7		N	Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5471	133	0	1	01	01	H5471_133_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5471	133	0	1	01	01	H5471_133_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5471	133	0	1	01	01	H5471_133_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5471	133	0	1	01	01	H5471_133_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5471	133	0	1	01	01	H5471_133_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5471	133	0	1	01	01	H5471_133_0	7		N	Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5471	134	0	1	01	01	H5471_134_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5471	134	0	1	01	01	H5471_134_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5471	134	0	1	01	01	H5471_134_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5471	134	0	1	01	01	H5471_134_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5471	134	0	1	01	01	H5471_134_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5471	134	0	1	01	01	H5471_134_0	7		N	Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5471	135	0	1	01	01	H5471_135_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5471	135	0	1	01	01	H5471_135_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5471	135	0	1	01	01	H5471_135_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5471	135	0	1	01	01	H5471_135_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5471	135	0	1	01	01	H5471_135_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5471	135	0	1	01	01	H5471_135_0	7		N	Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5471	136	0	1	01	01	H5471_136_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5471	136	0	1	01	01	H5471_136_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5471	136	0	1	01	01	H5471_136_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5471	136	0	1	01	01	H5471_136_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5471	136	0	1	01	01	H5471_136_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5471	136	0	1	01	01	H5471_136_0	7		N	Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5471	137	0	1	01	01	H5471_137_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5471	137	0	1	01	01	H5471_137_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5471	137	0	1	01	01	H5471_137_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5471	137	0	1	01	01	H5471_137_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5471	137	0	1	01	01	H5471_137_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5471	137	0	1	01	01	H5471_137_0	7		N	Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5471	138	0	1	01	01	H5471_138_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5471	138	0	1	01	01	H5471_138_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5471	138	0	1	01	01	H5471_138_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5471	138	0	1	01	01	H5471_138_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5471	138	0	1	01	01	H5471_138_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5471	138	0	1	01	01	H5471_138_0	7		N	Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5471	139	0	1	01	01	H5471_139_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5471	139	0	1	01	01	H5471_139_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5471	139	0	1	01	01	H5471_139_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5471	139	0	1	01	01	H5471_139_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5471	139	0	1	01	01	H5471_139_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5471	139	0	1	01	01	H5471_139_0	7		N	Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5471	140	0	1	01	01	H5471_140_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5471	140	0	1	01	01	H5471_140_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5471	140	0	1	01	01	H5471_140_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5471	140	0	1	01	01	H5471_140_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5471	140	0	1	01	01	H5471_140_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5471	140	0	1	01	01	H5471_140_0	7		N	Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5471	141	0	1	01	01	H5471_141_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5471	141	0	1	01	01	H5471_141_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5471	141	0	1	01	01	H5471_141_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5471	141	0	1	01	01	H5471_141_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5471	141	0	1	01	01	H5471_141_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5471	141	0	1	01	01	H5471_141_0	7		N	Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5471	142	0	1	01	01	H5471_142_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5471	142	0	1	01	01	H5471_142_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5471	142	0	1	01	01	H5471_142_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5471	142	0	1	01	01	H5471_142_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5471	142	0	1	01	01	H5471_142_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5471	142	0	1	01	01	H5471_142_0	7		N	Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5471	143	0	1	01	01	H5471_143_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5471	143	0	1	01	01	H5471_143_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5471	143	0	1	01	01	H5471_143_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5471	143	0	1	01	01	H5471_143_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5471	143	0	1	01	01	H5471_143_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H5471	143	0	1	01	01	H5471_143_0	7		N	Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H5472	001	0	1	02	01	H5472_001_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5472	001	0	1	02	01	H5472_001_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5472	001	0	1	02	01	H5472_001_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	3	2	45.00	
H5472	001	0	1	02	01	H5472_001_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	3	1		32
H5472	001	0	1	02	01	H5472_001_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5472	001	0	1	02	01	H5472_001_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5472	002	0	1	02	01	H5472_002_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5472	002	0	1	02	01	H5472_002_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5472	002	0	1	02	01	H5472_002_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	3	2	45.00	
H5472	002	0	1	02	01	H5472_002_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	3	1		32
H5472	002	0	1	02	01	H5472_002_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5472	002	0	1	02	01	H5472_002_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5472	003	0	1	02	01	H5472_003_0	10			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5472	003	0	1	02	01	H5472_003_0	10			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5472	003	0	1	02	01	H5472_003_0	10			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	3	2	45.00	
H5472	003	0	1	02	01	H5472_003_0	10			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	3	1		32
H5472	003	0	1	02	01	H5472_003_0	10			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5472	003	0	1	02	01	H5472_003_0	10			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5472	004	0	1	02	01	H5472_004_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5472	004	0	1	02	01	H5472_004_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5472	004	0	1	02	01	H5472_004_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5472	004	0	1	02	01	H5472_004_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5472	004	0	1	02	01	H5472_004_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5472	004	0	1	02	01	H5472_004_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5472	007	0	1	02	01	H5472_007_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5472	007	0	1	02	01	H5472_007_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5472	007	0	1	02	01	H5472_007_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5472	007	0	1	02	01	H5472_007_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5472	007	0	1	02	01	H5472_007_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5472	007	0	1	02	01	H5472_007_0	7		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5472	009	0	1	02	01	H5472_009_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5472	009	0	1	02	01	H5472_009_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5472	009	0	1	02	01	H5472_009_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5472	009	0	1	02	01	H5472_009_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5472	009	0	1	02	01	H5472_009_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5472	009	0	1	02	01	H5472_009_0	6		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5472	010	0	1	02	01	H5472_010_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5472	010	0	1	02	01	H5472_010_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5472	010	0	1	02	01	H5472_010_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	3	2	45.00	
H5472	010	0	1	02	01	H5472_010_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	3	1		40
H5472	010	0	1	02	01	H5472_010_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5472	010	0	1	02	01	H5472_010_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5475	001	0	1	02	01	H5475_001_0	9		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5475	001	0	1	02	01	H5475_001_0	9		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5475	001	0	1	02	01	H5475_001_0	9		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5475	001	0	1	02	01	H5475_001_0	9		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5475	001	0	1	02	01	H5475_001_0	9		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5475	001	0	1	02	01	H5475_001_0	9		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5475	026	0	1	02	01	H5475_026_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H5475	026	0	1	02	01	H5475_026_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5475	026	0	1	02	01	H5475_026_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5475	026	0	1	02	01	H5475_026_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5475	026	0	1	02	01	H5475_026_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5475	026	0	1	02	01	H5475_026_0	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5475	031	0	1	02	01	H5475_031_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H5475	031	0	1	02	01	H5475_031_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5475	031	0	1	02	01	H5475_031_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5475	031	0	1	02	01	H5475_031_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5475	031	0	1	02	01	H5475_031_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5475	031	0	1	02	01	H5475_031_0	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5475	038	0	1	02	01	H5475_038_0	9			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5475	038	0	1	02	01	H5475_038_0	9			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5475	038	0	1	02	01	H5475_038_0	9			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5475	038	0	1	02	01	H5475_038_0	9			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5475	038	0	1	02	01	H5475_038_0	9			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5475	038	0	1	02	01	H5475_038_0	9			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5475	039	0	1	02	01	H5475_039_0	9		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5475	039	0	1	02	01	H5475_039_0	9		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5475	039	0	1	02	01	H5475_039_0	9		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5475	039	0	1	02	01	H5475_039_0	9		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5475	039	0	1	02	01	H5475_039_0	9		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5475	039	0	1	02	01	H5475_039_0	9		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5496	005	0	1	01	01	H5496_005_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H5496	005	0	1	01	01	H5496_005_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5496	005	0	1	01	01	H5496_005_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5496	005	0	1	01	01	H5496_005_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5496	005	0	1	01	01	H5496_005_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5496	005	0	1	01	01	H5496_005_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	10	1	2	0.00	
H5496	012	0	1	01	01	H5496_012_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5496	012	0	1	01	01	H5496_012_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5496	012	0	1	01	01	H5496_012_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5496	012	0	1	01	01	H5496_012_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5496	012	0	1	01	01	H5496_012_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	015	0	1	04	01	H5521_015_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	015	0	1	04	01	H5521_015_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	015	0	1	04	01	H5521_015_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	015	0	1	04	01	H5521_015_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	015	0	1	04	01	H5521_015_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	016	0	1	04	01	H5521_016_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	016	0	1	04	01	H5521_016_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	016	0	1	04	01	H5521_016_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	016	0	1	04	01	H5521_016_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	016	0	1	04	01	H5521_016_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	020	0	1	04	01	H5521_020_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	020	0	1	04	01	H5521_020_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	020	0	1	04	01	H5521_020_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	020	0	1	04	01	H5521_020_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	020	0	1	04	01	H5521_020_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	022	0	1	04	01	H5521_022_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	022	0	1	04	01	H5521_022_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	022	0	1	04	01	H5521_022_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	022	0	1	04	01	H5521_022_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	022	0	1	04	01	H5521_022_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	033	0	1	04	01	H5521_033_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	033	0	1	04	01	H5521_033_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	033	0	1	04	01	H5521_033_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	033	0	1	04	01	H5521_033_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	033	0	1	04	01	H5521_033_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	037	0	1	04	01	H5521_037_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	037	0	1	04	01	H5521_037_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	037	0	1	04	01	H5521_037_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	037	0	1	04	01	H5521_037_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	037	0	1	04	01	H5521_037_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	055	0	1	04	01	H5521_055_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	055	0	1	04	01	H5521_055_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	055	0	1	04	01	H5521_055_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	055	0	1	04	01	H5521_055_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	055	0	1	04	01	H5521_055_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	077	0	1	04	01	H5521_077_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	077	0	1	04	01	H5521_077_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	077	0	1	04	01	H5521_077_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	077	0	1	04	01	H5521_077_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	077	0	1	04	01	H5521_077_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	081	0	1	04	01	H5521_081_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	081	0	1	04	01	H5521_081_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	081	0	1	04	01	H5521_081_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	081	0	1	04	01	H5521_081_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	081	0	1	04	01	H5521_081_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	084	0	1	04	01	H5521_084_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	084	0	1	04	01	H5521_084_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	084	0	1	04	01	H5521_084_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	084	0	1	04	01	H5521_084_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	084	0	1	04	01	H5521_084_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	085	0	1	04	01	H5521_085_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	085	0	1	04	01	H5521_085_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	085	0	1	04	01	H5521_085_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	085	0	1	04	01	H5521_085_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	085	0	1	04	01	H5521_085_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	086	0	1	04	01	H5521_086_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	086	0	1	04	01	H5521_086_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	086	0	1	04	01	H5521_086_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	086	0	1	04	01	H5521_086_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	086	0	1	04	01	H5521_086_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	087	0	1	04	01	H5521_087_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	087	0	1	04	01	H5521_087_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	087	0	1	04	01	H5521_087_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	087	0	1	04	01	H5521_087_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	087	0	1	04	01	H5521_087_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	088	0	1	04	01	H5521_088_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	088	0	1	04	01	H5521_088_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	088	0	1	04	01	H5521_088_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	088	0	1	04	01	H5521_088_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	088	0	1	04	01	H5521_088_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	089	0	1	04	01	H5521_089_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	089	0	1	04	01	H5521_089_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	089	0	1	04	01	H5521_089_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	089	0	1	04	01	H5521_089_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	089	0	1	04	01	H5521_089_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	091	0	1	04	01	H5521_091_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	091	0	1	04	01	H5521_091_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	091	0	1	04	01	H5521_091_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	091	0	1	04	01	H5521_091_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	091	0	1	04	01	H5521_091_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	095	0	1	04	01	H5521_095_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	095	0	1	04	01	H5521_095_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	095	0	1	04	01	H5521_095_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	095	0	1	04	01	H5521_095_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	095	0	1	04	01	H5521_095_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	099	0	1	04	01	H5521_099_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	099	0	1	04	01	H5521_099_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	099	0	1	04	01	H5521_099_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	099	0	1	04	01	H5521_099_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	099	0	1	04	01	H5521_099_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	116	0	1	04	01	H5521_116_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	116	0	1	04	01	H5521_116_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	116	0	1	04	01	H5521_116_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	116	0	1	04	01	H5521_116_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	116	0	1	04	01	H5521_116_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	119	0	1	04	01	H5521_119_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	119	0	1	04	01	H5521_119_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	119	0	1	04	01	H5521_119_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	119	0	1	04	01	H5521_119_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	119	0	1	04	01	H5521_119_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	120	0	1	04	01	H5521_120_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	120	0	1	04	01	H5521_120_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	120	0	1	04	01	H5521_120_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	120	0	1	04	01	H5521_120_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	120	0	1	04	01	H5521_120_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	121	0	1	04	01	H5521_121_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	121	0	1	04	01	H5521_121_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	121	0	1	04	01	H5521_121_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	121	0	1	04	01	H5521_121_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	121	0	1	04	01	H5521_121_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	122	0	1	04	01	H5521_122_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	122	0	1	04	01	H5521_122_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	122	0	1	04	01	H5521_122_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	122	0	1	04	01	H5521_122_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	122	0	1	04	01	H5521_122_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	123	0	1	04	01	H5521_123_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	123	0	1	04	01	H5521_123_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	123	0	1	04	01	H5521_123_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	123	0	1	04	01	H5521_123_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	123	0	1	04	01	H5521_123_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	124	0	1	04	01	H5521_124_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	124	0	1	04	01	H5521_124_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	124	0	1	04	01	H5521_124_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	124	0	1	04	01	H5521_124_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	124	0	1	04	01	H5521_124_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	139	0	1	04	01	H5521_139_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	139	0	1	04	01	H5521_139_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	139	0	1	04	01	H5521_139_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	139	0	1	04	01	H5521_139_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	139	0	1	04	01	H5521_139_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	140	0	1	04	01	H5521_140_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	140	0	1	04	01	H5521_140_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	140	0	1	04	01	H5521_140_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	140	0	1	04	01	H5521_140_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	140	0	1	04	01	H5521_140_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	141	0	1	04	01	H5521_141_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	141	0	1	04	01	H5521_141_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	141	0	1	04	01	H5521_141_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	141	0	1	04	01	H5521_141_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	141	0	1	04	01	H5521_141_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	150	0	1	04	01	H5521_150_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	150	0	1	04	01	H5521_150_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	150	0	1	04	01	H5521_150_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	150	0	1	04	01	H5521_150_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	150	0	1	04	01	H5521_150_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	156	0	1	04	01	H5521_156_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	156	0	1	04	01	H5521_156_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	156	0	1	04	01	H5521_156_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	156	0	1	04	01	H5521_156_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	156	0	1	04	01	H5521_156_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	157	0	1	04	01	H5521_157_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	157	0	1	04	01	H5521_157_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	157	0	1	04	01	H5521_157_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	157	0	1	04	01	H5521_157_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	157	0	1	04	01	H5521_157_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	159	0	1	04	01	H5521_159_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	159	0	1	04	01	H5521_159_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	159	0	1	04	01	H5521_159_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	159	0	1	04	01	H5521_159_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	159	0	1	04	01	H5521_159_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	160	0	1	04	01	H5521_160_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	160	0	1	04	01	H5521_160_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	160	0	1	04	01	H5521_160_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	160	0	1	04	01	H5521_160_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	160	0	1	04	01	H5521_160_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	169	0	1	04	01	H5521_169_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	169	0	1	04	01	H5521_169_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	169	0	1	04	01	H5521_169_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	169	0	1	04	01	H5521_169_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	169	0	1	04	01	H5521_169_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	170	0	1	04	01	H5521_170_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	170	0	1	04	01	H5521_170_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	170	0	1	04	01	H5521_170_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	170	0	1	04	01	H5521_170_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	170	0	1	04	01	H5521_170_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	171	0	1	04	01	H5521_171_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	171	0	1	04	01	H5521_171_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	171	0	1	04	01	H5521_171_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	171	0	1	04	01	H5521_171_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	171	0	1	04	01	H5521_171_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	194	0	1	04	01	H5521_194_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	194	0	1	04	01	H5521_194_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	194	0	1	04	01	H5521_194_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	194	0	1	04	01	H5521_194_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	194	0	1	04	01	H5521_194_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	195	0	1	04	01	H5521_195_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	195	0	1	04	01	H5521_195_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	195	0	1	04	01	H5521_195_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	195	0	1	04	01	H5521_195_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	195	0	1	04	01	H5521_195_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	207	0	1	04	01	H5521_207_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	207	0	1	04	01	H5521_207_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	207	0	1	04	01	H5521_207_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	207	0	1	04	01	H5521_207_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	207	0	1	04	01	H5521_207_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	211	0	1	04	01	H5521_211_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	211	0	1	04	01	H5521_211_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	211	0	1	04	01	H5521_211_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	211	0	1	04	01	H5521_211_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	211	0	1	04	01	H5521_211_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	214	0	1	04	01	H5521_214_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	214	0	1	04	01	H5521_214_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	214	0	1	04	01	H5521_214_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	214	0	1	04	01	H5521_214_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	214	0	1	04	01	H5521_214_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	215	0	1	04	01	H5521_215_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	215	0	1	04	01	H5521_215_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	215	0	1	04	01	H5521_215_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	215	0	1	04	01	H5521_215_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	215	0	1	04	01	H5521_215_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	218	0	1	04	01	H5521_218_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	218	0	1	04	01	H5521_218_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	218	0	1	04	01	H5521_218_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	218	0	1	04	01	H5521_218_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	218	0	1	04	01	H5521_218_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	219	0	1	04	01	H5521_219_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	219	0	1	04	01	H5521_219_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	219	0	1	04	01	H5521_219_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	219	0	1	04	01	H5521_219_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	219	0	1	04	01	H5521_219_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	223	0	1	04	01	H5521_223_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	223	0	1	04	01	H5521_223_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	223	0	1	04	01	H5521_223_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	223	0	1	04	01	H5521_223_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	223	0	1	04	01	H5521_223_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	224	0	1	04	01	H5521_224_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	224	0	1	04	01	H5521_224_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	224	0	1	04	01	H5521_224_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	224	0	1	04	01	H5521_224_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	224	0	1	04	01	H5521_224_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	227	0	1	04	01	H5521_227_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	227	0	1	04	01	H5521_227_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	227	0	1	04	01	H5521_227_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	227	0	1	04	01	H5521_227_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	227	0	1	04	01	H5521_227_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	231	0	1	04	01	H5521_231_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	231	0	1	04	01	H5521_231_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	231	0	1	04	01	H5521_231_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	231	0	1	04	01	H5521_231_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	231	0	1	04	01	H5521_231_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	233	0	1	04	01	H5521_233_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	233	0	1	04	01	H5521_233_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	233	0	1	04	01	H5521_233_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	233	0	1	04	01	H5521_233_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	233	0	1	04	01	H5521_233_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	236	0	1	04	01	H5521_236_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	236	0	1	04	01	H5521_236_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	236	0	1	04	01	H5521_236_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	236	0	1	04	01	H5521_236_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	236	0	1	04	01	H5521_236_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	243	0	1	04	01	H5521_243_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	243	0	1	04	01	H5521_243_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	243	0	1	04	01	H5521_243_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	243	0	1	04	01	H5521_243_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	243	0	1	04	01	H5521_243_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	245	0	1	04	01	H5521_245_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	245	0	1	04	01	H5521_245_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	245	0	1	04	01	H5521_245_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	245	0	1	04	01	H5521_245_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	245	0	1	04	01	H5521_245_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	246	0	1	04	01	H5521_246_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	246	0	1	04	01	H5521_246_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	246	0	1	04	01	H5521_246_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	246	0	1	04	01	H5521_246_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	246	0	1	04	01	H5521_246_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	249	0	1	04	01	H5521_249_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	249	0	1	04	01	H5521_249_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	249	0	1	04	01	H5521_249_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	249	0	1	04	01	H5521_249_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	249	0	1	04	01	H5521_249_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	250	0	1	04	01	H5521_250_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	250	0	1	04	01	H5521_250_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	250	0	1	04	01	H5521_250_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	250	0	1	04	01	H5521_250_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	250	0	1	04	01	H5521_250_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	251	0	1	04	01	H5521_251_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	251	0	1	04	01	H5521_251_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	251	0	1	04	01	H5521_251_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	251	0	1	04	01	H5521_251_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	251	0	1	04	01	H5521_251_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	254	0	1	04	01	H5521_254_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	254	0	1	04	01	H5521_254_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	254	0	1	04	01	H5521_254_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	254	0	1	04	01	H5521_254_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	254	0	1	04	01	H5521_254_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	260	0	1	04	01	H5521_260_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	260	0	1	04	01	H5521_260_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	260	0	1	04	01	H5521_260_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	260	0	1	04	01	H5521_260_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	260	0	1	04	01	H5521_260_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	261	0	1	04	01	H5521_261_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	261	0	1	04	01	H5521_261_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	261	0	1	04	01	H5521_261_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	261	0	1	04	01	H5521_261_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	261	0	1	04	01	H5521_261_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	263	0	1	04	01	H5521_263_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	263	0	1	04	01	H5521_263_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	263	0	1	04	01	H5521_263_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	263	0	1	04	01	H5521_263_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	263	0	1	04	01	H5521_263_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	269	0	1	04	01	H5521_269_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	269	0	1	04	01	H5521_269_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	269	0	1	04	01	H5521_269_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	269	0	1	04	01	H5521_269_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	269	0	1	04	01	H5521_269_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	270	0	1	04	01	H5521_270_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	270	0	1	04	01	H5521_270_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	270	0	1	04	01	H5521_270_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	270	0	1	04	01	H5521_270_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	270	0	1	04	01	H5521_270_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	271	0	1	04	01	H5521_271_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	271	0	1	04	01	H5521_271_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	271	0	1	04	01	H5521_271_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	271	0	1	04	01	H5521_271_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	271	0	1	04	01	H5521_271_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	272	0	1	04	01	H5521_272_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	272	0	1	04	01	H5521_272_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	272	0	1	04	01	H5521_272_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	272	0	1	04	01	H5521_272_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	272	0	1	04	01	H5521_272_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	273	0	1	04	01	H5521_273_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	273	0	1	04	01	H5521_273_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	273	0	1	04	01	H5521_273_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	273	0	1	04	01	H5521_273_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	273	0	1	04	01	H5521_273_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	275	0	1	04	01	H5521_275_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	275	0	1	04	01	H5521_275_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	275	0	1	04	01	H5521_275_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	275	0	1	04	01	H5521_275_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	275	0	1	04	01	H5521_275_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	277	0	1	04	01	H5521_277_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	277	0	1	04	01	H5521_277_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	277	0	1	04	01	H5521_277_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	277	0	1	04	01	H5521_277_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	277	0	1	04	01	H5521_277_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	285	0	1	04	01	H5521_285_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	285	0	1	04	01	H5521_285_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	285	0	1	04	01	H5521_285_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	285	0	1	04	01	H5521_285_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	285	0	1	04	01	H5521_285_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	289	0	1	04	01	H5521_289_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	289	0	1	04	01	H5521_289_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	289	0	1	04	01	H5521_289_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	289	0	1	04	01	H5521_289_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	289	0	1	04	01	H5521_289_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	292	0	1	04	01	H5521_292_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	292	0	1	04	01	H5521_292_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	292	0	1	04	01	H5521_292_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	292	0	1	04	01	H5521_292_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	292	0	1	04	01	H5521_292_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	299	0	1	04	01	H5521_299_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	299	0	1	04	01	H5521_299_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	299	0	1	04	01	H5521_299_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	299	0	1	04	01	H5521_299_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	299	0	1	04	01	H5521_299_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	302	0	1	04	01	H5521_302_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	302	0	1	04	01	H5521_302_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	302	0	1	04	01	H5521_302_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	302	0	1	04	01	H5521_302_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	302	0	1	04	01	H5521_302_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	303	0	1	04	01	H5521_303_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	303	0	1	04	01	H5521_303_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	303	0	1	04	01	H5521_303_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	303	0	1	04	01	H5521_303_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	303	0	1	04	01	H5521_303_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	305	0	1	04	01	H5521_305_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	305	0	1	04	01	H5521_305_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	305	0	1	04	01	H5521_305_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	305	0	1	04	01	H5521_305_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	305	0	1	04	01	H5521_305_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	314	0	1	04	01	H5521_314_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	314	0	1	04	01	H5521_314_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	314	0	1	04	01	H5521_314_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	314	0	1	04	01	H5521_314_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	314	0	1	04	01	H5521_314_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	319	0	1	04	01	H5521_319_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	319	0	1	04	01	H5521_319_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	319	0	1	04	01	H5521_319_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	319	0	1	04	01	H5521_319_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	319	0	1	04	01	H5521_319_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	326	0	1	04	01	H5521_326_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	326	0	1	04	01	H5521_326_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	326	0	1	04	01	H5521_326_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	326	0	1	04	01	H5521_326_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	326	0	1	04	01	H5521_326_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	340	0	1	04	01	H5521_340_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	340	0	1	04	01	H5521_340_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	340	0	1	04	01	H5521_340_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	340	0	1	04	01	H5521_340_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	340	0	1	04	01	H5521_340_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	348	0	1	04	01	H5521_348_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	348	0	1	04	01	H5521_348_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	348	0	1	04	01	H5521_348_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	348	0	1	04	01	H5521_348_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	348	0	1	04	01	H5521_348_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	352	0	1	04	01	H5521_352_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	352	0	1	04	01	H5521_352_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	352	0	1	04	01	H5521_352_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	352	0	1	04	01	H5521_352_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	352	0	1	04	01	H5521_352_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	363	0	1	04	01	H5521_363_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	363	0	1	04	01	H5521_363_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	363	0	1	04	01	H5521_363_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	363	0	1	04	01	H5521_363_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	363	0	1	04	01	H5521_363_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	364	0	1	04	01	H5521_364_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	364	0	1	04	01	H5521_364_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	364	0	1	04	01	H5521_364_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	364	0	1	04	01	H5521_364_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	364	0	1	04	01	H5521_364_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	365	0	1	04	01	H5521_365_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	365	0	1	04	01	H5521_365_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	365	0	1	04	01	H5521_365_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	365	0	1	04	01	H5521_365_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	365	0	1	04	01	H5521_365_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	375	0	1	04	01	H5521_375_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	375	0	1	04	01	H5521_375_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	375	0	1	04	01	H5521_375_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	375	0	1	04	01	H5521_375_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	375	0	1	04	01	H5521_375_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	381	0	1	04	01	H5521_381_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	381	0	1	04	01	H5521_381_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	381	0	1	04	01	H5521_381_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	381	0	1	04	01	H5521_381_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	381	0	1	04	01	H5521_381_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	388	0	1	04	01	H5521_388_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	388	0	1	04	01	H5521_388_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	388	0	1	04	01	H5521_388_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	388	0	1	04	01	H5521_388_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	388	0	1	04	01	H5521_388_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	392	0	1	04	01	H5521_392_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	392	0	1	04	01	H5521_392_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	392	0	1	04	01	H5521_392_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	392	0	1	04	01	H5521_392_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	392	0	1	04	01	H5521_392_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	395	0	1	04	01	H5521_395_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	395	0	1	04	01	H5521_395_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	395	0	1	04	01	H5521_395_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	395	0	1	04	01	H5521_395_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	395	0	1	04	01	H5521_395_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	398	0	1	04	01	H5521_398_0	2		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	398	0	1	04	01	H5521_398_0	2		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	398	0	1	04	01	H5521_398_0	2		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	398	0	1	04	01	H5521_398_0	2		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	398	0	1	04	01	H5521_398_0	2		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	399	0	1	04	01	H5521_399_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	399	0	1	04	01	H5521_399_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	399	0	1	04	01	H5521_399_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	399	0	1	04	01	H5521_399_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	399	0	1	04	01	H5521_399_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	400	0	1	04	01	H5521_400_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	400	0	1	04	01	H5521_400_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	400	0	1	04	01	H5521_400_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	400	0	1	04	01	H5521_400_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	400	0	1	04	01	H5521_400_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	403	0	1	04	01	H5521_403_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	403	0	1	04	01	H5521_403_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	403	0	1	04	01	H5521_403_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	403	0	1	04	01	H5521_403_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	403	0	1	04	01	H5521_403_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	404	0	1	04	01	H5521_404_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	404	0	1	04	01	H5521_404_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	404	0	1	04	01	H5521_404_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	404	0	1	04	01	H5521_404_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	404	0	1	04	01	H5521_404_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	406	0	1	04	01	H5521_406_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	406	0	1	04	01	H5521_406_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	406	0	1	04	01	H5521_406_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	406	0	1	04	01	H5521_406_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	406	0	1	04	01	H5521_406_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	407	0	1	04	01	H5521_407_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	407	0	1	04	01	H5521_407_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	407	0	1	04	01	H5521_407_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	407	0	1	04	01	H5521_407_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	407	0	1	04	01	H5521_407_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	414	0	1	04	01	H5521_414_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	414	0	1	04	01	H5521_414_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	414	0	1	04	01	H5521_414_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	414	0	1	04	01	H5521_414_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	414	0	1	04	01	H5521_414_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	419	0	1	04	01	H5521_419_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	419	0	1	04	01	H5521_419_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	419	0	1	04	01	H5521_419_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	419	0	1	04	01	H5521_419_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	419	0	1	04	01	H5521_419_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	422	0	1	04	01	H5521_422_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	422	0	1	04	01	H5521_422_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	422	0	1	04	01	H5521_422_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	422	0	1	04	01	H5521_422_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	422	0	1	04	01	H5521_422_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	425	0	1	04	01	H5521_425_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	425	0	1	04	01	H5521_425_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	425	0	1	04	01	H5521_425_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	425	0	1	04	01	H5521_425_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	425	0	1	04	01	H5521_425_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	431	0	1	04	01	H5521_431_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	431	0	1	04	01	H5521_431_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	431	0	1	04	01	H5521_431_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	431	0	1	04	01	H5521_431_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	431	0	1	04	01	H5521_431_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	432	0	1	04	01	H5521_432_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	432	0	1	04	01	H5521_432_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	432	0	1	04	01	H5521_432_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	432	0	1	04	01	H5521_432_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	432	0	1	04	01	H5521_432_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	433	0	1	04	01	H5521_433_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	433	0	1	04	01	H5521_433_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	433	0	1	04	01	H5521_433_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	433	0	1	04	01	H5521_433_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	433	0	1	04	01	H5521_433_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	434	0	1	04	01	H5521_434_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	434	0	1	04	01	H5521_434_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	434	0	1	04	01	H5521_434_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	434	0	1	04	01	H5521_434_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	434	0	1	04	01	H5521_434_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	435	0	1	04	01	H5521_435_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	435	0	1	04	01	H5521_435_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	435	0	1	04	01	H5521_435_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	435	0	1	04	01	H5521_435_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	435	0	1	04	01	H5521_435_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	439	0	1	04	01	H5521_439_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	439	0	1	04	01	H5521_439_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	439	0	1	04	01	H5521_439_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	439	0	1	04	01	H5521_439_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	439	0	1	04	01	H5521_439_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	443	0	1	04	01	H5521_443_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	443	0	1	04	01	H5521_443_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	443	0	1	04	01	H5521_443_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	443	0	1	04	01	H5521_443_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	443	0	1	04	01	H5521_443_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	446	0	1	04	01	H5521_446_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	446	0	1	04	01	H5521_446_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	446	0	1	04	01	H5521_446_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	446	0	1	04	01	H5521_446_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	446	0	1	04	01	H5521_446_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	449	0	1	04	01	H5521_449_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	449	0	1	04	01	H5521_449_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	449	0	1	04	01	H5521_449_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	449	0	1	04	01	H5521_449_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	449	0	1	04	01	H5521_449_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	450	0	1	04	01	H5521_450_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	450	0	1	04	01	H5521_450_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	450	0	1	04	01	H5521_450_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	450	0	1	04	01	H5521_450_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	450	0	1	04	01	H5521_450_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	451	0	1	04	01	H5521_451_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	451	0	1	04	01	H5521_451_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	451	0	1	04	01	H5521_451_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	451	0	1	04	01	H5521_451_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	451	0	1	04	01	H5521_451_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	457	0	1	04	01	H5521_457_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	457	0	1	04	01	H5521_457_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	457	0	1	04	01	H5521_457_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	457	0	1	04	01	H5521_457_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	457	0	1	04	01	H5521_457_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	464	0	1	04	01	H5521_464_0	3		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	464	0	1	04	01	H5521_464_0	3		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	464	0	1	04	01	H5521_464_0	3		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	464	0	1	04	01	H5521_464_0	3		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	464	0	1	04	01	H5521_464_0	3		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	465	0	1	04	01	H5521_465_0	2		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	465	0	1	04	01	H5521_465_0	2		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	465	0	1	04	01	H5521_465_0	2		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	465	0	1	04	01	H5521_465_0	2		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	465	0	1	04	01	H5521_465_0	2		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	467	0	1	04	01	H5521_467_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	467	0	1	04	01	H5521_467_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	467	0	1	04	01	H5521_467_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	467	0	1	04	01	H5521_467_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	467	0	1	04	01	H5521_467_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	470	0	1	04	01	H5521_470_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	470	0	1	04	01	H5521_470_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	470	0	1	04	01	H5521_470_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	470	0	1	04	01	H5521_470_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	470	0	1	04	01	H5521_470_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	472	0	1	04	01	H5521_472_0	2		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	472	0	1	04	01	H5521_472_0	2		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	472	0	1	04	01	H5521_472_0	2		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	472	0	1	04	01	H5521_472_0	2		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	472	0	1	04	01	H5521_472_0	2		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	475	0	1	04	01	H5521_475_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	475	0	1	04	01	H5521_475_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	475	0	1	04	01	H5521_475_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	475	0	1	04	01	H5521_475_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	475	0	1	04	01	H5521_475_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	476	0	1	04	01	H5521_476_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	476	0	1	04	01	H5521_476_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	476	0	1	04	01	H5521_476_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	476	0	1	04	01	H5521_476_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	476	0	1	04	01	H5521_476_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	477	0	1	04	01	H5521_477_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	477	0	1	04	01	H5521_477_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	477	0	1	04	01	H5521_477_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	477	0	1	04	01	H5521_477_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	477	0	1	04	01	H5521_477_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	478	0	1	04	01	H5521_478_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	478	0	1	04	01	H5521_478_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	478	0	1	04	01	H5521_478_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	478	0	1	04	01	H5521_478_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	478	0	1	04	01	H5521_478_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	482	0	1	04	01	H5521_482_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	482	0	1	04	01	H5521_482_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	482	0	1	04	01	H5521_482_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	482	0	1	04	01	H5521_482_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	482	0	1	04	01	H5521_482_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	484	0	1	04	01	H5521_484_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	484	0	1	04	01	H5521_484_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	484	0	1	04	01	H5521_484_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	484	0	1	04	01	H5521_484_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	484	0	1	04	01	H5521_484_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	490	0	1	04	01	H5521_490_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	490	0	1	04	01	H5521_490_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	490	0	1	04	01	H5521_490_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	490	0	1	04	01	H5521_490_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	490	0	1	04	01	H5521_490_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	492	0	1	04	01	H5521_492_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	492	0	1	04	01	H5521_492_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	492	0	1	04	01	H5521_492_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	492	0	1	04	01	H5521_492_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	492	0	1	04	01	H5521_492_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	495	0	1	04	01	H5521_495_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	495	0	1	04	01	H5521_495_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	495	0	1	04	01	H5521_495_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	495	0	1	04	01	H5521_495_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	495	0	1	04	01	H5521_495_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	496	0	1	04	01	H5521_496_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	496	0	1	04	01	H5521_496_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	496	0	1	04	01	H5521_496_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	496	0	1	04	01	H5521_496_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	496	0	1	04	01	H5521_496_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	500	0	1	04	01	H5521_500_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	500	0	1	04	01	H5521_500_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	500	0	1	04	01	H5521_500_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	500	0	1	04	01	H5521_500_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	500	0	1	04	01	H5521_500_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	501	0	1	04	01	H5521_501_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	501	0	1	04	01	H5521_501_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	501	0	1	04	01	H5521_501_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	501	0	1	04	01	H5521_501_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	501	0	1	04	01	H5521_501_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	502	0	1	04	01	H5521_502_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	502	0	1	04	01	H5521_502_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	502	0	1	04	01	H5521_502_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	502	0	1	04	01	H5521_502_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	502	0	1	04	01	H5521_502_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	510	0	1	04	01	H5521_510_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	510	0	1	04	01	H5521_510_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	510	0	1	04	01	H5521_510_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	510	0	1	04	01	H5521_510_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	510	0	1	04	01	H5521_510_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	512	0	1	04	01	H5521_512_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	512	0	1	04	01	H5521_512_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	512	0	1	04	01	H5521_512_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	512	0	1	04	01	H5521_512_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	512	0	1	04	01	H5521_512_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	513	0	1	04	01	H5521_513_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	513	0	1	04	01	H5521_513_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	513	0	1	04	01	H5521_513_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	513	0	1	04	01	H5521_513_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	513	0	1	04	01	H5521_513_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	520	0	1	04	01	H5521_520_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	520	0	1	04	01	H5521_520_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	520	0	1	04	01	H5521_520_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	520	0	1	04	01	H5521_520_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	520	0	1	04	01	H5521_520_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	521	0	1	04	01	H5521_521_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	521	0	1	04	01	H5521_521_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	521	0	1	04	01	H5521_521_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	521	0	1	04	01	H5521_521_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	521	0	1	04	01	H5521_521_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	522	0	1	04	01	H5521_522_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	522	0	1	04	01	H5521_522_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	522	0	1	04	01	H5521_522_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	522	0	1	04	01	H5521_522_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	522	0	1	04	01	H5521_522_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	536	0	1	04	01	H5521_536_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	536	0	1	04	01	H5521_536_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	536	0	1	04	01	H5521_536_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	536	0	1	04	01	H5521_536_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	536	0	1	04	01	H5521_536_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	537	0	1	04	01	H5521_537_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	537	0	1	04	01	H5521_537_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	537	0	1	04	01	H5521_537_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	537	0	1	04	01	H5521_537_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	537	0	1	04	01	H5521_537_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	553	0	1	04	01	H5521_553_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	553	0	1	04	01	H5521_553_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	553	0	1	04	01	H5521_553_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	553	0	1	04	01	H5521_553_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	553	0	1	04	01	H5521_553_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	554	0	1	04	01	H5521_554_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	554	0	1	04	01	H5521_554_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	554	0	1	04	01	H5521_554_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	554	0	1	04	01	H5521_554_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	554	0	1	04	01	H5521_554_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	558	0	1	04	01	H5521_558_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	558	0	1	04	01	H5521_558_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	558	0	1	04	01	H5521_558_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	558	0	1	04	01	H5521_558_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	558	0	1	04	01	H5521_558_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	569	0	1	04	01	H5521_569_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	569	0	1	04	01	H5521_569_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	569	0	1	04	01	H5521_569_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	569	0	1	04	01	H5521_569_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	569	0	1	04	01	H5521_569_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	578	0	1	04	01	H5521_578_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	578	0	1	04	01	H5521_578_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	578	0	1	04	01	H5521_578_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	578	0	1	04	01	H5521_578_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	578	0	1	04	01	H5521_578_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	580	0	1	04	01	H5521_580_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	580	0	1	04	01	H5521_580_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	580	0	1	04	01	H5521_580_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	580	0	1	04	01	H5521_580_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	580	0	1	04	01	H5521_580_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	581	0	1	04	01	H5521_581_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	581	0	1	04	01	H5521_581_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	581	0	1	04	01	H5521_581_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	581	0	1	04	01	H5521_581_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	581	0	1	04	01	H5521_581_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	586	0	1	04	01	H5521_586_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	586	0	1	04	01	H5521_586_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	586	0	1	04	01	H5521_586_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	586	0	1	04	01	H5521_586_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	586	0	1	04	01	H5521_586_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	598	0	1	04	01	H5521_598_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	598	0	1	04	01	H5521_598_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	598	0	1	04	01	H5521_598_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	598	0	1	04	01	H5521_598_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	598	0	1	04	01	H5521_598_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	607	0	1	04	01	H5521_607_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	607	0	1	04	01	H5521_607_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	607	0	1	04	01	H5521_607_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	607	0	1	04	01	H5521_607_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	607	0	1	04	01	H5521_607_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	609	0	1	04	01	H5521_609_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	609	0	1	04	01	H5521_609_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	609	0	1	04	01	H5521_609_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	609	0	1	04	01	H5521_609_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	609	0	1	04	01	H5521_609_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	644	0	1	04	01	H5521_644_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	644	0	1	04	01	H5521_644_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	644	0	1	04	01	H5521_644_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	644	0	1	04	01	H5521_644_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	644	0	1	04	01	H5521_644_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	645	0	1	04	01	H5521_645_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	645	0	1	04	01	H5521_645_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	645	0	1	04	01	H5521_645_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	645	0	1	04	01	H5521_645_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	645	0	1	04	01	H5521_645_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	646	0	1	04	01	H5521_646_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	646	0	1	04	01	H5521_646_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	646	0	1	04	01	H5521_646_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	646	0	1	04	01	H5521_646_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	646	0	1	04	01	H5521_646_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	649	0	1	04	01	H5521_649_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	649	0	1	04	01	H5521_649_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	649	0	1	04	01	H5521_649_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	649	0	1	04	01	H5521_649_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	649	0	1	04	01	H5521_649_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	650	0	1	04	01	H5521_650_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	650	0	1	04	01	H5521_650_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	650	0	1	04	01	H5521_650_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	650	0	1	04	01	H5521_650_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	650	0	1	04	01	H5521_650_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	652	0	1	04	01	H5521_652_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	652	0	1	04	01	H5521_652_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	652	0	1	04	01	H5521_652_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	652	0	1	04	01	H5521_652_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	652	0	1	04	01	H5521_652_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	654	0	1	04	01	H5521_654_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	654	0	1	04	01	H5521_654_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	654	0	1	04	01	H5521_654_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	654	0	1	04	01	H5521_654_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	654	0	1	04	01	H5521_654_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	656	0	1	04	01	H5521_656_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	656	0	1	04	01	H5521_656_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	656	0	1	04	01	H5521_656_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	656	0	1	04	01	H5521_656_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	656	0	1	04	01	H5521_656_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	661	0	1	04	01	H5521_661_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	661	0	1	04	01	H5521_661_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	661	0	1	04	01	H5521_661_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	661	0	1	04	01	H5521_661_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	661	0	1	04	01	H5521_661_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	662	0	1	04	01	H5521_662_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	662	0	1	04	01	H5521_662_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	662	0	1	04	01	H5521_662_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	662	0	1	04	01	H5521_662_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	662	0	1	04	01	H5521_662_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	664	0	1	04	01	H5521_664_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	664	0	1	04	01	H5521_664_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	664	0	1	04	01	H5521_664_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	664	0	1	04	01	H5521_664_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	664	0	1	04	01	H5521_664_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	665	0	1	04	01	H5521_665_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	665	0	1	04	01	H5521_665_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	665	0	1	04	01	H5521_665_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	665	0	1	04	01	H5521_665_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	665	0	1	04	01	H5521_665_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	669	0	1	04	01	H5521_669_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	669	0	1	04	01	H5521_669_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	669	0	1	04	01	H5521_669_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	669	0	1	04	01	H5521_669_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	669	0	1	04	01	H5521_669_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	674	0	1	04	01	H5521_674_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	674	0	1	04	01	H5521_674_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	674	0	1	04	01	H5521_674_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	674	0	1	04	01	H5521_674_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	674	0	1	04	01	H5521_674_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	676	0	1	04	01	H5521_676_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	676	0	1	04	01	H5521_676_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	676	0	1	04	01	H5521_676_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	676	0	1	04	01	H5521_676_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	676	0	1	04	01	H5521_676_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	685	0	1	04	01	H5521_685_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	685	0	1	04	01	H5521_685_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	685	0	1	04	01	H5521_685_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	685	0	1	04	01	H5521_685_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	685	0	1	04	01	H5521_685_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	686	0	1	04	01	H5521_686_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	686	0	1	04	01	H5521_686_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	686	0	1	04	01	H5521_686_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	686	0	1	04	01	H5521_686_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	686	0	1	04	01	H5521_686_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	687	0	1	04	01	H5521_687_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	687	0	1	04	01	H5521_687_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	687	0	1	04	01	H5521_687_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	687	0	1	04	01	H5521_687_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	687	0	1	04	01	H5521_687_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	688	0	1	04	01	H5521_688_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	688	0	1	04	01	H5521_688_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	688	0	1	04	01	H5521_688_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	688	0	1	04	01	H5521_688_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	688	0	1	04	01	H5521_688_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	698	0	1	04	01	H5521_698_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	698	0	1	04	01	H5521_698_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	698	0	1	04	01	H5521_698_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	698	0	1	04	01	H5521_698_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	698	0	1	04	01	H5521_698_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	699	0	1	04	01	H5521_699_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	699	0	1	04	01	H5521_699_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	699	0	1	04	01	H5521_699_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	699	0	1	04	01	H5521_699_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	699	0	1	04	01	H5521_699_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	702	0	1	04	01	H5521_702_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	702	0	1	04	01	H5521_702_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	702	0	1	04	01	H5521_702_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	702	0	1	04	01	H5521_702_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	702	0	1	04	01	H5521_702_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	704	0	1	04	01	H5521_704_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	704	0	1	04	01	H5521_704_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	704	0	1	04	01	H5521_704_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	704	0	1	04	01	H5521_704_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	704	0	1	04	01	H5521_704_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	705	0	1	04	01	H5521_705_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	705	0	1	04	01	H5521_705_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	705	0	1	04	01	H5521_705_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	705	0	1	04	01	H5521_705_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	705	0	1	04	01	H5521_705_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	706	0	1	04	01	H5521_706_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	706	0	1	04	01	H5521_706_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	706	0	1	04	01	H5521_706_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	706	0	1	04	01	H5521_706_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	706	0	1	04	01	H5521_706_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5521	710	0	1	04	01	H5521_710_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5521	710	0	1	04	01	H5521_710_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5521	710	0	1	04	01	H5521_710_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5521	710	0	1	04	01	H5521_710_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5521	710	0	1	04	01	H5521_710_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5522	001	0	1	04	01	H5522_001_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5522	001	0	1	04	01	H5522_001_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5522	001	0	1	04	01	H5522_001_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5522	001	0	1	04	01	H5522_001_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5522	001	0	1	04	01	H5522_001_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5522	002	0	1	04	01	H5522_002_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5522	002	0	1	04	01	H5522_002_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5522	002	0	1	04	01	H5522_002_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5522	002	0	1	04	01	H5522_002_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5522	002	0	1	04	01	H5522_002_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5522	004	0	1	04	01	H5522_004_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5522	004	0	1	04	01	H5522_004_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5522	004	0	1	04	01	H5522_004_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5522	004	0	1	04	01	H5522_004_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5522	004	0	1	04	01	H5522_004_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5522	005	0	1	04	01	H5522_005_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5522	005	0	1	04	01	H5522_005_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5522	005	0	1	04	01	H5522_005_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5522	005	0	1	04	01	H5522_005_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5522	005	0	1	04	01	H5522_005_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5522	013	0	1	04	01	H5522_013_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5522	013	0	1	04	01	H5522_013_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5522	013	0	1	04	01	H5522_013_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5522	013	0	1	04	01	H5522_013_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5522	013	0	1	04	01	H5522_013_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5522	014	0	1	04	01	H5522_014_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5522	014	0	1	04	01	H5522_014_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5522	014	0	1	04	01	H5522_014_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5522	014	0	1	04	01	H5522_014_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5522	014	0	1	04	01	H5522_014_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5522	017	0	1	04	01	H5522_017_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5522	017	0	1	04	01	H5522_017_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5522	017	0	1	04	01	H5522_017_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5522	017	0	1	04	01	H5522_017_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5522	017	0	1	04	01	H5522_017_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5522	022	0	1	04	01	H5522_022_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5522	022	0	1	04	01	H5522_022_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5522	022	0	1	04	01	H5522_022_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5522	022	0	1	04	01	H5522_022_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5522	022	0	1	04	01	H5522_022_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5522	028	0	1	04	01	H5522_028_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5522	028	0	1	04	01	H5522_028_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5522	028	0	1	04	01	H5522_028_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5522	028	0	1	04	01	H5522_028_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5522	028	0	1	04	01	H5522_028_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5522	029	0	1	04	01	H5522_029_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5522	029	0	1	04	01	H5522_029_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5522	029	0	1	04	01	H5522_029_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5522	029	0	1	04	01	H5522_029_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5522	029	0	1	04	01	H5522_029_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5522	032	0	1	04	01	H5522_032_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5522	032	0	1	04	01	H5522_032_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5522	032	0	1	04	01	H5522_032_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5522	032	0	1	04	01	H5522_032_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5522	032	0	1	04	01	H5522_032_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5525	004	0	1	04	01	H5525_004_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5525	004	0	1	04	01	H5525_004_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5525	004	0	1	04	01	H5525_004_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5525	004	0	1	04	01	H5525_004_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5525	004	0	1	04	01	H5525_004_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5525	005	0	1	04	01	H5525_005_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5525	005	0	1	04	01	H5525_005_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5525	005	0	1	04	01	H5525_005_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5525	005	0	1	04	01	H5525_005_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5525	005	0	1	04	01	H5525_005_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5525	006	0	1	04	01	H5525_006_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5525	006	0	1	04	01	H5525_006_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5525	006	0	1	04	01	H5525_006_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5525	006	0	1	04	01	H5525_006_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5525	006	0	1	04	01	H5525_006_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5525	008	0	1	04	01	H5525_008_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5525	008	0	1	04	01	H5525_008_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5525	008	0	1	04	01	H5525_008_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5525	008	0	1	04	01	H5525_008_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5525	008	0	1	04	01	H5525_008_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5525	030	0	1	04	01	H5525_030_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5525	030	0	1	04	01	H5525_030_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5525	030	0	1	04	01	H5525_030_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5525	030	0	1	04	01	H5525_030_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5525	030	0	1	04	01	H5525_030_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5525	034	0	1	04	01	H5525_034_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5525	034	0	1	04	01	H5525_034_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5525	034	0	1	04	01	H5525_034_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5525	034	0	1	04	01	H5525_034_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5525	034	0	1	04	01	H5525_034_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5525	035	0	1	04	01	H5525_035_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5525	035	0	1	04	01	H5525_035_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5525	035	0	1	04	01	H5525_035_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5525	035	0	1	04	01	H5525_035_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5525	035	0	1	04	01	H5525_035_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5525	036	0	1	04	01	H5525_036_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5525	036	0	1	04	01	H5525_036_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5525	036	0	1	04	01	H5525_036_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5525	036	0	1	04	01	H5525_036_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5525	036	0	1	04	01	H5525_036_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5525	041	0	1	04	01	H5525_041_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5525	041	0	1	04	01	H5525_041_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5525	041	0	1	04	01	H5525_041_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5525	041	0	1	04	01	H5525_041_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5525	041	0	1	04	01	H5525_041_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5525	042	0	1	04	01	H5525_042_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5525	042	0	1	04	01	H5525_042_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5525	042	0	1	04	01	H5525_042_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5525	042	0	1	04	01	H5525_042_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5525	042	0	1	04	01	H5525_042_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5525	045	0	1	04	01	H5525_045_0	3		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5525	045	0	1	04	01	H5525_045_0	3		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5525	045	0	1	04	01	H5525_045_0	3		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5525	045	0	1	04	01	H5525_045_0	3		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5525	045	0	1	04	01	H5525_045_0	3		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5525	046	0	1	04	01	H5525_046_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5525	046	0	1	04	01	H5525_046_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5525	046	0	1	04	01	H5525_046_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5525	046	0	1	04	01	H5525_046_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5525	046	0	1	04	01	H5525_046_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5525	049	0	1	04	01	H5525_049_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5525	049	0	1	04	01	H5525_049_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5525	049	0	1	04	01	H5525_049_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5525	049	0	1	04	01	H5525_049_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5525	049	0	1	04	01	H5525_049_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5525	050	0	1	04	01	H5525_050_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5525	050	0	1	04	01	H5525_050_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5525	050	0	1	04	01	H5525_050_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5525	050	0	1	04	01	H5525_050_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5525	050	0	1	04	01	H5525_050_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5525	051	1	1	04	01	H5525_051_1	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5525	051	1	1	04	01	H5525_051_1	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5525	051	1	1	04	01	H5525_051_1	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5525	051	1	1	04	01	H5525_051_1	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5525	051	1	1	04	01	H5525_051_1	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5525	051	2	1	04	01	H5525_051_2	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5525	051	2	1	04	01	H5525_051_2	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5525	051	2	1	04	01	H5525_051_2	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5525	051	2	1	04	01	H5525_051_2	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5525	051	2	1	04	01	H5525_051_2	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5525	054	0	1	04	01	H5525_054_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5525	054	0	1	04	01	H5525_054_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5525	054	0	1	04	01	H5525_054_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5525	054	0	1	04	01	H5525_054_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5525	054	0	1	04	01	H5525_054_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5525	056	0	1	04	01	H5525_056_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5525	056	0	1	04	01	H5525_056_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5525	056	0	1	04	01	H5525_056_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5525	056	0	1	04	01	H5525_056_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5525	056	0	1	04	01	H5525_056_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5525	057	0	1	04	01	H5525_057_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5525	057	0	1	04	01	H5525_057_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5525	057	0	1	04	01	H5525_057_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5525	057	0	1	04	01	H5525_057_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5525	057	0	1	04	01	H5525_057_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5525	059	0	1	04	01	H5525_059_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5525	059	0	1	04	01	H5525_059_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5525	059	0	1	04	01	H5525_059_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5525	059	0	1	04	01	H5525_059_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5525	059	0	1	04	01	H5525_059_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5525	070	0	1	04	01	H5525_070_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5525	070	0	1	04	01	H5525_070_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5525	070	0	1	04	01	H5525_070_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5525	070	0	1	04	01	H5525_070_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5525	070	0	1	04	01	H5525_070_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5525	072	0	1	04	01	H5525_072_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5525	072	0	1	04	01	H5525_072_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5525	072	0	1	04	01	H5525_072_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5525	072	0	1	04	01	H5525_072_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5525	072	0	1	04	01	H5525_072_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5525	074	0	1	04	01	H5525_074_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5525	074	0	1	04	01	H5525_074_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5525	074	0	1	04	01	H5525_074_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5525	074	0	1	04	01	H5525_074_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5525	074	0	1	04	01	H5525_074_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5525	075	0	1	04	01	H5525_075_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5525	075	0	1	04	01	H5525_075_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5525	075	0	1	04	01	H5525_075_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5525	075	0	1	04	01	H5525_075_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5525	075	0	1	04	01	H5525_075_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5525	077	0	1	04	01	H5525_077_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5525	077	0	1	04	01	H5525_077_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5525	077	0	1	04	01	H5525_077_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5525	077	0	1	04	01	H5525_077_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5525	077	0	1	04	01	H5525_077_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5525	080	0	1	04	01	H5525_080_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5525	080	0	1	04	01	H5525_080_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5525	080	0	1	04	01	H5525_080_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5525	080	0	1	04	01	H5525_080_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5525	080	0	1	04	01	H5525_080_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5525	083	0	1	04	01	H5525_083_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5525	083	0	1	04	01	H5525_083_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5525	083	0	1	04	01	H5525_083_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5525	083	0	1	04	01	H5525_083_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5525	083	0	1	04	01	H5525_083_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5525	084	0	1	04	01	H5525_084_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5525	084	0	1	04	01	H5525_084_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5525	084	0	1	04	01	H5525_084_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5525	084	0	1	04	01	H5525_084_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5525	084	0	1	04	01	H5525_084_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5525	085	1	1	04	01	H5525_085_1	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5525	085	1	1	04	01	H5525_085_1	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5525	085	1	1	04	01	H5525_085_1	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5525	085	1	1	04	01	H5525_085_1	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5525	085	1	1	04	01	H5525_085_1	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5525	085	2	1	04	01	H5525_085_2	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5525	085	2	1	04	01	H5525_085_2	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5525	085	2	1	04	01	H5525_085_2	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5525	085	2	1	04	01	H5525_085_2	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5525	085	2	1	04	01	H5525_085_2	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5525	086	1	1	04	01	H5525_086_1	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5525	086	1	1	04	01	H5525_086_1	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5525	086	1	1	04	01	H5525_086_1	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5525	086	1	1	04	01	H5525_086_1	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5525	086	1	1	04	01	H5525_086_1	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5525	086	2	1	04	01	H5525_086_2	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5525	086	2	1	04	01	H5525_086_2	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5525	086	2	1	04	01	H5525_086_2	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5525	086	2	1	04	01	H5525_086_2	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5525	086	2	1	04	01	H5525_086_2	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5525	087	0	1	04	01	H5525_087_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5525	087	0	1	04	01	H5525_087_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5525	087	0	1	04	01	H5525_087_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5525	087	0	1	04	01	H5525_087_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5525	087	0	1	04	01	H5525_087_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5526	004	0	1	04	01	H5526_004_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5526	004	0	1	04	01	H5526_004_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5526	004	0	1	04	01	H5526_004_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5526	004	0	1	04	01	H5526_004_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5526	004	0	1	04	01	H5526_004_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5526	016	0	1	04	01	H5526_016_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5526	016	0	1	04	01	H5526_016_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5526	016	0	1	04	01	H5526_016_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5526	016	0	1	04	01	H5526_016_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5526	016	0	1	04	01	H5526_016_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5526	018	0	1	04	01	H5526_018_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5526	018	0	1	04	01	H5526_018_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5526	018	0	1	04	01	H5526_018_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5526	018	0	1	04	01	H5526_018_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5526	018	0	1	04	01	H5526_018_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5533	003	0	1	04	01	H5533_003_0	15			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5533	003	0	1	04	01	H5533_003_0	15			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5533	003	0	1	04	01	H5533_003_0	15			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5533	003	0	1	04	01	H5533_003_0	15			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5533	003	0	1	04	01	H5533_003_0	15			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5533	005	0	1	04	01	H5533_005_0	15			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5533	005	0	1	04	01	H5533_005_0	15			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5533	005	0	1	04	01	H5533_005_0	15			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5533	005	0	1	04	01	H5533_005_0	15			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5533	005	0	1	04	01	H5533_005_0	15			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5533	008	0	1	04	01	H5533_008_0	16			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5533	008	0	1	04	01	H5533_008_0	16			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5533	008	0	1	04	01	H5533_008_0	16			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5533	008	0	1	04	01	H5533_008_0	16			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5533	008	0	1	04	01	H5533_008_0	16			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5533	011	0	1	04	01	H5533_011_0	17			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5533	011	0	1	04	01	H5533_011_0	17			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5533	011	0	1	04	01	H5533_011_0	17			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5533	011	0	1	04	01	H5533_011_0	17			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5533	011	0	1	04	01	H5533_011_0	17			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5533	013	0	1	04	01	H5533_013_0	18			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5533	013	0	1	04	01	H5533_013_0	18			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5533	013	0	1	04	01	H5533_013_0	18			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5533	013	0	1	04	01	H5533_013_0	18			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5533	013	0	1	04	01	H5533_013_0	18			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5533	015	1	1	04	01	H5533_015_1	17			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5533	015	1	1	04	01	H5533_015_1	17			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5533	015	1	1	04	01	H5533_015_1	17			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5533	015	1	1	04	01	H5533_015_1	17			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5533	015	1	1	04	01	H5533_015_1	17			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5533	015	2	1	04	01	H5533_015_2	17			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5533	015	2	1	04	01	H5533_015_2	17			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5533	015	2	1	04	01	H5533_015_2	17			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5533	015	2	1	04	01	H5533_015_2	17			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5533	015	2	1	04	01	H5533_015_2	17			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5533	015	3	1	04	01	H5533_015_3	17			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5533	015	3	1	04	01	H5533_015_3	17			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5533	015	3	1	04	01	H5533_015_3	17			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5533	015	3	1	04	01	H5533_015_3	17			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5533	015	3	1	04	01	H5533_015_3	17			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5533	015	4	1	04	01	H5533_015_4	15			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5533	015	4	1	04	01	H5533_015_4	15			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5533	015	4	1	04	01	H5533_015_4	15			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5533	015	4	1	04	01	H5533_015_4	15			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5533	015	4	1	04	01	H5533_015_4	15			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5533	015	6	1	04	01	H5533_015_6	16			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5533	015	6	1	04	01	H5533_015_6	16			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5533	015	6	1	04	01	H5533_015_6	16			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5533	015	6	1	04	01	H5533_015_6	16			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5533	015	6	1	04	01	H5533_015_6	16			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5533	017	1	1	04	01	H5533_017_1	15			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5533	017	1	1	04	01	H5533_017_1	15			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5533	017	1	1	04	01	H5533_017_1	15			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5533	017	1	1	04	01	H5533_017_1	15			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5533	017	1	1	04	01	H5533_017_1	15			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5533	017	2	1	04	01	H5533_017_2	15			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5533	017	2	1	04	01	H5533_017_2	15			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5533	017	2	1	04	01	H5533_017_2	15			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5533	017	2	1	04	01	H5533_017_2	15			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5533	017	2	1	04	01	H5533_017_2	15			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5549	011	0	1	01	01	H5549_011_0	5		N	Generic	4	Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5549	011	0	1	01	01	H5549_011_0	5		N	Preferred Brand	4	Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	2	2	10	1	2	0.00	
H5549	011	0	1	01	01	H5549_011_0	5		N	Non-Preferred Brand	4	Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H5549	011	0	1	01	01	H5549_011_0	5		N	Specialty Tier	4	Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5549	011	0	1	01	01	H5549_011_0	5		N	Select Care Drugs	4	Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5549	012	0	1	01	01	H5549_012_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5549	012	0	1	01	01	H5549_012_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H5549	012	0	1	01	01	H5549_012_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H5549	012	0	1	01	01	H5549_012_0	6			Non-Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	4	2	10	1	2	0.00	
H5549	012	0	1	01	01	H5549_012_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5549	012	0	1	01	01	H5549_012_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5577	005	0	1	01	01	H5577_005_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5577	005	0	1	01	01	H5577_005_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H5577	005	0	1	01	01	H5577_005_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H5577	005	0	1	01	01	H5577_005_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5577	005	0	1	01	01	H5577_005_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5577	008	0	1	02	01	H5577_008_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5577	008	0	1	02	01	H5577_008_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H5577	008	0	1	02	01	H5577_008_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H5577	008	0	1	02	01	H5577_008_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5577	008	0	1	02	01	H5577_008_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5577	038	0	1	01	01	H5577_038_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5577	038	0	1	01	01	H5577_038_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H5577	038	0	1	01	01	H5577_038_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H5577	038	0	1	01	01	H5577_038_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5577	038	0	1	01	01	H5577_038_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5577	042	0	1	01	01	H5577_042_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5577	042	0	1	01	01	H5577_042_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H5577	042	0	1	01	01	H5577_042_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H5577	042	0	1	01	01	H5577_042_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5577	042	0	1	01	01	H5577_042_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5577	043	0	1	01	01	H5577_043_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5577	043	0	1	01	01	H5577_043_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H5577	043	0	1	01	01	H5577_043_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H5577	043	0	1	01	01	H5577_043_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5577	043	0	1	01	01	H5577_043_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5577	044	0	1	01	01	H5577_044_0	10			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5577	044	0	1	01	01	H5577_044_0	10			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H5577	044	0	1	01	01	H5577_044_0	10			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H5577	044	0	1	01	01	H5577_044_0	10			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5577	044	0	1	01	01	H5577_044_0	10			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5577	052	0	1	01	01	H5577_052_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5577	052	0	1	01	01	H5577_052_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H5577	052	0	1	01	01	H5577_052_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H5577	052	0	1	01	01	H5577_052_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5577	052	0	1	01	01	H5577_052_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5577	056	1	1	01	01	H5577_056_1	10			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5577	056	1	1	01	01	H5577_056_1	10			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H5577	056	1	1	01	01	H5577_056_1	10			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H5577	056	1	1	01	01	H5577_056_1	10			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5577	056	1	1	01	01	H5577_056_1	10			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5577	056	2	1	01	01	H5577_056_2	10			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5577	056	2	1	01	01	H5577_056_2	10			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H5577	056	2	1	01	01	H5577_056_2	10			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H5577	056	2	1	01	01	H5577_056_2	10			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5577	056	2	1	01	01	H5577_056_2	10			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5577	056	4	1	01	01	H5577_056_4	10			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5577	056	4	1	01	01	H5577_056_4	10			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H5577	056	4	1	01	01	H5577_056_4	10			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H5577	056	4	1	01	01	H5577_056_4	10			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5577	056	4	1	01	01	H5577_056_4	10			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5577	059	0	1	01	01	H5577_059_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5577	059	0	1	01	01	H5577_059_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H5577	059	0	1	01	01	H5577_059_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H5577	059	0	1	01	01	H5577_059_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5577	059	0	1	01	01	H5577_059_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5577	060	0	1	01	01	H5577_060_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5577	060	0	1	01	01	H5577_060_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H5577	060	0	1	01	01	H5577_060_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H5577	060	0	1	01	01	H5577_060_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5577	060	0	1	01	01	H5577_060_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5590	008	0	1	01	01	H5590_008_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5590	008	0	1	01	01	H5590_008_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5590	008	0	1	01	01	H5590_008_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5590	008	0	1	01	01	H5590_008_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5590	008	0	1	01	01	H5590_008_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5590	008	0	1	01	01	H5590_008_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5590	010	0	1	01	01	H5590_010_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5590	010	0	1	01	01	H5590_010_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5590	010	0	1	01	01	H5590_010_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5590	010	0	1	01	01	H5590_010_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5590	010	0	1	01	01	H5590_010_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5590	010	0	1	01	01	H5590_010_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5591	006	1	1	02	01	H5591_006_1	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5591	006	1	1	02	01	H5591_006_1	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H5591	006	1	1	02	01	H5591_006_1	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H5591	006	1	1	02	01	H5591_006_1	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5591	006	1	1	02	01	H5591_006_1	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5591	006	1	1	02	01	H5591_006_1	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5591	006	2	1	02	01	H5591_006_2	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5591	006	2	1	02	01	H5591_006_2	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H5591	006	2	1	02	01	H5591_006_2	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H5591	006	2	1	02	01	H5591_006_2	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5591	006	2	1	02	01	H5591_006_2	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5591	006	2	1	02	01	H5591_006_2	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5591	016	0	1	02	01	H5591_016_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5591	016	0	1	02	01	H5591_016_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H5591	016	0	1	02	01	H5591_016_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H5591	016	0	1	02	01	H5591_016_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5591	016	0	1	02	01	H5591_016_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5591	016	0	1	02	01	H5591_016_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5591	017	0	1	02	01	H5591_017_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5591	017	0	1	02	01	H5591_017_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H5591	017	0	1	02	01	H5591_017_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H5591	017	0	1	02	01	H5591_017_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5591	017	0	1	02	01	H5591_017_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5591	017	0	1	02	01	H5591_017_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5591	018	0	1	02	01	H5591_018_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5591	018	0	1	02	01	H5591_018_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5591	018	0	1	02	01	H5591_018_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H5591	018	0	1	02	01	H5591_018_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5591	018	0	1	02	01	H5591_018_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5593	001	0	1	01	01	H5593_001_0	3		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5593	001	0	1	01	01	H5593_001_0	3		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5593	001	0	1	01	01	H5593_001_0	3		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5593	001	0	1	01	01	H5593_001_0	3		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5593	001	0	1	01	01	H5593_001_0	3		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5594	001	0	1	01	01	H5594_001_0	5			Preferred Generic	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5594	001	0	1	01	01	H5594_001_0	5			Preferred Brand	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	30.00	
H5594	001	0	1	01	01	H5594_001_0	5			Non-Preferred Drug	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	3	2	75.00	
H5594	001	0	1	01	01	H5594_001_0	5			Specialty Tier	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5594	002	0	1	01	01	H5594_002_0	5			Preferred Generic	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5594	002	0	1	01	01	H5594_002_0	5			Preferred Brand	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	5.00	
H5594	002	0	1	01	01	H5594_002_0	5			Non-Preferred Drug	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	3	2	55.00	
H5594	002	0	1	01	01	H5594_002_0	5			Specialty Tier	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5594	016	0	1	01	01	H5594_016_0	7		N	Preferred Generic	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5594	016	0	1	01	01	H5594_016_0	7		N	Preferred Brand	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5594	016	0	1	01	01	H5594_016_0	7		N	Non-Preferred Drug	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5594	016	0	1	01	01	H5594_016_0	7		N	Specialty Tier	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5594	016	0	1	01	01	H5594_016_0	7		N	Supplemental Drugs	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	2	2	0.00	
H5594	017	0	1	01	01	H5594_017_0	7		N	Preferred Generic	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H5594	017	0	1	01	01	H5594_017_0	7		N	Preferred Brand	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H5594	017	0	1	01	01	H5594_017_0	7		N	Non-Preferred Drug	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H5594	017	0	1	01	01	H5594_017_0	7		N	Specialty Tier	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H5594	017	0	1	01	01	H5594_017_0	7		N	Supplemental Drugs	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	2	2	0.00	
H5594	019	0	1	01	01	H5594_019_0	4			Preferred Generic	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5594	019	0	1	01	01	H5594_019_0	4			Preferred Brand	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	10.00	
H5594	019	0	1	01	01	H5594_019_0	4			Non-Preferred Drug	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	3	2	55.00	
H5594	019	0	1	01	01	H5594_019_0	4			Specialty Tier	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5594	022	0	1	01	01	H5594_022_0	5			Preferred Generic	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5594	022	0	1	01	01	H5594_022_0	5			Preferred Brand	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	10.00	
H5594	022	0	1	01	01	H5594_022_0	5			Non-Preferred Drug	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	3	2	75.00	
H5594	022	0	1	01	01	H5594_022_0	5			Specialty Tier	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5594	026	0	1	01	01	H5594_026_0	4			Preferred Generic	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5594	026	0	1	01	01	H5594_026_0	4			Preferred Brand	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	10.00	
H5594	026	0	1	01	01	H5594_026_0	4			Non-Preferred Drug	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	3	2	55.00	
H5594	026	0	1	01	01	H5594_026_0	4			Specialty Tier	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5594	028	0	1	01	01	H5594_028_0	6			Preferred Generic	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	1	2	11	3	2	0.00	
H5594	028	0	1	01	01	H5594_028_0	6			Preferred Brand	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	2	2	11	3	2	15.00	
H5594	028	0	1	01	01	H5594_028_0	6			Non-Preferred Drug	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	3	2	11	3	2	60.00	
H5594	028	0	1	01	01	H5594_028_0	6			Specialty Tier	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	4	2	11	1	2	0.00	
H5594	028	0	1	01	01	H5594_028_0	6			Select Diabetic Drugs	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	5	2	11	1	2	0.00	
H5594	029	0	1	01	01	H5594_029_0	6			Preferred Generic	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5594	029	0	1	01	01	H5594_029_0	6			Preferred Brand	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	10.00	
H5594	029	0	1	01	01	H5594_029_0	6			Non-Preferred Drug	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	3	2	50.00	
H5594	029	0	1	01	01	H5594_029_0	6			Specialty Tier	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5594	030	0	1	01	01	H5594_030_0	5			Preferred Generic	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	1	2	11	3	2	0.00	
H5594	030	0	1	01	01	H5594_030_0	5			Preferred Brand	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	2	2	11	3	2	35.00	
H5594	030	0	1	01	01	H5594_030_0	5			Non-Preferred Drug	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	3	2	11	3	2	90.00	
H5594	030	0	1	01	01	H5594_030_0	5			Specialty Tier	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	4	2	11	1	2	0.00	
H5594	030	0	1	01	01	H5594_030_0	5			Select Diabetic Drugs	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	5	2	11	1	2	0.00	
H5594	031	0	1	01	01	H5594_031_0	5			Preferred Generic	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5594	031	0	1	01	01	H5594_031_0	5			Preferred Brand	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	35.00	
H5594	031	0	1	01	01	H5594_031_0	5			Non-Preferred Drug	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	3	2	90.00	
H5594	031	0	1	01	01	H5594_031_0	5			Specialty Tier	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5594	032	0	1	01	01	H5594_032_0	5			Preferred Generic	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5594	032	0	1	01	01	H5594_032_0	5			Preferred Brand	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	10.00	
H5594	032	0	1	01	01	H5594_032_0	5			Non-Preferred Drug	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	3	2	55.00	
H5594	032	0	1	01	01	H5594_032_0	5			Specialty Tier	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5594	034	0	1	01	01	H5594_034_0	5			Preferred Generic	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	1	2	11	3	2	0.00	
H5594	034	0	1	01	01	H5594_034_0	5			Preferred Brand	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	2	2	11	3	2	47.00	
H5594	034	0	1	01	01	H5594_034_0	5			Non-Preferred Drug	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	3	2	11	3	2	100.00	
H5594	034	0	1	01	01	H5594_034_0	5			Specialty Tier	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	4	2	11	1	2	0.00	
H5594	034	0	1	01	01	H5594_034_0	5			Select Diabetic Drugs	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	5	2	11	1	2	0.00	
H5594	035	0	1	01	01	H5594_035_0	5			Preferred Generic	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5594	035	0	1	01	01	H5594_035_0	5			Preferred Brand	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	47.00	
H5594	035	0	1	01	01	H5594_035_0	5			Non-Preferred Drug	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	3	2	100.00	
H5594	035	0	1	01	01	H5594_035_0	5			Specialty Tier	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5594	036	0	1	01	01	H5594_036_0	6			Preferred Generic	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	1	2	11	3	2	0.00	
H5594	036	0	1	01	01	H5594_036_0	6			Preferred Brand	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	2	2	11	3	2	5.00	
H5594	036	0	1	01	01	H5594_036_0	6			Non-Preferred Drug	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	3	2	11	3	2	45.00	
H5594	036	0	1	01	01	H5594_036_0	6			Specialty Tier	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	4	2	11	1	2	0.00	
H5594	036	0	1	01	01	H5594_036_0	6			Select Diabetic Drugs	4	Preferred Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	5	2	11	1	2	0.00	
H5599	002	0	1	02	01	H5599_002_0	9			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5599	002	0	1	02	01	H5599_002_0	9			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5599	002	0	1	02	01	H5599_002_0	9			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5599	002	0	1	02	01	H5599_002_0	9			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5599	002	0	1	02	01	H5599_002_0	9			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5599	002	0	1	02	01	H5599_002_0	9			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5599	003	0	1	01	01	H5599_003_0	9		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5599	003	0	1	01	01	H5599_003_0	9		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5599	003	0	1	01	01	H5599_003_0	9		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5599	003	0	1	01	01	H5599_003_0	9		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5599	003	0	1	01	01	H5599_003_0	9		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5599	003	0	1	01	01	H5599_003_0	9		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5599	004	0	1	02	01	H5599_004_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H5599	004	0	1	02	01	H5599_004_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5599	004	0	1	02	01	H5599_004_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5599	004	0	1	02	01	H5599_004_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5599	004	0	1	02	01	H5599_004_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5599	004	0	1	02	01	H5599_004_0	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5599	013	1	1	01	01	H5599_013_1	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5599	013	1	1	01	01	H5599_013_1	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5599	013	1	1	01	01	H5599_013_1	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5599	013	1	1	01	01	H5599_013_1	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5599	013	1	1	01	01	H5599_013_1	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5599	013	1	1	01	01	H5599_013_1	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5599	013	2	1	01	01	H5599_013_2	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5599	013	2	1	01	01	H5599_013_2	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5599	013	2	1	01	01	H5599_013_2	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5599	013	2	1	01	01	H5599_013_2	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5599	013	2	1	01	01	H5599_013_2	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5599	013	2	1	01	01	H5599_013_2	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5608	002	0	1	01	01	H5608_002_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5608	002	0	1	01	01	H5608_002_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H5608	002	0	1	01	01	H5608_002_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H5608	002	0	1	01	01	H5608_002_0	7			Non-Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	4	2	10	1	2	0.00	
H5608	002	0	1	01	01	H5608_002_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5608	002	0	1	01	01	H5608_002_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5619	001	0	1	01	01	H5619_001_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5619	001	0	1	01	01	H5619_001_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5619	001	0	1	01	01	H5619_001_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5619	001	0	1	01	01	H5619_001_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5619	001	0	1	01	01	H5619_001_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5619	003	0	1	01	01	H5619_003_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5619	003	0	1	01	01	H5619_003_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5619	003	0	1	01	01	H5619_003_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5619	003	0	1	01	01	H5619_003_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5619	003	0	1	01	01	H5619_003_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5619	012	0	1	01	01	H5619_012_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5619	012	0	1	01	01	H5619_012_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5619	012	0	1	01	01	H5619_012_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5619	012	0	1	01	01	H5619_012_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5619	012	0	1	01	01	H5619_012_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5619	015	0	1	01	01	H5619_015_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5619	015	0	1	01	01	H5619_015_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5619	015	0	1	01	01	H5619_015_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5619	015	0	1	01	01	H5619_015_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5619	015	0	1	01	01	H5619_015_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5619	016	0	1	01	01	H5619_016_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5619	016	0	1	01	01	H5619_016_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5619	016	0	1	01	01	H5619_016_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5619	016	0	1	01	01	H5619_016_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5619	016	0	1	01	01	H5619_016_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5619	021	0	1	01	01	H5619_021_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5619	021	0	1	01	01	H5619_021_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5619	021	0	1	01	01	H5619_021_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5619	021	0	1	01	01	H5619_021_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5619	021	0	1	01	01	H5619_021_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5619	026	0	1	01	01	H5619_026_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5619	026	0	1	01	01	H5619_026_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5619	026	0	1	01	01	H5619_026_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5619	026	0	1	01	01	H5619_026_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5619	026	0	1	01	01	H5619_026_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5619	038	0	1	01	01	H5619_038_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5619	038	0	1	01	01	H5619_038_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5619	038	0	1	01	01	H5619_038_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5619	038	0	1	01	01	H5619_038_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5619	038	0	1	01	01	H5619_038_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5619	046	0	1	01	01	H5619_046_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5619	046	0	1	01	01	H5619_046_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5619	046	0	1	01	01	H5619_046_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5619	046	0	1	01	01	H5619_046_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5619	046	0	1	01	01	H5619_046_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5619	046	0	1	01	01	H5619_046_0	2			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5619	047	0	1	01	01	H5619_047_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5619	047	0	1	01	01	H5619_047_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5619	047	0	1	01	01	H5619_047_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5619	047	0	1	01	01	H5619_047_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5619	047	0	1	01	01	H5619_047_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5619	049	0	1	02	01	H5619_049_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5619	049	0	1	02	01	H5619_049_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5619	049	0	1	02	01	H5619_049_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5619	049	0	1	02	01	H5619_049_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5619	049	0	1	02	01	H5619_049_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5619	051	0	1	02	01	H5619_051_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5619	051	0	1	02	01	H5619_051_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5619	051	0	1	02	01	H5619_051_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5619	051	0	1	02	01	H5619_051_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5619	051	0	1	02	01	H5619_051_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5619	053	0	1	02	01	H5619_053_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5619	053	0	1	02	01	H5619_053_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5619	053	0	1	02	01	H5619_053_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5619	053	0	1	02	01	H5619_053_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5619	053	0	1	02	01	H5619_053_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5619	055	0	1	01	01	H5619_055_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5619	055	0	1	01	01	H5619_055_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5619	055	0	1	01	01	H5619_055_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5619	055	0	1	01	01	H5619_055_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5619	055	0	1	01	01	H5619_055_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5619	055	0	1	01	01	H5619_055_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5619	057	0	1	01	01	H5619_057_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5619	057	0	1	01	01	H5619_057_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5619	057	0	1	01	01	H5619_057_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5619	057	0	1	01	01	H5619_057_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5619	057	0	1	01	01	H5619_057_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5619	059	0	1	01	01	H5619_059_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5619	059	0	1	01	01	H5619_059_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5619	059	0	1	01	01	H5619_059_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5619	059	0	1	01	01	H5619_059_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5619	059	0	1	01	01	H5619_059_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5619	061	0	1	01	01	H5619_061_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5619	061	0	1	01	01	H5619_061_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5619	061	0	1	01	01	H5619_061_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5619	061	0	1	01	01	H5619_061_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5619	061	0	1	01	01	H5619_061_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5619	066	0	1	01	01	H5619_066_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5619	066	0	1	01	01	H5619_066_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5619	066	0	1	01	01	H5619_066_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5619	066	0	1	01	01	H5619_066_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5619	066	0	1	01	01	H5619_066_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5619	069	0	1	02	01	H5619_069_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5619	069	0	1	02	01	H5619_069_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5619	069	0	1	02	01	H5619_069_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5619	069	0	1	02	01	H5619_069_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5619	069	0	1	02	01	H5619_069_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5619	071	0	1	01	01	H5619_071_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5619	071	0	1	01	01	H5619_071_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5619	071	0	1	01	01	H5619_071_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5619	071	0	1	01	01	H5619_071_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5619	071	0	1	01	01	H5619_071_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5619	075	0	1	01	01	H5619_075_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5619	075	0	1	01	01	H5619_075_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5619	075	0	1	01	01	H5619_075_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5619	075	0	1	01	01	H5619_075_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5619	075	0	1	01	01	H5619_075_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5619	083	0	1	01	01	H5619_083_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5619	083	0	1	01	01	H5619_083_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5619	083	0	1	01	01	H5619_083_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5619	083	0	1	01	01	H5619_083_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5619	083	0	1	01	01	H5619_083_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5619	089	0	1	01	01	H5619_089_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5619	089	0	1	01	01	H5619_089_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5619	089	0	1	01	01	H5619_089_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5619	089	0	1	01	01	H5619_089_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5619	089	0	1	01	01	H5619_089_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5619	090	0	1	01	01	H5619_090_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5619	090	0	1	01	01	H5619_090_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5619	090	0	1	01	01	H5619_090_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5619	090	0	1	01	01	H5619_090_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5619	090	0	1	01	01	H5619_090_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5619	091	0	1	01	01	H5619_091_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5619	091	0	1	01	01	H5619_091_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5619	091	0	1	01	01	H5619_091_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5619	091	0	1	01	01	H5619_091_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5619	091	0	1	01	01	H5619_091_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5619	093	0	1	01	01	H5619_093_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5619	093	0	1	01	01	H5619_093_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5619	093	0	1	01	01	H5619_093_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5619	093	0	1	01	01	H5619_093_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5619	093	0	1	01	01	H5619_093_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5619	095	0	1	01	01	H5619_095_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5619	095	0	1	01	01	H5619_095_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5619	095	0	1	01	01	H5619_095_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5619	095	0	1	01	01	H5619_095_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5619	095	0	1	01	01	H5619_095_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5619	111	0	1	02	01	H5619_111_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5619	111	0	1	02	01	H5619_111_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5619	111	0	1	02	01	H5619_111_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5619	111	0	1	02	01	H5619_111_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5619	111	0	1	02	01	H5619_111_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5619	113	0	1	02	01	H5619_113_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5619	113	0	1	02	01	H5619_113_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5619	113	0	1	02	01	H5619_113_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5619	113	0	1	02	01	H5619_113_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5619	113	0	1	02	01	H5619_113_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5619	116	0	1	01	01	H5619_116_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5619	116	0	1	01	01	H5619_116_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5619	116	0	1	01	01	H5619_116_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5619	116	0	1	01	01	H5619_116_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5619	116	0	1	01	01	H5619_116_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5619	119	0	1	01	01	H5619_119_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5619	119	0	1	01	01	H5619_119_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5619	119	0	1	01	01	H5619_119_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5619	119	0	1	01	01	H5619_119_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5619	119	0	1	01	01	H5619_119_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5619	122	0	1	01	01	H5619_122_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5619	122	0	1	01	01	H5619_122_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5619	122	0	1	01	01	H5619_122_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5619	122	0	1	01	01	H5619_122_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5619	122	0	1	01	01	H5619_122_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5619	123	0	1	02	01	H5619_123_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5619	123	0	1	02	01	H5619_123_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5619	123	0	1	02	01	H5619_123_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5619	123	0	1	02	01	H5619_123_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5619	123	0	1	02	01	H5619_123_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5619	126	0	1	02	01	H5619_126_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5619	126	0	1	02	01	H5619_126_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5619	126	0	1	02	01	H5619_126_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5619	126	0	1	02	01	H5619_126_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5619	126	0	1	02	01	H5619_126_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5619	133	0	1	01	01	H5619_133_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5619	133	0	1	01	01	H5619_133_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5619	133	0	1	01	01	H5619_133_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5619	133	0	1	01	01	H5619_133_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5619	133	0	1	01	01	H5619_133_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5619	135	0	1	01	01	H5619_135_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5619	135	0	1	01	01	H5619_135_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5619	135	0	1	01	01	H5619_135_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5619	135	0	1	01	01	H5619_135_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5619	135	0	1	01	01	H5619_135_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5619	137	0	1	01	01	H5619_137_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5619	137	0	1	01	01	H5619_137_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5619	137	0	1	01	01	H5619_137_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5619	137	0	1	01	01	H5619_137_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5619	137	0	1	01	01	H5619_137_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5619	143	0	1	01	01	H5619_143_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5619	143	0	1	01	01	H5619_143_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5619	143	0	1	01	01	H5619_143_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5619	143	0	1	01	01	H5619_143_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5619	143	0	1	01	01	H5619_143_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5619	145	0	1	01	01	H5619_145_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5619	145	0	1	01	01	H5619_145_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5619	145	0	1	01	01	H5619_145_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5619	145	0	1	01	01	H5619_145_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5619	145	0	1	01	01	H5619_145_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5619	145	0	1	01	01	H5619_145_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5619	146	0	1	01	01	H5619_146_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5619	146	0	1	01	01	H5619_146_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5619	146	0	1	01	01	H5619_146_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5619	146	0	1	01	01	H5619_146_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5619	146	0	1	01	01	H5619_146_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5619	147	0	1	01	01	H5619_147_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5619	147	0	1	01	01	H5619_147_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5619	147	0	1	01	01	H5619_147_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5619	147	0	1	01	01	H5619_147_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5619	147	0	1	01	01	H5619_147_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5619	148	0	1	01	01	H5619_148_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5619	148	0	1	01	01	H5619_148_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5619	148	0	1	01	01	H5619_148_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5619	148	0	1	01	01	H5619_148_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5619	148	0	1	01	01	H5619_148_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5619	150	0	1	01	01	H5619_150_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5619	150	0	1	01	01	H5619_150_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5619	150	0	1	01	01	H5619_150_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5619	150	0	1	01	01	H5619_150_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5619	150	0	1	01	01	H5619_150_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5619	152	0	1	01	01	H5619_152_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5619	152	0	1	01	01	H5619_152_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5619	152	0	1	01	01	H5619_152_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5619	152	0	1	01	01	H5619_152_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5619	152	0	1	01	01	H5619_152_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5619	157	0	1	01	01	H5619_157_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5619	157	0	1	01	01	H5619_157_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5619	157	0	1	01	01	H5619_157_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5619	157	0	1	01	01	H5619_157_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5619	157	0	1	01	01	H5619_157_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5619	159	0	1	01	01	H5619_159_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5619	159	0	1	01	01	H5619_159_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5619	159	0	1	01	01	H5619_159_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5619	159	0	1	01	01	H5619_159_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5619	159	0	1	01	01	H5619_159_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5619	161	0	1	01	01	H5619_161_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H5619	161	0	1	01	01	H5619_161_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5619	161	0	1	01	01	H5619_161_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5619	161	0	1	01	01	H5619_161_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5619	161	0	1	01	01	H5619_161_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5619	161	0	1	01	01	H5619_161_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5619	162	0	1	02	01	H5619_162_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5619	162	0	1	02	01	H5619_162_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5619	162	0	1	02	01	H5619_162_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5619	162	0	1	02	01	H5619_162_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5619	162	0	1	02	01	H5619_162_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5619	163	0	1	01	01	H5619_163_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5619	163	0	1	01	01	H5619_163_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5619	163	0	1	01	01	H5619_163_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5619	163	0	1	01	01	H5619_163_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5619	163	0	1	01	01	H5619_163_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5619	165	0	1	01	01	H5619_165_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5619	165	0	1	01	01	H5619_165_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5619	165	0	1	01	01	H5619_165_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5619	165	0	1	01	01	H5619_165_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5619	165	0	1	01	01	H5619_165_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5619	166	0	1	01	01	H5619_166_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5619	166	0	1	01	01	H5619_166_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5619	166	0	1	01	01	H5619_166_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5619	166	0	1	01	01	H5619_166_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5619	166	0	1	01	01	H5619_166_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5619	167	0	1	01	01	H5619_167_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5619	167	0	1	01	01	H5619_167_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5619	167	0	1	01	01	H5619_167_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5619	167	0	1	01	01	H5619_167_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5619	167	0	1	01	01	H5619_167_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5619	169	0	1	01	01	H5619_169_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5619	169	0	1	01	01	H5619_169_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5619	169	0	1	01	01	H5619_169_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5619	169	0	1	01	01	H5619_169_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5619	169	0	1	01	01	H5619_169_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5619	170	0	1	01	01	H5619_170_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5619	170	0	1	01	01	H5619_170_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5619	170	0	1	01	01	H5619_170_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5619	170	0	1	01	01	H5619_170_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5619	170	0	1	01	01	H5619_170_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5619	170	0	1	01	01	H5619_170_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5619	171	0	1	01	01	H5619_171_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5619	171	0	1	01	01	H5619_171_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5619	171	0	1	01	01	H5619_171_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5619	171	0	1	01	01	H5619_171_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5619	171	0	1	01	01	H5619_171_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5619	173	0	1	01	01	H5619_173_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5619	173	0	1	01	01	H5619_173_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5619	173	0	1	01	01	H5619_173_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5619	173	0	1	01	01	H5619_173_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5619	173	0	1	01	01	H5619_173_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5619	174	0	1	01	01	H5619_174_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5619	174	0	1	01	01	H5619_174_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5619	174	0	1	01	01	H5619_174_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5619	174	0	1	01	01	H5619_174_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5619	174	0	1	01	01	H5619_174_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5619	177	0	1	01	01	H5619_177_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5619	177	0	1	01	01	H5619_177_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5619	177	0	1	01	01	H5619_177_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5619	177	0	1	01	01	H5619_177_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5619	177	0	1	01	01	H5619_177_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5619	178	0	1	01	01	H5619_178_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5619	178	0	1	01	01	H5619_178_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5619	178	0	1	01	01	H5619_178_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5619	178	0	1	01	01	H5619_178_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5619	178	0	1	01	01	H5619_178_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5619	179	0	1	02	01	H5619_179_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5619	179	0	1	02	01	H5619_179_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5619	179	0	1	02	01	H5619_179_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5619	179	0	1	02	01	H5619_179_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5619	179	0	1	02	01	H5619_179_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5619	180	0	1	01	01	H5619_180_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5619	180	0	1	01	01	H5619_180_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5619	180	0	1	01	01	H5619_180_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5619	180	0	1	01	01	H5619_180_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5619	180	0	1	01	01	H5619_180_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5619	181	0	1	01	01	H5619_181_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H5619	181	0	1	01	01	H5619_181_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5619	181	0	1	01	01	H5619_181_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5619	181	0	1	01	01	H5619_181_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5619	181	0	1	01	01	H5619_181_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5619	181	0	1	01	01	H5619_181_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5619	182	0	1	01	01	H5619_182_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5619	182	0	1	01	01	H5619_182_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5619	182	0	1	01	01	H5619_182_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5619	182	0	1	01	01	H5619_182_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5619	182	0	1	01	01	H5619_182_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5619	183	0	1	01	01	H5619_183_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5619	183	0	1	01	01	H5619_183_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5619	183	0	1	01	01	H5619_183_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5619	183	0	1	01	01	H5619_183_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5619	183	0	1	01	01	H5619_183_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5619	184	0	1	01	01	H5619_184_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5619	184	0	1	01	01	H5619_184_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5619	184	0	1	01	01	H5619_184_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5619	184	0	1	01	01	H5619_184_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5619	184	0	1	01	01	H5619_184_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5628	001	0	1	01	01	H5628_001_0	8		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5628	001	0	1	01	01	H5628_001_0	8		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5628	001	0	1	01	01	H5628_001_0	8		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5628	001	0	1	01	01	H5628_001_0	8		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5628	001	0	1	01	01	H5628_001_0	8		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5628	001	0	1	01	01	H5628_001_0	8		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5628	012	0	1	01	01	H5628_012_0	8		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5628	012	0	1	01	01	H5628_012_0	8		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5628	012	0	1	01	01	H5628_012_0	8		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5628	012	0	1	01	01	H5628_012_0	8		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5628	012	0	1	01	01	H5628_012_0	8		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5628	012	0	1	01	01	H5628_012_0	8		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5628	013	1	1	01	01	H5628_013_1	9		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5628	013	1	1	01	01	H5628_013_1	9		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5628	013	1	1	01	01	H5628_013_1	9		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5628	013	1	1	01	01	H5628_013_1	9		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5628	013	1	1	01	01	H5628_013_1	9		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5628	013	1	1	01	01	H5628_013_1	9		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5628	013	2	1	01	01	H5628_013_2	9		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5628	013	2	1	01	01	H5628_013_2	9		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5628	013	2	1	01	01	H5628_013_2	9		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5628	013	2	1	01	01	H5628_013_2	9		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5628	013	2	1	01	01	H5628_013_2	9		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5628	013	2	1	01	01	H5628_013_2	9		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5628	014	1	1	01	01	H5628_014_1	9		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5628	014	1	1	01	01	H5628_014_1	9		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5628	014	1	1	01	01	H5628_014_1	9		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5628	014	1	1	01	01	H5628_014_1	9		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5628	014	1	1	01	01	H5628_014_1	9		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5628	014	1	1	01	01	H5628_014_1	9		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5628	014	2	1	01	01	H5628_014_2	9		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5628	014	2	1	01	01	H5628_014_2	9		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5628	014	2	1	01	01	H5628_014_2	9		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5628	014	2	1	01	01	H5628_014_2	9		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5628	014	2	1	01	01	H5628_014_2	9		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5628	014	2	1	01	01	H5628_014_2	9		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5649	001	0	1	01	01	H5649_001_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5649	001	0	1	01	01	H5649_001_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5649	001	0	1	01	01	H5649_001_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5649	001	0	1	01	01	H5649_001_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5649	001	0	1	01	01	H5649_001_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5649	001	0	1	01	01	H5649_001_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	3	2	0.00	
H5649	009	0	1	01	01	H5649_009_0	8		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5649	009	0	1	01	01	H5649_009_0	8		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5649	009	0	1	01	01	H5649_009_0	8		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5649	009	0	1	01	01	H5649_009_0	8		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5649	009	0	1	01	01	H5649_009_0	8		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5649	009	0	1	01	01	H5649_009_0	8		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5649	018	0	1	01	01	H5649_018_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5649	018	0	1	01	01	H5649_018_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5649	018	0	1	01	01	H5649_018_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5649	018	0	1	01	01	H5649_018_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5649	018	0	1	01	01	H5649_018_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5649	018	0	1	01	01	H5649_018_0	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	3	2	0.00	
H5649	022	0	1	01	01	H5649_022_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5649	022	0	1	01	01	H5649_022_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5649	022	0	1	01	01	H5649_022_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5649	022	0	1	01	01	H5649_022_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5649	022	0	1	01	01	H5649_022_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5649	022	0	1	01	01	H5649_022_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	3	2	0.00	
H5649	023	0	1	01	01	H5649_023_0	10			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5649	023	0	1	01	01	H5649_023_0	10			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5649	023	0	1	01	01	H5649_023_0	10			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5649	023	0	1	01	01	H5649_023_0	10			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5649	023	0	1	01	01	H5649_023_0	10			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5649	023	0	1	01	01	H5649_023_0	10			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	3	2	0.00	
H5649	024	0	1	01	01	H5649_024_0	9		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5649	024	0	1	01	01	H5649_024_0	9		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5649	024	0	1	01	01	H5649_024_0	9		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5649	024	0	1	01	01	H5649_024_0	9		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5649	024	0	1	01	01	H5649_024_0	9		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5649	024	0	1	01	01	H5649_024_0	9		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5649	025	1	1	01	01	H5649_025_1	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5649	025	1	1	01	01	H5649_025_1	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5649	025	1	1	01	01	H5649_025_1	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5649	025	1	1	01	01	H5649_025_1	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5649	025	1	1	01	01	H5649_025_1	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5649	025	1	1	01	01	H5649_025_1	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	3	2	0.00	
H5649	025	2	1	01	01	H5649_025_2	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5649	025	2	1	01	01	H5649_025_2	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5649	025	2	1	01	01	H5649_025_2	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5649	025	2	1	01	01	H5649_025_2	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5649	025	2	1	01	01	H5649_025_2	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5649	025	2	1	01	01	H5649_025_2	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	3	2	0.00	
H5649	025	3	1	01	01	H5649_025_3	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5649	025	3	1	01	01	H5649_025_3	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5649	025	3	1	01	01	H5649_025_3	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5649	025	3	1	01	01	H5649_025_3	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5649	025	3	1	01	01	H5649_025_3	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5649	025	3	1	01	01	H5649_025_3	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	3	2	0.00	
H5649	025	4	1	01	01	H5649_025_4	10			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5649	025	4	1	01	01	H5649_025_4	10			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5649	025	4	1	01	01	H5649_025_4	10			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5649	025	4	1	01	01	H5649_025_4	10			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5649	025	4	1	01	01	H5649_025_4	10			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5649	025	4	1	01	01	H5649_025_4	10			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	3	2	0.00	
H5649	026	1	1	01	01	H5649_026_1	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5649	026	1	1	01	01	H5649_026_1	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5649	026	1	1	01	01	H5649_026_1	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5649	026	1	1	01	01	H5649_026_1	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5649	026	1	1	01	01	H5649_026_1	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5649	026	1	1	01	01	H5649_026_1	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5649	026	2	1	01	01	H5649_026_2	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5649	026	2	1	01	01	H5649_026_2	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5649	026	2	1	01	01	H5649_026_2	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5649	026	2	1	01	01	H5649_026_2	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5649	026	2	1	01	01	H5649_026_2	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5649	026	2	1	01	01	H5649_026_2	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5649	026	3	1	01	01	H5649_026_3	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5649	026	3	1	01	01	H5649_026_3	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5649	026	3	1	01	01	H5649_026_3	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5649	026	3	1	01	01	H5649_026_3	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5649	026	3	1	01	01	H5649_026_3	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5649	026	3	1	01	01	H5649_026_3	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5649	026	4	1	01	01	H5649_026_4	10			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5649	026	4	1	01	01	H5649_026_4	10			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5649	026	4	1	01	01	H5649_026_4	10			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5649	026	4	1	01	01	H5649_026_4	10			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5649	026	4	1	01	01	H5649_026_4	10			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5649	026	4	1	01	01	H5649_026_4	10			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5649	027	0	1	01	01	H5649_027_0	10			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5649	027	0	1	01	01	H5649_027_0	10			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5649	027	0	1	01	01	H5649_027_0	10			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5649	027	0	1	01	01	H5649_027_0	10			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5649	027	0	1	01	01	H5649_027_0	10			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5649	027	0	1	01	01	H5649_027_0	10			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	3	2	0.00	
H5649	028	0	1	01	01	H5649_028_0	10			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5649	028	0	1	01	01	H5649_028_0	10			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5649	028	0	1	01	01	H5649_028_0	10			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5649	028	0	1	01	01	H5649_028_0	10			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5649	028	0	1	01	01	H5649_028_0	10			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5649	028	0	1	01	01	H5649_028_0	10			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	3	2	0.00	
H5649	029	0	1	01	01	H5649_029_0	11			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5649	029	0	1	01	01	H5649_029_0	11			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5649	029	0	1	01	01	H5649_029_0	11			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5649	029	0	1	01	01	H5649_029_0	11			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5649	029	0	1	01	01	H5649_029_0	11			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5649	029	0	1	01	01	H5649_029_0	11			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	3	2	0.00	
H5652	001	0	1	02	01	H5652_001_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5652	001	0	1	02	01	H5652_001_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	5.00	
H5652	001	0	1	02	01	H5652_001_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5652	001	0	1	02	01	H5652_001_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5652	001	0	1	02	01	H5652_001_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5652	003	0	1	02	01	H5652_003_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5652	003	0	1	02	01	H5652_003_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
H5652	003	0	1	02	01	H5652_003_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5652	003	0	1	02	01	H5652_003_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5652	003	0	1	02	01	H5652_003_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5652	004	0	1	02	01	H5652_004_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5652	004	0	1	02	01	H5652_004_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	5.00	
H5652	004	0	1	02	01	H5652_004_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5652	004	0	1	02	01	H5652_004_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5652	004	0	1	02	01	H5652_004_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5652	006	0	1	02	01	H5652_006_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5652	006	0	1	02	01	H5652_006_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H5652	006	0	1	02	01	H5652_006_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5652	006	0	1	02	01	H5652_006_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5652	006	0	1	02	01	H5652_006_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5652	008	0	1	02	01	H5652_008_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5652	008	0	1	02	01	H5652_008_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	15.00	
H5652	008	0	1	02	01	H5652_008_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5652	008	0	1	02	01	H5652_008_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5652	008	0	1	02	01	H5652_008_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5692	001	0	1	01	01	H5692_001_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5692	001	0	1	01	01	H5692_001_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H5692	001	0	1	01	01	H5692_001_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H5692	001	0	1	01	01	H5692_001_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5692	001	0	1	01	01	H5692_001_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5692	001	0	1	01	01	H5692_001_0	6		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5718	001	0	1	04	01	H5718_001_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5718	001	0	1	04	01	H5718_001_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H5718	001	0	1	04	01	H5718_001_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5718	001	0	1	04	01	H5718_001_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5718	001	0	1	04	01	H5718_001_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5718	002	0	1	04	01	H5718_002_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5718	002	0	1	04	01	H5718_002_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H5718	002	0	1	04	01	H5718_002_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5718	002	0	1	04	01	H5718_002_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5718	002	0	1	04	01	H5718_002_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5718	003	0	1	04	01	H5718_003_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5718	003	0	1	04	01	H5718_003_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H5718	003	0	1	04	01	H5718_003_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5718	003	0	1	04	01	H5718_003_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5718	003	0	1	04	01	H5718_003_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5718	004	0	1	04	01	H5718_004_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5718	004	0	1	04	01	H5718_004_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5718	004	0	1	04	01	H5718_004_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5718	004	0	1	04	01	H5718_004_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5718	004	0	1	04	01	H5718_004_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5718	004	0	1	04	01	H5718_004_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5718	005	0	1	04	01	H5718_005_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5718	005	0	1	04	01	H5718_005_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5718	005	0	1	04	01	H5718_005_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5718	005	0	1	04	01	H5718_005_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5718	005	0	1	04	01	H5718_005_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5718	005	0	1	04	01	H5718_005_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5718	006	0	1	04	01	H5718_006_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5718	006	0	1	04	01	H5718_006_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5718	006	0	1	04	01	H5718_006_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5718	006	0	1	04	01	H5718_006_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5718	006	0	1	04	01	H5718_006_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5718	006	0	1	04	01	H5718_006_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5734	001	0	1	01	01	H5734_001_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5734	001	0	1	01	01	H5734_001_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H5734	001	0	1	01	01	H5734_001_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H5734	001	0	1	01	01	H5734_001_0	5		N	Non-Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	4	2	10	1	2	0.00	
H5734	001	0	1	01	01	H5734_001_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5734	001	0	1	01	01	H5734_001_0	5		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5774	022	0	1	01	01	H5774_022_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H5774	022	0	1	01	01	H5774_022_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	2	2	01	3	2	0.00	
H5774	022	0	1	01	01	H5774_022_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	3	2	10	3	2	0.00	
H5774	022	0	1	01	01	H5774_022_0	5			Non-Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	4	2	10	3	2	0.00	
H5774	022	0	1	01	01	H5774_022_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5774	022	0	1	01	01	H5774_022_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5774	031	0	1	02	01	H5774_031_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H5774	031	0	1	02	01	H5774_031_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	2	2	01	3	2	0.00	
H5774	031	0	1	02	01	H5774_031_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	3	2	10	3	2	0.00	
H5774	031	0	1	02	01	H5774_031_0	5			Non-Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	4	2	10	3	2	0.00	
H5774	031	0	1	02	01	H5774_031_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5774	031	0	1	02	01	H5774_031_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5774	038	0	1	01	01	H5774_038_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H5774	038	0	1	01	01	H5774_038_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	2	2	01	3	2	0.00	
H5774	038	0	1	01	01	H5774_038_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	3	2	10	3	2	0.00	
H5774	038	0	1	01	01	H5774_038_0	6			Non-Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	4	2	10	3	2	0.00	
H5774	038	0	1	01	01	H5774_038_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5774	038	0	1	01	01	H5774_038_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5774	046	0	1	01	01	H5774_046_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H5774	046	0	1	01	01	H5774_046_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	2	2	01	3	2	0.00	
H5774	046	0	1	01	01	H5774_046_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	3	2	10	3	2	0.00	
H5774	046	0	1	01	01	H5774_046_0	6			Non-Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	4	2	10	3	2	0.00	
H5774	046	0	1	01	01	H5774_046_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5774	046	0	1	01	01	H5774_046_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5774	047	1	1	01	01	H5774_047_1	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H5774	047	1	1	01	01	H5774_047_1	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	2	2	01	3	2	0.00	
H5774	047	1	1	01	01	H5774_047_1	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	3	2	10	3	2	0.00	
H5774	047	1	1	01	01	H5774_047_1	6			Non-Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	4	2	10	3	2	0.00	
H5774	047	1	1	01	01	H5774_047_1	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5774	047	1	1	01	01	H5774_047_1	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5774	047	2	1	01	01	H5774_047_2	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H5774	047	2	1	01	01	H5774_047_2	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	2	2	01	3	2	0.00	
H5774	047	2	1	01	01	H5774_047_2	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	3	2	10	3	2	0.00	
H5774	047	2	1	01	01	H5774_047_2	6			Non-Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	4	2	10	3	2	0.00	
H5774	047	2	1	01	01	H5774_047_2	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5774	047	2	1	01	01	H5774_047_2	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5774	047	3	1	01	01	H5774_047_3	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H5774	047	3	1	01	01	H5774_047_3	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	2	2	01	3	2	0.00	
H5774	047	3	1	01	01	H5774_047_3	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	3	2	10	3	2	0.00	
H5774	047	3	1	01	01	H5774_047_3	6			Non-Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	4	2	10	3	2	0.00	
H5774	047	3	1	01	01	H5774_047_3	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5774	047	3	1	01	01	H5774_047_3	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5774	047	4	1	01	01	H5774_047_4	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H5774	047	4	1	01	01	H5774_047_4	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	2	2	01	3	2	0.00	
H5774	047	4	1	01	01	H5774_047_4	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	3	2	10	3	2	0.00	
H5774	047	4	1	01	01	H5774_047_4	6			Non-Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	4	2	10	3	2	0.00	
H5774	047	4	1	01	01	H5774_047_4	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5774	047	4	1	01	01	H5774_047_4	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5774	047	5	1	01	01	H5774_047_5	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H5774	047	5	1	01	01	H5774_047_5	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	2	2	01	3	2	0.00	
H5774	047	5	1	01	01	H5774_047_5	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	3	2	10	3	2	0.00	
H5774	047	5	1	01	01	H5774_047_5	6			Non-Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	4	2	10	3	2	0.00	
H5774	047	5	1	01	01	H5774_047_5	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5774	047	5	1	01	01	H5774_047_5	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5779	002	0	1	01	01	H5779_002_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H5779	002	0	1	01	01	H5779_002_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5779	002	0	1	01	01	H5779_002_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5779	002	0	1	01	01	H5779_002_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5779	002	0	1	01	01	H5779_002_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5779	002	0	1	01	01	H5779_002_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5779	007	0	1	01	01	H5779_007_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H5779	007	0	1	01	01	H5779_007_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5779	007	0	1	01	01	H5779_007_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5779	007	0	1	01	01	H5779_007_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5779	007	0	1	01	01	H5779_007_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5779	007	0	1	01	01	H5779_007_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5779	009	0	1	01	01	H5779_009_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H5779	009	0	1	01	01	H5779_009_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5779	009	0	1	01	01	H5779_009_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5779	009	0	1	01	01	H5779_009_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5779	009	0	1	01	01	H5779_009_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5779	009	0	1	01	01	H5779_009_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5779	010	0	1	01	01	H5779_010_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H5779	010	0	1	01	01	H5779_010_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5779	010	0	1	01	01	H5779_010_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5779	010	0	1	01	01	H5779_010_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5779	010	0	1	01	01	H5779_010_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5779	010	0	1	01	01	H5779_010_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5793	001	0	1	02	01	H5793_001_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5793	001	0	1	02	01	H5793_001_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5793	001	0	1	02	01	H5793_001_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5793	001	0	1	02	01	H5793_001_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5793	001	0	1	02	01	H5793_001_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5793	010	0	1	02	01	H5793_010_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5793	010	0	1	02	01	H5793_010_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5793	010	0	1	02	01	H5793_010_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5793	010	0	1	02	01	H5793_010_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5793	010	0	1	02	01	H5793_010_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5793	014	0	1	02	01	H5793_014_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5793	014	0	1	02	01	H5793_014_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5793	014	0	1	02	01	H5793_014_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5793	014	0	1	02	01	H5793_014_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5793	014	0	1	02	01	H5793_014_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5793	015	0	1	02	01	H5793_015_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5793	015	0	1	02	01	H5793_015_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5793	015	0	1	02	01	H5793_015_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5793	015	0	1	02	01	H5793_015_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5793	015	0	1	02	01	H5793_015_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5793	017	0	1	02	01	H5793_017_0	2		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5793	017	0	1	02	01	H5793_017_0	2		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5793	017	0	1	02	01	H5793_017_0	2		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5793	017	0	1	02	01	H5793_017_0	2		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5793	017	0	1	02	01	H5793_017_0	2		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5793	018	0	1	02	01	H5793_018_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5793	018	0	1	02	01	H5793_018_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5793	018	0	1	02	01	H5793_018_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5793	018	0	1	02	01	H5793_018_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5793	018	0	1	02	01	H5793_018_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5793	019	0	1	02	01	H5793_019_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5793	019	0	1	02	01	H5793_019_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5793	019	0	1	02	01	H5793_019_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5793	019	0	1	02	01	H5793_019_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5793	019	0	1	02	01	H5793_019_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5793	020	0	1	02	01	H5793_020_0	2		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5793	020	0	1	02	01	H5793_020_0	2		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5793	020	0	1	02	01	H5793_020_0	2		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5793	020	0	1	02	01	H5793_020_0	2		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5793	020	0	1	02	01	H5793_020_0	2		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5810	014	0	1	01	01	H5810_014_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5810	014	0	1	01	01	H5810_014_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5810	014	0	1	01	01	H5810_014_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5810	014	0	1	01	01	H5810_014_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5810	014	0	1	01	01	H5810_014_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5810	014	0	1	01	01	H5810_014_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5823	010	0	1	01	01	H5823_010_0	8		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5823	010	0	1	01	01	H5823_010_0	8		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5823	010	0	1	01	01	H5823_010_0	8		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5823	010	0	1	01	01	H5823_010_0	8		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5823	010	0	1	01	01	H5823_010_0	8		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5823	010	0	1	01	01	H5823_010_0	8		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5823	013	1	1	01	01	H5823_013_1	8		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5823	013	1	1	01	01	H5823_013_1	8		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5823	013	1	1	01	01	H5823_013_1	8		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5823	013	1	1	01	01	H5823_013_1	8		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5823	013	1	1	01	01	H5823_013_1	8		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5823	013	1	1	01	01	H5823_013_1	8		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5823	013	2	1	01	01	H5823_013_2	8		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5823	013	2	1	01	01	H5823_013_2	8		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5823	013	2	1	01	01	H5823_013_2	8		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5823	013	2	1	01	01	H5823_013_2	8		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5823	013	2	1	01	01	H5823_013_2	8		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5823	013	2	1	01	01	H5823_013_2	8		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5826	014	0	1	01	01	H5826_014_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5826	014	0	1	01	01	H5826_014_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H5826	014	0	1	01	01	H5826_014_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5826	014	0	1	01	01	H5826_014_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5826	014	0	1	01	01	H5826_014_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5826	014	0	1	01	01	H5826_014_0	5		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5826	017	0	1	01	01	H5826_017_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5826	017	0	1	01	01	H5826_017_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H5826	017	0	1	01	01	H5826_017_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5826	017	0	1	01	01	H5826_017_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5826	017	0	1	01	01	H5826_017_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5826	017	0	1	01	01	H5826_017_0	6		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5828	001	0	1	01	01	H5828_001_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5828	001	0	1	01	01	H5828_001_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5828	001	0	1	01	01	H5828_001_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5828	001	0	1	01	01	H5828_001_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5828	001	0	1	01	01	H5828_001_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5828	001	0	1	01	01	H5828_001_0	6		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5828	002	0	1	01	01	H5828_002_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5828	002	0	1	01	01	H5828_002_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5828	002	0	1	01	01	H5828_002_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5828	002	0	1	01	01	H5828_002_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5828	002	0	1	01	01	H5828_002_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5828	002	0	1	01	01	H5828_002_0	6		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5828	008	0	1	02	01	H5828_008_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5828	008	0	1	02	01	H5828_008_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5828	008	0	1	02	01	H5828_008_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5828	008	0	1	02	01	H5828_008_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5828	008	0	1	02	01	H5828_008_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5828	008	0	1	02	01	H5828_008_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5828	013	0	1	02	01	H5828_013_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5828	013	0	1	02	01	H5828_013_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5828	013	0	1	02	01	H5828_013_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5828	013	0	1	02	01	H5828_013_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5828	013	0	1	02	01	H5828_013_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5828	013	0	1	02	01	H5828_013_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5828	014	0	1	02	01	H5828_014_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5828	014	0	1	02	01	H5828_014_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5828	014	0	1	02	01	H5828_014_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5828	014	0	1	02	01	H5828_014_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5828	014	0	1	02	01	H5828_014_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5828	015	0	1	02	01	H5828_015_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5828	015	0	1	02	01	H5828_015_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5828	015	0	1	02	01	H5828_015_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5828	015	0	1	02	01	H5828_015_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5828	015	0	1	02	01	H5828_015_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5828	016	0	1	02	01	H5828_016_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5828	016	0	1	02	01	H5828_016_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5828	016	0	1	02	01	H5828_016_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5828	016	0	1	02	01	H5828_016_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5828	016	0	1	02	01	H5828_016_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5828	017	0	1	02	01	H5828_017_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5828	017	0	1	02	01	H5828_017_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5828	017	0	1	02	01	H5828_017_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5828	017	0	1	02	01	H5828_017_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5828	017	0	1	02	01	H5828_017_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5828	018	0	1	01	01	H5828_018_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5828	018	0	1	01	01	H5828_018_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5828	018	0	1	01	01	H5828_018_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5828	018	0	1	01	01	H5828_018_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5828	018	0	1	01	01	H5828_018_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5828	018	0	1	01	01	H5828_018_0	6		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5843	001	0	1	01	01	H5843_001_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5843	001	0	1	01	01	H5843_001_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5843	001	0	1	01	01	H5843_001_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5843	001	0	1	01	01	H5843_001_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5843	001	0	1	01	01	H5843_001_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5852	001	0	1	01	01	H5852_001_0	6			Generic	3	Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5852	001	0	1	01	01	H5852_001_0	6			Preferred Brand	3	Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	2	2	10	1	2	0.00	
H5852	001	0	1	01	01	H5852_001_0	6			Non-Preferred Brand	3	Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H5852	001	0	1	01	01	H5852_001_0	6			Specialty Tier	3	Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	4	2	10	1	2	0.00	
H5852	001	0	1	01	01	H5852_001_0	6			Select Care Drugs	3	Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	5	2	01	1	2	0.00	
H5854	012	0	1	02	01	H5854_012_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5854	012	0	1	02	01	H5854_012_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5854	012	0	1	02	01	H5854_012_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5854	012	0	1	02	01	H5854_012_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5854	012	0	1	02	01	H5854_012_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5854	012	0	1	02	01	H5854_012_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5854	013	0	1	01	01	H5854_013_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5854	013	0	1	01	01	H5854_013_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5854	013	0	1	01	01	H5854_013_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5854	013	0	1	01	01	H5854_013_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5854	013	0	1	01	01	H5854_013_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5854	013	0	1	01	01	H5854_013_0	5		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5854	019	1	1	01	01	H5854_019_1	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5854	019	1	1	01	01	H5854_019_1	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5854	019	1	1	01	01	H5854_019_1	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5854	019	1	1	01	01	H5854_019_1	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5854	019	1	1	01	01	H5854_019_1	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5854	019	1	1	01	01	H5854_019_1	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5854	019	2	1	01	01	H5854_019_2	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5854	019	2	1	01	01	H5854_019_2	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5854	019	2	1	01	01	H5854_019_2	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5854	019	2	1	01	01	H5854_019_2	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5854	019	2	1	01	01	H5854_019_2	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5854	019	2	1	01	01	H5854_019_2	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5854	020	0	1	01	01	H5854_020_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5854	020	0	1	01	01	H5854_020_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5854	020	0	1	01	01	H5854_020_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5854	020	0	1	01	01	H5854_020_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5854	020	0	1	01	01	H5854_020_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5854	020	0	1	01	01	H5854_020_0	5		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5859	001	0	1	01	01	H5859_001_0	9		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5859	001	0	1	01	01	H5859_001_0	9		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	3	1		25
H5859	001	0	1	01	01	H5859_001_0	9		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H5859	001	0	1	01	01	H5859_001_0	9		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5859	001	0	1	01	01	H5859_001_0	9		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5859	001	0	1	01	01	H5859_001_0	9		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5883	002	1	1	02	01	H5883_002_1	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5883	002	1	1	02	01	H5883_002_1	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5883	002	1	1	02	01	H5883_002_1	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5883	002	1	1	02	01	H5883_002_1	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5883	002	1	1	02	01	H5883_002_1	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5883	002	2	1	02	01	H5883_002_2	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5883	002	2	1	02	01	H5883_002_2	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5883	002	2	1	02	01	H5883_002_2	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5883	002	2	1	02	01	H5883_002_2	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5883	002	2	1	02	01	H5883_002_2	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5883	002	3	1	02	01	H5883_002_3	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5883	002	3	1	02	01	H5883_002_3	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5883	002	3	1	02	01	H5883_002_3	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5883	002	3	1	02	01	H5883_002_3	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5883	002	3	1	02	01	H5883_002_3	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5883	002	4	1	02	01	H5883_002_4	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5883	002	4	1	02	01	H5883_002_4	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5883	002	4	1	02	01	H5883_002_4	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5883	002	4	1	02	01	H5883_002_4	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5883	002	4	1	02	01	H5883_002_4	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5883	002	7	1	02	01	H5883_002_7	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5883	002	7	1	02	01	H5883_002_7	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5883	002	7	1	02	01	H5883_002_7	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5883	002	7	1	02	01	H5883_002_7	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5883	002	7	1	02	01	H5883_002_7	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5883	003	1	1	02	01	H5883_003_1	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5883	003	1	1	02	01	H5883_003_1	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5883	003	1	1	02	01	H5883_003_1	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5883	003	1	1	02	01	H5883_003_1	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5883	003	1	1	02	01	H5883_003_1	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5883	003	2	1	02	01	H5883_003_2	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5883	003	2	1	02	01	H5883_003_2	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5883	003	2	1	02	01	H5883_003_2	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5883	003	2	1	02	01	H5883_003_2	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5883	003	2	1	02	01	H5883_003_2	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5883	003	3	1	02	01	H5883_003_3	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5883	003	3	1	02	01	H5883_003_3	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5883	003	3	1	02	01	H5883_003_3	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5883	003	3	1	02	01	H5883_003_3	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5883	003	3	1	02	01	H5883_003_3	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5883	003	4	1	02	01	H5883_003_4	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5883	003	4	1	02	01	H5883_003_4	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5883	003	4	1	02	01	H5883_003_4	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5883	003	4	1	02	01	H5883_003_4	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5883	003	4	1	02	01	H5883_003_4	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5883	003	5	1	02	01	H5883_003_5	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5883	003	5	1	02	01	H5883_003_5	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5883	003	5	1	02	01	H5883_003_5	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5883	003	5	1	02	01	H5883_003_5	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5883	003	5	1	02	01	H5883_003_5	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5883	007	0	1	01	01	H5883_007_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5883	007	0	1	01	01	H5883_007_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5883	007	0	1	01	01	H5883_007_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5883	007	0	1	01	01	H5883_007_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5883	007	0	1	01	01	H5883_007_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5883	014	1	1	02	01	H5883_014_1	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5883	014	1	1	02	01	H5883_014_1	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5883	014	1	1	02	01	H5883_014_1	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5883	014	1	1	02	01	H5883_014_1	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5883	014	1	1	02	01	H5883_014_1	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5883	014	2	1	02	01	H5883_014_2	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5883	014	2	1	02	01	H5883_014_2	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5883	014	2	1	02	01	H5883_014_2	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5883	014	2	1	02	01	H5883_014_2	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5883	014	2	1	02	01	H5883_014_2	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5883	014	4	1	02	01	H5883_014_4	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5883	014	4	1	02	01	H5883_014_4	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5883	014	4	1	02	01	H5883_014_4	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5883	014	4	1	02	01	H5883_014_4	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5883	014	4	1	02	01	H5883_014_4	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5883	014	5	1	02	01	H5883_014_5	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5883	014	5	1	02	01	H5883_014_5	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5883	014	5	1	02	01	H5883_014_5	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5883	014	5	1	02	01	H5883_014_5	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5883	014	5	1	02	01	H5883_014_5	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5900	001	0	1	04	01	H5900_001_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5900	001	0	1	04	01	H5900_001_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5900	001	0	1	04	01	H5900_001_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5900	001	0	1	04	01	H5900_001_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5900	001	0	1	04	01	H5900_001_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5900	004	0	1	04	01	H5900_004_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5900	004	0	1	04	01	H5900_004_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5900	004	0	1	04	01	H5900_004_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5900	004	0	1	04	01	H5900_004_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5900	004	0	1	04	01	H5900_004_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5900	008	0	1	04	01	H5900_008_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5900	008	0	1	04	01	H5900_008_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5900	008	0	1	04	01	H5900_008_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5900	008	0	1	04	01	H5900_008_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5900	008	0	1	04	01	H5900_008_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5926	001	0	1	01	01	H5926_001_0	8		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5926	001	0	1	01	01	H5926_001_0	8		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5926	001	0	1	01	01	H5926_001_0	8		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5926	001	0	1	01	01	H5926_001_0	8		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5926	001	0	1	01	01	H5926_001_0	8		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5926	001	0	1	01	01	H5926_001_0	8		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5926	008	0	1	01	01	H5926_008_0	9		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5926	008	0	1	01	01	H5926_008_0	9		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5926	008	0	1	01	01	H5926_008_0	9		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5926	008	0	1	01	01	H5926_008_0	9		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5926	008	0	1	01	01	H5926_008_0	9		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5926	008	0	1	01	01	H5926_008_0	9		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5926	009	0	1	01	01	H5926_009_0	9		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5926	009	0	1	01	01	H5926_009_0	9		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5926	009	0	1	01	01	H5926_009_0	9		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5926	009	0	1	01	01	H5926_009_0	9		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5926	009	0	1	01	01	H5926_009_0	9		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5926	009	0	1	01	01	H5926_009_0	9		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5928	004	0	1	01	01	H5928_004_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5928	004	0	1	01	01	H5928_004_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5928	004	0	1	01	01	H5928_004_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5928	004	0	1	01	01	H5928_004_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5928	004	0	1	01	01	H5928_004_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5928	010	0	1	01	01	H5928_010_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H5928	010	0	1	01	01	H5928_010_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H5928	010	0	1	01	01	H5928_010_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5928	010	0	1	01	01	H5928_010_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5928	010	0	1	01	01	H5928_010_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5938	001	0	1	01	01	H5938_001_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5938	001	0	1	01	01	H5938_001_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H5938	001	0	1	01	01	H5938_001_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5938	001	0	1	01	01	H5938_001_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5938	001	0	1	01	01	H5938_001_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5938	001	0	1	01	01	H5938_001_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5938	006	0	1	01	01	H5938_006_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5938	006	0	1	01	01	H5938_006_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H5938	006	0	1	01	01	H5938_006_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5938	006	0	1	01	01	H5938_006_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5938	006	0	1	01	01	H5938_006_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5938	006	0	1	01	01	H5938_006_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5938	008	0	1	01	01	H5938_008_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5938	008	0	1	01	01	H5938_008_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H5938	008	0	1	01	01	H5938_008_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5938	008	0	1	01	01	H5938_008_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5938	008	0	1	01	01	H5938_008_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5938	008	0	1	01	01	H5938_008_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5938	009	0	1	01	01	H5938_009_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5938	009	0	1	01	01	H5938_009_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H5938	009	0	1	01	01	H5938_009_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5938	009	0	1	01	01	H5938_009_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5938	009	0	1	01	01	H5938_009_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5938	009	0	1	01	01	H5938_009_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5943	003	0	1	02	01	H5943_003_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5943	003	0	1	02	01	H5943_003_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5943	003	0	1	02	01	H5943_003_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5943	003	0	1	02	01	H5943_003_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5943	003	0	1	02	01	H5943_003_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5943	004	0	1	02	01	H5943_004_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5943	004	0	1	02	01	H5943_004_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5943	004	0	1	02	01	H5943_004_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5943	004	0	1	02	01	H5943_004_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5943	004	0	1	02	01	H5943_004_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5945	001	0	1	01	01	H5945_001_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H5945	001	0	1	01	01	H5945_001_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H5945	001	0	1	01	01	H5945_001_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5945	001	0	1	01	01	H5945_001_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5945	001	0	1	01	01	H5945_001_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5945	001	0	1	01	01	H5945_001_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5945	002	0	1	01	01	H5945_002_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H5945	002	0	1	01	01	H5945_002_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H5945	002	0	1	01	01	H5945_002_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5945	002	0	1	01	01	H5945_002_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5945	002	0	1	01	01	H5945_002_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5945	002	0	1	01	01	H5945_002_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5945	013	0	1	01	01	H5945_013_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H5945	013	0	1	01	01	H5945_013_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H5945	013	0	1	01	01	H5945_013_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5945	013	0	1	01	01	H5945_013_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5945	013	0	1	01	01	H5945_013_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5945	013	0	1	01	01	H5945_013_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5945	014	0	1	01	01	H5945_014_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H5945	014	0	1	01	01	H5945_014_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H5945	014	0	1	01	01	H5945_014_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5945	014	0	1	01	01	H5945_014_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5945	014	0	1	01	01	H5945_014_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5945	014	0	1	01	01	H5945_014_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5945	016	0	1	01	01	H5945_016_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H5945	016	0	1	01	01	H5945_016_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H5945	016	0	1	01	01	H5945_016_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5945	016	0	1	01	01	H5945_016_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5945	016	0	1	01	01	H5945_016_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5945	016	0	1	01	01	H5945_016_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5945	017	0	1	01	01	H5945_017_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H5945	017	0	1	01	01	H5945_017_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H5945	017	0	1	01	01	H5945_017_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5945	017	0	1	01	01	H5945_017_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5945	017	0	1	01	01	H5945_017_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5945	017	0	1	01	01	H5945_017_0	6		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5945	018	0	1	01	01	H5945_018_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H5945	018	0	1	01	01	H5945_018_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H5945	018	0	1	01	01	H5945_018_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5945	018	0	1	01	01	H5945_018_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5945	018	0	1	01	01	H5945_018_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5945	018	0	1	01	01	H5945_018_0	7		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5945	027	0	1	01	01	H5945_027_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H5945	027	0	1	01	01	H5945_027_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H5945	027	0	1	01	01	H5945_027_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5945	027	0	1	01	01	H5945_027_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5945	027	0	1	01	01	H5945_027_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5945	027	0	1	01	01	H5945_027_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5959	009	0	1	04	01	H5959_009_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5959	009	0	1	04	01	H5959_009_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5959	009	0	1	04	01	H5959_009_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5959	009	0	1	04	01	H5959_009_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5959	009	0	1	04	01	H5959_009_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5959	010	1	1	04	01	H5959_010_1	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5959	010	1	1	04	01	H5959_010_1	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5959	010	1	1	04	01	H5959_010_1	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5959	010	1	1	04	01	H5959_010_1	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5959	010	1	1	04	01	H5959_010_1	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5959	010	2	1	04	01	H5959_010_2	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5959	010	2	1	04	01	H5959_010_2	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5959	010	2	1	04	01	H5959_010_2	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5959	010	2	1	04	01	H5959_010_2	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5959	010	2	1	04	01	H5959_010_2	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5959	011	0	1	04	01	H5959_011_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5959	011	0	1	04	01	H5959_011_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5959	011	0	1	04	01	H5959_011_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5959	011	0	1	04	01	H5959_011_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5959	011	0	1	04	01	H5959_011_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5959	012	0	1	04	01	H5959_012_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5959	012	0	1	04	01	H5959_012_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5959	012	0	1	04	01	H5959_012_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5959	012	0	1	04	01	H5959_012_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5959	012	0	1	04	01	H5959_012_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5959	013	1	1	04	01	H5959_013_1	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5959	013	1	1	04	01	H5959_013_1	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5959	013	1	1	04	01	H5959_013_1	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5959	013	1	1	04	01	H5959_013_1	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5959	013	1	1	04	01	H5959_013_1	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5959	013	2	1	04	01	H5959_013_2	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5959	013	2	1	04	01	H5959_013_2	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5959	013	2	1	04	01	H5959_013_2	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5959	013	2	1	04	01	H5959_013_2	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5959	013	2	1	04	01	H5959_013_2	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5959	014	1	1	04	01	H5959_014_1	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5959	014	1	1	04	01	H5959_014_1	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5959	014	1	1	04	01	H5959_014_1	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5959	014	1	1	04	01	H5959_014_1	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5959	014	1	1	04	01	H5959_014_1	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5959	014	2	1	04	01	H5959_014_2	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5959	014	2	1	04	01	H5959_014_2	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5959	014	2	1	04	01	H5959_014_2	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5959	014	2	1	04	01	H5959_014_2	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5959	014	2	1	04	01	H5959_014_2	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5959	015	0	1	04	01	H5959_015_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5959	015	0	1	04	01	H5959_015_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5959	015	0	1	04	01	H5959_015_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5959	015	0	1	04	01	H5959_015_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5959	015	0	1	04	01	H5959_015_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5959	016	0	1	04	01	H5959_016_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5959	016	0	1	04	01	H5959_016_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5959	016	0	1	04	01	H5959_016_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5959	016	0	1	04	01	H5959_016_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5959	016	0	1	04	01	H5959_016_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5965	004	0	1	04	01	H5965_004_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5965	004	0	1	04	01	H5965_004_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5965	004	0	1	04	01	H5965_004_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5965	004	0	1	04	01	H5965_004_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5965	004	0	1	04	01	H5965_004_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5965	004	0	1	04	01	H5965_004_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5965	006	0	1	04	01	H5965_006_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5965	006	0	1	04	01	H5965_006_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5965	006	0	1	04	01	H5965_006_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5965	006	0	1	04	01	H5965_006_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5965	006	0	1	04	01	H5965_006_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5965	006	0	1	04	01	H5965_006_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5965	008	0	1	04	01	H5965_008_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H5965	008	0	1	04	01	H5965_008_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5965	008	0	1	04	01	H5965_008_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5965	008	0	1	04	01	H5965_008_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5965	008	0	1	04	01	H5965_008_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5965	008	0	1	04	01	H5965_008_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H5969	002	0	1	01	01	H5969_002_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5969	002	0	1	01	01	H5969_002_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H5969	002	0	1	01	01	H5969_002_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H5969	002	0	1	01	01	H5969_002_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5969	002	0	1	01	01	H5969_002_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5969	002	0	1	01	01	H5969_002_0	5		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5969	003	0	1	01	01	H5969_003_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5969	003	0	1	01	01	H5969_003_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H5969	003	0	1	01	01	H5969_003_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H5969	003	0	1	01	01	H5969_003_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5969	003	0	1	01	01	H5969_003_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5969	003	0	1	01	01	H5969_003_0	6		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5970	028	0	1	04	01	H5970_028_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5970	028	0	1	04	01	H5970_028_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5970	028	0	1	04	01	H5970_028_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5970	028	0	1	04	01	H5970_028_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5970	028	0	1	04	01	H5970_028_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5970	029	0	1	04	01	H5970_029_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H5970	029	0	1	04	01	H5970_029_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5970	029	0	1	04	01	H5970_029_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5970	029	0	1	04	01	H5970_029_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5970	029	0	1	04	01	H5970_029_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5970	030	0	1	04	01	H5970_030_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5970	030	0	1	04	01	H5970_030_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5970	030	0	1	04	01	H5970_030_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5970	030	0	1	04	01	H5970_030_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5970	030	0	1	04	01	H5970_030_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5970	031	0	1	04	01	H5970_031_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5970	031	0	1	04	01	H5970_031_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5970	031	0	1	04	01	H5970_031_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5970	031	0	1	04	01	H5970_031_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5970	031	0	1	04	01	H5970_031_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5970	032	0	1	04	01	H5970_032_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H5970	032	0	1	04	01	H5970_032_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H5970	032	0	1	04	01	H5970_032_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H5970	032	0	1	04	01	H5970_032_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H5970	032	0	1	04	01	H5970_032_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H5989	011	0	1	01	01	H5989_011_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5989	011	0	1	01	01	H5989_011_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	3	2	2.00	
H5989	011	0	1	01	01	H5989_011_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5989	011	0	1	01	01	H5989_011_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5989	011	0	1	01	01	H5989_011_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5989	011	0	1	01	01	H5989_011_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5992	007	0	1	01	01	H5992_007_0	9		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5992	007	0	1	01	01	H5992_007_0	9		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5992	007	0	1	01	01	H5992_007_0	9		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5992	007	0	1	01	01	H5992_007_0	9		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5992	007	0	1	01	01	H5992_007_0	9		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5992	007	0	1	01	01	H5992_007_0	9		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5992	010	0	1	01	01	H5992_010_0	8		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H5992	010	0	1	01	01	H5992_010_0	8		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H5992	010	0	1	01	01	H5992_010_0	8		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H5992	010	0	1	01	01	H5992_010_0	8		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5992	010	0	1	01	01	H5992_010_0	8		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5992	010	0	1	01	01	H5992_010_0	8		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H5995	004	0	1	01	01	H5995_004_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H5995	004	0	1	01	01	H5995_004_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	3	2	0.00	
H5995	004	0	1	01	01	H5995_004_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H5995	004	0	1	01	01	H5995_004_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H5995	004	0	1	01	01	H5995_004_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H5995	004	0	1	01	01	H5995_004_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H6018	002	0	1	04	01	H6018_002_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6018	002	0	1	04	01	H6018_002_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H6018	002	0	1	04	01	H6018_002_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6018	002	0	1	04	01	H6018_002_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6018	002	0	1	04	01	H6018_002_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6018	003	0	1	04	01	H6018_003_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6018	003	0	1	04	01	H6018_003_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H6018	003	0	1	04	01	H6018_003_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6018	003	0	1	04	01	H6018_003_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6018	003	0	1	04	01	H6018_003_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6018	007	0	1	04	01	H6018_007_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6018	007	0	1	04	01	H6018_007_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H6018	007	0	1	04	01	H6018_007_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6018	007	0	1	04	01	H6018_007_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6018	007	0	1	04	01	H6018_007_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6018	008	0	1	04	01	H6018_008_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6018	008	0	1	04	01	H6018_008_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H6018	008	0	1	04	01	H6018_008_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6018	008	0	1	04	01	H6018_008_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6018	008	0	1	04	01	H6018_008_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6018	010	0	1	04	01	H6018_010_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6018	010	0	1	04	01	H6018_010_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H6018	010	0	1	04	01	H6018_010_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6018	010	0	1	04	01	H6018_010_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6018	010	0	1	04	01	H6018_010_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6018	011	0	1	04	01	H6018_011_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6018	011	0	1	04	01	H6018_011_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H6018	011	0	1	04	01	H6018_011_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6018	011	0	1	04	01	H6018_011_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6018	011	0	1	04	01	H6018_011_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6019	001	0	1	01	01	H6019_001_0	4		N	Generic	4	Generic, Brand	1	2	01	3	2	0.00	
H6019	001	0	1	01	01	H6019_001_0	4		N	Brand	4	Generic, Brand	2	2	10	3	2	0.00	
H6154	001	0	1	02	01	H6154_001_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H6154	001	0	1	02	01	H6154_001_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H6154	001	0	1	02	01	H6154_001_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6154	001	0	1	02	01	H6154_001_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6154	001	0	1	02	01	H6154_001_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6158	001	0	1	01	01	H6158_001_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6158	001	0	1	01	01	H6158_001_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H6158	001	0	1	01	01	H6158_001_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6158	001	0	1	01	01	H6158_001_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6158	001	0	1	01	01	H6158_001_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6158	003	0	1	01	01	H6158_003_0	5			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6158	003	0	1	01	01	H6158_003_0	5			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H6158	003	0	1	01	01	H6158_003_0	5			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6158	003	0	1	01	01	H6158_003_0	5			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6158	003	0	1	01	01	H6158_003_0	5			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6170	001	0	1	02	01	H6170_001_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H6170	001	0	1	02	01	H6170_001_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H6170	001	0	1	02	01	H6170_001_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H6170	001	0	1	02	01	H6170_001_0	9			Non-Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6170	001	0	1	02	01	H6170_001_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6170	001	0	1	02	01	H6170_001_0	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H6170	002	0	1	02	01	H6170_002_0	12			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H6170	002	0	1	02	01	H6170_002_0	12			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H6170	002	0	1	02	01	H6170_002_0	12			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H6170	002	0	1	02	01	H6170_002_0	12			Non-Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6170	002	0	1	02	01	H6170_002_0	12			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6170	002	0	1	02	01	H6170_002_0	12			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H6170	003	0	1	02	01	H6170_003_0	10			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H6170	003	0	1	02	01	H6170_003_0	10			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H6170	003	0	1	02	01	H6170_003_0	10			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H6170	003	0	1	02	01	H6170_003_0	10			Non-Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6170	003	0	1	02	01	H6170_003_0	10			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6170	003	0	1	02	01	H6170_003_0	10			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H6170	007	0	1	01	01	H6170_007_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H6170	007	0	1	01	01	H6170_007_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H6170	007	0	1	01	01	H6170_007_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H6170	007	0	1	01	01	H6170_007_0	8			Non-Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6170	007	0	1	01	01	H6170_007_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6170	007	0	1	01	01	H6170_007_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H6170	008	0	1	01	01	H6170_008_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H6170	008	0	1	01	01	H6170_008_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H6170	008	0	1	01	01	H6170_008_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H6170	008	0	1	01	01	H6170_008_0	7			Non-Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6170	008	0	1	01	01	H6170_008_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6170	008	0	1	01	01	H6170_008_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H6170	009	0	1	01	01	H6170_009_0	11			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H6170	009	0	1	01	01	H6170_009_0	11			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H6170	009	0	1	01	01	H6170_009_0	11			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H6170	009	0	1	01	01	H6170_009_0	11			Non-Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6170	009	0	1	01	01	H6170_009_0	11			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6170	009	0	1	01	01	H6170_009_0	11			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H6170	010	0	1	01	01	H6170_010_0	10			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H6170	010	0	1	01	01	H6170_010_0	10			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H6170	010	0	1	01	01	H6170_010_0	10			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H6170	010	0	1	01	01	H6170_010_0	10			Non-Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6170	010	0	1	01	01	H6170_010_0	10			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6170	010	0	1	01	01	H6170_010_0	10			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H6200	001	0	1	04	01	H6200_001_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H6200	001	0	1	04	01	H6200_001_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H6200	001	0	1	04	01	H6200_001_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H6200	001	0	1	04	01	H6200_001_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6200	001	0	1	04	01	H6200_001_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6200	004	0	1	04	01	H6200_004_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H6200	004	0	1	04	01	H6200_004_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H6200	004	0	1	04	01	H6200_004_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H6200	004	0	1	04	01	H6200_004_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6200	004	0	1	04	01	H6200_004_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6200	006	0	1	04	01	H6200_006_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H6200	006	0	1	04	01	H6200_006_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H6200	006	0	1	04	01	H6200_006_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H6200	006	0	1	04	01	H6200_006_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6200	006	0	1	04	01	H6200_006_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6200	008	0	1	04	01	H6200_008_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H6200	008	0	1	04	01	H6200_008_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	20.00	
H6200	008	0	1	04	01	H6200_008_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H6200	008	0	1	04	01	H6200_008_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6200	008	0	1	04	01	H6200_008_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6200	009	0	1	04	01	H6200_009_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H6200	009	0	1	04	01	H6200_009_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H6200	009	0	1	04	01	H6200_009_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H6200	009	0	1	04	01	H6200_009_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6200	009	0	1	04	01	H6200_009_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6200	010	0	1	04	01	H6200_010_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H6200	010	0	1	04	01	H6200_010_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H6200	010	0	1	04	01	H6200_010_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H6200	010	0	1	04	01	H6200_010_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6200	010	0	1	04	01	H6200_010_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6200	011	0	1	04	01	H6200_011_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H6200	011	0	1	04	01	H6200_011_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	20.00	
H6200	011	0	1	04	01	H6200_011_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H6200	011	0	1	04	01	H6200_011_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6200	011	0	1	04	01	H6200_011_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6202	004	0	1	04	01	H6202_004_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H6202	004	0	1	04	01	H6202_004_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H6202	004	0	1	04	01	H6202_004_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H6202	004	0	1	04	01	H6202_004_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6202	004	0	1	04	01	H6202_004_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6202	005	0	1	04	01	H6202_005_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H6202	005	0	1	04	01	H6202_005_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H6202	005	0	1	04	01	H6202_005_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H6202	005	0	1	04	01	H6202_005_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6202	005	0	1	04	01	H6202_005_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6237	009	0	1	01	01	H6237_009_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H6237	009	0	1	01	01	H6237_009_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H6237	009	0	1	01	01	H6237_009_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6237	009	0	1	01	01	H6237_009_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6237	009	0	1	01	01	H6237_009_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6248	001	0	1	01	01	H6248_001_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H6248	001	0	1	01	01	H6248_001_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H6248	001	0	1	01	01	H6248_001_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H6248	001	0	1	01	01	H6248_001_0	4			Non-Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	4	2	10	1	2	0.00	
H6248	001	0	1	01	01	H6248_001_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6248	001	0	1	01	01	H6248_001_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H6309	001	0	1	04	01	H6309_001_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6309	001	0	1	04	01	H6309_001_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H6309	001	0	1	04	01	H6309_001_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6309	001	0	1	04	01	H6309_001_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6309	001	0	1	04	01	H6309_001_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6309	002	0	1	04	01	H6309_002_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6309	002	0	1	04	01	H6309_002_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H6309	002	0	1	04	01	H6309_002_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6309	002	0	1	04	01	H6309_002_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6309	002	0	1	04	01	H6309_002_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6316	002	0	1	01	01	H6316_002_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H6316	002	0	1	01	01	H6316_002_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H6316	002	0	1	01	01	H6316_002_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H6316	002	0	1	01	01	H6316_002_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6316	002	0	1	01	01	H6316_002_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6316	002	0	1	01	01	H6316_002_0	5		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H6316	005	0	1	01	01	H6316_005_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H6316	005	0	1	01	01	H6316_005_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H6316	005	0	1	01	01	H6316_005_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H6316	005	0	1	01	01	H6316_005_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6316	005	0	1	01	01	H6316_005_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6316	005	0	1	01	01	H6316_005_0	5		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H6322	001	0	1	01	01	H6322_001_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H6322	001	0	1	01	01	H6322_001_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H6322	001	0	1	01	01	H6322_001_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H6322	001	0	1	01	01	H6322_001_0	7			Non-Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	4	2	10	1	2	0.00	
H6322	001	0	1	01	01	H6322_001_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6322	001	0	1	01	01	H6322_001_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H6322	002	0	1	01	01	H6322_002_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H6322	002	0	1	01	01	H6322_002_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H6322	002	0	1	01	01	H6322_002_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H6322	002	0	1	01	01	H6322_002_0	7			Non-Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	4	2	10	1	2	0.00	
H6322	002	0	1	01	01	H6322_002_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6322	002	0	1	01	01	H6322_002_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H6322	008	0	1	01	01	H6322_008_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H6322	008	0	1	01	01	H6322_008_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H6322	008	0	1	01	01	H6322_008_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H6322	008	0	1	01	01	H6322_008_0	8			Non-Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	4	2	10	1	2	0.00	
H6322	008	0	1	01	01	H6322_008_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6322	008	0	1	01	01	H6322_008_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H6341	001	0	1	01	01	H6341_001_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H6341	001	0	1	01	01	H6341_001_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H6341	001	0	1	01	01	H6341_001_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H6341	001	0	1	01	01	H6341_001_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6341	001	0	1	01	01	H6341_001_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6341	001	0	1	01	01	H6341_001_0	6		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H6348	002	0	1	04	01	H6348_002_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H6348	002	0	1	04	01	H6348_002_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H6348	002	0	1	04	01	H6348_002_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H6348	002	0	1	04	01	H6348_002_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6348	002	0	1	04	01	H6348_002_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6348	002	0	1	04	01	H6348_002_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H6348	008	0	1	04	01	H6348_008_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H6348	008	0	1	04	01	H6348_008_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H6348	008	0	1	04	01	H6348_008_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H6348	008	0	1	04	01	H6348_008_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6348	008	0	1	04	01	H6348_008_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6348	008	0	1	04	01	H6348_008_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H6348	009	0	1	04	01	H6348_009_0	8			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H6348	009	0	1	04	01	H6348_009_0	8			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H6348	009	0	1	04	01	H6348_009_0	8			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H6348	009	0	1	04	01	H6348_009_0	8			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6348	009	0	1	04	01	H6348_009_0	8			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6348	009	0	1	04	01	H6348_009_0	8			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H6351	004	0	1	01	01	H6351_004_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	1	2	01	1	2	0.00	
H6351	004	0	1	01	01	H6351_004_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	2	2	01	1	2	0.00	
H6351	004	0	1	01	01	H6351_004_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	3	2	10	1	2	0.00	
H6351	004	0	1	01	01	H6351_004_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	4	2	11	1	2	0.00	
H6351	004	0	1	01	01	H6351_004_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	5	2	11	1	2	0.00	
H6351	004	0	1	01	01	H6351_004_0	8			Select Diabetic Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Diabetic Drugs	6	2	11	1	2	0.00	
H6368	001	0	1	01	01	H6368_001_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H6368	001	0	1	01	01	H6368_001_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	3	2	0.00	
H6368	001	0	1	01	01	H6368_001_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H6368	001	0	1	01	01	H6368_001_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6368	001	0	1	01	01	H6368_001_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6368	001	0	1	01	01	H6368_001_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H6368	002	0	1	01	01	H6368_002_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H6368	002	0	1	01	01	H6368_002_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	3	2	7.00	
H6368	002	0	1	01	01	H6368_002_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H6368	002	0	1	01	01	H6368_002_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6368	002	0	1	01	01	H6368_002_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6368	002	0	1	01	01	H6368_002_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H6378	001	0	1	01	01	H6378_001_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H6378	001	0	1	01	01	H6378_001_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H6378	001	0	1	01	01	H6378_001_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H6378	001	0	1	01	01	H6378_001_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6378	001	0	1	01	01	H6378_001_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6378	001	0	1	01	01	H6378_001_0	6		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H6379	001	0	1	01	01	H6379_001_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H6379	001	0	1	01	01	H6379_001_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H6379	001	0	1	01	01	H6379_001_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H6379	001	0	1	01	01	H6379_001_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6379	001	0	1	01	01	H6379_001_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6379	001	0	1	01	01	H6379_001_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H6379	002	0	1	01	01	H6379_002_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H6379	002	0	1	01	01	H6379_002_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H6379	002	0	1	01	01	H6379_002_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H6379	002	0	1	01	01	H6379_002_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6379	002	0	1	01	01	H6379_002_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6379	002	0	1	01	01	H6379_002_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H6396	017	0	1	01	01	H6396_017_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6396	017	0	1	01	01	H6396_017_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H6396	017	0	1	01	01	H6396_017_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6396	017	0	1	01	01	H6396_017_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6396	017	0	1	01	01	H6396_017_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6453	013	1	1	02	01	H6453_013_1	12			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H6453	013	1	1	02	01	H6453_013_1	12			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H6453	013	1	1	02	01	H6453_013_1	12			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6453	013	1	1	02	01	H6453_013_1	12			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6453	013	1	1	02	01	H6453_013_1	12			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6453	013	2	1	02	01	H6453_013_2	12			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H6453	013	2	1	02	01	H6453_013_2	12			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H6453	013	2	1	02	01	H6453_013_2	12			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6453	013	2	1	02	01	H6453_013_2	12			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6453	013	2	1	02	01	H6453_013_2	12			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6453	013	3	1	02	01	H6453_013_3	12			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H6453	013	3	1	02	01	H6453_013_3	12			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H6453	013	3	1	02	01	H6453_013_3	12			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6453	013	3	1	02	01	H6453_013_3	12			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6453	013	3	1	02	01	H6453_013_3	12			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6453	013	4	1	02	01	H6453_013_4	12			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H6453	013	4	1	02	01	H6453_013_4	12			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H6453	013	4	1	02	01	H6453_013_4	12			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6453	013	4	1	02	01	H6453_013_4	12			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6453	013	4	1	02	01	H6453_013_4	12			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6453	013	5	1	02	01	H6453_013_5	12			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H6453	013	5	1	02	01	H6453_013_5	12			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H6453	013	5	1	02	01	H6453_013_5	12			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6453	013	5	1	02	01	H6453_013_5	12			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6453	013	5	1	02	01	H6453_013_5	12			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6453	017	1	1	02	01	H6453_017_1	12			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H6453	017	1	1	02	01	H6453_017_1	12			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H6453	017	1	1	02	01	H6453_017_1	12			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6453	017	1	1	02	01	H6453_017_1	12			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6453	017	1	1	02	01	H6453_017_1	12			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6453	017	2	1	02	01	H6453_017_2	12			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H6453	017	2	1	02	01	H6453_017_2	12			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H6453	017	2	1	02	01	H6453_017_2	12			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6453	017	2	1	02	01	H6453_017_2	12			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6453	017	2	1	02	01	H6453_017_2	12			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6453	018	1	1	02	01	H6453_018_1	12			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H6453	018	1	1	02	01	H6453_018_1	12			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H6453	018	1	1	02	01	H6453_018_1	12			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6453	018	1	1	02	01	H6453_018_1	12			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6453	018	1	1	02	01	H6453_018_1	12			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6453	018	2	1	02	01	H6453_018_2	12			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H6453	018	2	1	02	01	H6453_018_2	12			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H6453	018	2	1	02	01	H6453_018_2	12			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6453	018	2	1	02	01	H6453_018_2	12			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6453	018	2	1	02	01	H6453_018_2	12			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6453	019	0	1	02	01	H6453_019_0	13		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H6453	019	0	1	02	01	H6453_019_0	13		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H6453	019	0	1	02	01	H6453_019_0	13		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H6453	019	0	1	02	01	H6453_019_0	13		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6453	019	0	1	02	01	H6453_019_0	13		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6453	020	1	1	02	01	H6453_020_1	12			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H6453	020	1	1	02	01	H6453_020_1	12			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H6453	020	1	1	02	01	H6453_020_1	12			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6453	020	1	1	02	01	H6453_020_1	12			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6453	020	1	1	02	01	H6453_020_1	12			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6453	020	2	1	02	01	H6453_020_2	12			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H6453	020	2	1	02	01	H6453_020_2	12			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H6453	020	2	1	02	01	H6453_020_2	12			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6453	020	2	1	02	01	H6453_020_2	12			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6453	020	2	1	02	01	H6453_020_2	12			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6474	001	0	1	02	01	H6474_001_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H6474	001	0	1	02	01	H6474_001_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H6474	001	0	1	02	01	H6474_001_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H6474	001	0	1	02	01	H6474_001_0	8			Non-Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6474	001	0	1	02	01	H6474_001_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6474	001	0	1	02	01	H6474_001_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H6474	002	0	1	02	01	H6474_002_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H6474	002	0	1	02	01	H6474_002_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H6474	002	0	1	02	01	H6474_002_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H6474	002	0	1	02	01	H6474_002_0	9			Non-Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6474	002	0	1	02	01	H6474_002_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6474	002	0	1	02	01	H6474_002_0	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H6474	003	0	1	02	01	H6474_003_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H6474	003	0	1	02	01	H6474_003_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H6474	003	0	1	02	01	H6474_003_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H6474	003	0	1	02	01	H6474_003_0	8			Non-Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6474	003	0	1	02	01	H6474_003_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6474	003	0	1	02	01	H6474_003_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H6474	007	0	1	01	01	H6474_007_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H6474	007	0	1	01	01	H6474_007_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H6474	007	0	1	01	01	H6474_007_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H6474	007	0	1	01	01	H6474_007_0	8			Non-Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6474	007	0	1	01	01	H6474_007_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6474	007	0	1	01	01	H6474_007_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H6474	008	0	1	01	01	H6474_008_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H6474	008	0	1	01	01	H6474_008_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H6474	008	0	1	01	01	H6474_008_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H6474	008	0	1	01	01	H6474_008_0	7			Non-Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6474	008	0	1	01	01	H6474_008_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6474	008	0	1	01	01	H6474_008_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H6474	009	0	1	01	01	H6474_009_0	11			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H6474	009	0	1	01	01	H6474_009_0	11			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H6474	009	0	1	01	01	H6474_009_0	11			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H6474	009	0	1	01	01	H6474_009_0	11			Non-Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6474	009	0	1	01	01	H6474_009_0	11			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6474	009	0	1	01	01	H6474_009_0	11			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H6474	010	0	1	01	01	H6474_010_0	11			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H6474	010	0	1	01	01	H6474_010_0	11			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H6474	010	0	1	01	01	H6474_010_0	11			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H6474	010	0	1	01	01	H6474_010_0	11			Non-Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6474	010	0	1	01	01	H6474_010_0	11			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6474	010	0	1	01	01	H6474_010_0	11			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H6515	001	0	1	01	01	H6515_001_0	9		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H6515	001	0	1	01	01	H6515_001_0	9		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H6515	001	0	1	01	01	H6515_001_0	9		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H6515	001	0	1	01	01	H6515_001_0	9		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6515	001	0	1	01	01	H6515_001_0	9		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6515	001	0	1	01	01	H6515_001_0	9		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H6515	002	0	1	01	01	H6515_002_0	9		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H6515	002	0	1	01	01	H6515_002_0	9		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H6515	002	0	1	01	01	H6515_002_0	9		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H6515	002	0	1	01	01	H6515_002_0	9		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6515	002	0	1	01	01	H6515_002_0	9		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6515	002	0	1	01	01	H6515_002_0	9		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H6515	003	0	1	01	01	H6515_003_0	9		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H6515	003	0	1	01	01	H6515_003_0	9		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H6515	003	0	1	01	01	H6515_003_0	9		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H6515	003	0	1	01	01	H6515_003_0	9		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6515	003	0	1	01	01	H6515_003_0	9		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6515	003	0	1	01	01	H6515_003_0	9		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H6515	004	0	1	01	01	H6515_004_0	9		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H6515	004	0	1	01	01	H6515_004_0	9		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H6515	004	0	1	01	01	H6515_004_0	9		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H6515	004	0	1	01	01	H6515_004_0	9		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6515	004	0	1	01	01	H6515_004_0	9		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6515	004	0	1	01	01	H6515_004_0	9		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H6515	005	0	1	01	01	H6515_005_0	9		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H6515	005	0	1	01	01	H6515_005_0	9		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H6515	005	0	1	01	01	H6515_005_0	9		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H6515	005	0	1	01	01	H6515_005_0	9		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6515	005	0	1	01	01	H6515_005_0	9		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6515	005	0	1	01	01	H6515_005_0	9		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H6529	004	0	1	01	01	H6529_004_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H6529	004	0	1	01	01	H6529_004_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H6529	004	0	1	01	01	H6529_004_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H6529	004	0	1	01	01	H6529_004_0	7			Non-Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6529	004	0	1	01	01	H6529_004_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6529	004	0	1	01	01	H6529_004_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H6545	001	0	1	04	01	H6545_001_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6545	001	0	1	04	01	H6545_001_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H6545	001	0	1	04	01	H6545_001_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6545	001	0	1	04	01	H6545_001_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6545	001	0	1	04	01	H6545_001_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6545	010	0	1	04	01	H6545_010_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6545	010	0	1	04	01	H6545_010_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H6545	010	0	1	04	01	H6545_010_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6545	010	0	1	04	01	H6545_010_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6545	010	0	1	04	01	H6545_010_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6550	003	0	1	02	01	H6550_003_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H6550	003	0	1	02	01	H6550_003_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H6550	003	0	1	02	01	H6550_003_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H6550	003	0	1	02	01	H6550_003_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6550	003	0	1	02	01	H6550_003_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6550	003	0	1	02	01	H6550_003_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H6550	004	0	1	02	01	H6550_004_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H6550	004	0	1	02	01	H6550_004_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H6550	004	0	1	02	01	H6550_004_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H6550	004	0	1	02	01	H6550_004_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6550	004	0	1	02	01	H6550_004_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6550	004	0	1	02	01	H6550_004_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H6550	009	0	1	02	01	H6550_009_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H6550	009	0	1	02	01	H6550_009_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H6550	009	0	1	02	01	H6550_009_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H6550	009	0	1	02	01	H6550_009_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6550	009	0	1	02	01	H6550_009_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6550	009	0	1	02	01	H6550_009_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H6586	001	0	1	04	01	H6586_001_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6586	001	0	1	04	01	H6586_001_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H6586	001	0	1	04	01	H6586_001_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6586	001	0	1	04	01	H6586_001_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6586	001	0	1	04	01	H6586_001_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6586	002	0	1	04	01	H6586_002_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6586	002	0	1	04	01	H6586_002_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	5.00	
H6586	002	0	1	04	01	H6586_002_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6586	002	0	1	04	01	H6586_002_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6586	002	0	1	04	01	H6586_002_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6586	003	0	1	04	01	H6586_003_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6586	003	0	1	04	01	H6586_003_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H6586	003	0	1	04	01	H6586_003_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6586	003	0	1	04	01	H6586_003_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6586	003	0	1	04	01	H6586_003_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6586	006	0	1	04	01	H6586_006_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6586	006	0	1	04	01	H6586_006_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H6586	006	0	1	04	01	H6586_006_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6586	006	0	1	04	01	H6586_006_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6586	006	0	1	04	01	H6586_006_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6595	003	0	1	02	01	H6595_003_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H6595	003	0	1	02	01	H6595_003_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H6595	003	0	1	02	01	H6595_003_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6595	003	0	1	02	01	H6595_003_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6595	003	0	1	02	01	H6595_003_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6595	004	0	1	02	01	H6595_004_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H6595	004	0	1	02	01	H6595_004_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H6595	004	0	1	02	01	H6595_004_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6595	004	0	1	02	01	H6595_004_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6595	004	0	1	02	01	H6595_004_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6595	005	0	1	02	01	H6595_005_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H6595	005	0	1	02	01	H6595_005_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H6595	005	0	1	02	01	H6595_005_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6595	005	0	1	02	01	H6595_005_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6595	005	0	1	02	01	H6595_005_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6622	001	0	1	01	01	H6622_001_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H6622	001	0	1	01	01	H6622_001_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H6622	001	0	1	01	01	H6622_001_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6622	001	0	1	01	01	H6622_001_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6622	001	0	1	01	01	H6622_001_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6622	004	0	1	01	01	H6622_004_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6622	004	0	1	01	01	H6622_004_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H6622	004	0	1	01	01	H6622_004_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6622	004	0	1	01	01	H6622_004_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6622	004	0	1	01	01	H6622_004_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6622	007	0	1	01	01	H6622_007_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6622	007	0	1	01	01	H6622_007_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H6622	007	0	1	01	01	H6622_007_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6622	007	0	1	01	01	H6622_007_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6622	007	0	1	01	01	H6622_007_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6622	008	0	1	01	01	H6622_008_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6622	008	0	1	01	01	H6622_008_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H6622	008	0	1	01	01	H6622_008_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6622	008	0	1	01	01	H6622_008_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6622	008	0	1	01	01	H6622_008_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6622	013	0	1	02	01	H6622_013_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6622	013	0	1	02	01	H6622_013_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H6622	013	0	1	02	01	H6622_013_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6622	013	0	1	02	01	H6622_013_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6622	013	0	1	02	01	H6622_013_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6622	014	0	1	02	01	H6622_014_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6622	014	0	1	02	01	H6622_014_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H6622	014	0	1	02	01	H6622_014_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6622	014	0	1	02	01	H6622_014_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6622	014	0	1	02	01	H6622_014_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6622	015	0	1	01	01	H6622_015_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6622	015	0	1	01	01	H6622_015_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H6622	015	0	1	01	01	H6622_015_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6622	015	0	1	01	01	H6622_015_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6622	015	0	1	01	01	H6622_015_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6622	017	0	1	01	01	H6622_017_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H6622	017	0	1	01	01	H6622_017_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H6622	017	0	1	01	01	H6622_017_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H6622	017	0	1	01	01	H6622_017_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6622	017	0	1	01	01	H6622_017_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6622	017	0	1	01	01	H6622_017_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H6622	018	0	1	01	01	H6622_018_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6622	018	0	1	01	01	H6622_018_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H6622	018	0	1	01	01	H6622_018_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6622	018	0	1	01	01	H6622_018_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6622	018	0	1	01	01	H6622_018_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6622	021	1	1	02	01	H6622_021_1	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6622	021	1	1	02	01	H6622_021_1	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H6622	021	1	1	02	01	H6622_021_1	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6622	021	1	1	02	01	H6622_021_1	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6622	021	1	1	02	01	H6622_021_1	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6622	021	2	1	02	01	H6622_021_2	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6622	021	2	1	02	01	H6622_021_2	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H6622	021	2	1	02	01	H6622_021_2	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6622	021	2	1	02	01	H6622_021_2	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6622	021	2	1	02	01	H6622_021_2	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6622	022	0	1	02	01	H6622_022_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6622	022	0	1	02	01	H6622_022_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H6622	022	0	1	02	01	H6622_022_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6622	022	0	1	02	01	H6622_022_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6622	022	0	1	02	01	H6622_022_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6622	023	0	1	02	01	H6622_023_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6622	023	0	1	02	01	H6622_023_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H6622	023	0	1	02	01	H6622_023_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6622	023	0	1	02	01	H6622_023_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6622	023	0	1	02	01	H6622_023_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6622	025	0	1	02	01	H6622_025_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6622	025	0	1	02	01	H6622_025_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H6622	025	0	1	02	01	H6622_025_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6622	025	0	1	02	01	H6622_025_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6622	025	0	1	02	01	H6622_025_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6622	026	0	1	02	01	H6622_026_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6622	026	0	1	02	01	H6622_026_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H6622	026	0	1	02	01	H6622_026_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6622	026	0	1	02	01	H6622_026_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6622	026	0	1	02	01	H6622_026_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6622	027	0	1	02	01	H6622_027_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6622	027	0	1	02	01	H6622_027_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H6622	027	0	1	02	01	H6622_027_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6622	027	0	1	02	01	H6622_027_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6622	027	0	1	02	01	H6622_027_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6622	028	0	1	01	01	H6622_028_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H6622	028	0	1	01	01	H6622_028_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H6622	028	0	1	01	01	H6622_028_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6622	028	0	1	01	01	H6622_028_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6622	028	0	1	01	01	H6622_028_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6622	029	0	1	01	01	H6622_029_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H6622	029	0	1	01	01	H6622_029_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H6622	029	0	1	01	01	H6622_029_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H6622	029	0	1	01	01	H6622_029_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6622	029	0	1	01	01	H6622_029_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6622	029	0	1	01	01	H6622_029_0	3			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H6622	032	0	1	01	01	H6622_032_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6622	032	0	1	01	01	H6622_032_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H6622	032	0	1	01	01	H6622_032_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6622	032	0	1	01	01	H6622_032_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6622	032	0	1	01	01	H6622_032_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6622	033	0	1	01	01	H6622_033_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6622	033	0	1	01	01	H6622_033_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H6622	033	0	1	01	01	H6622_033_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6622	033	0	1	01	01	H6622_033_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6622	033	0	1	01	01	H6622_033_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6622	035	0	1	01	01	H6622_035_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H6622	035	0	1	01	01	H6622_035_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H6622	035	0	1	01	01	H6622_035_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6622	035	0	1	01	01	H6622_035_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6622	035	0	1	01	01	H6622_035_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6622	036	0	1	01	01	H6622_036_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H6622	036	0	1	01	01	H6622_036_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H6622	036	0	1	01	01	H6622_036_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6622	036	0	1	01	01	H6622_036_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6622	036	0	1	01	01	H6622_036_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6622	037	0	1	01	01	H6622_037_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H6622	037	0	1	01	01	H6622_037_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H6622	037	0	1	01	01	H6622_037_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6622	037	0	1	01	01	H6622_037_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6622	037	0	1	01	01	H6622_037_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6622	047	0	1	01	01	H6622_047_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6622	047	0	1	01	01	H6622_047_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H6622	047	0	1	01	01	H6622_047_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6622	047	0	1	01	01	H6622_047_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6622	047	0	1	01	01	H6622_047_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6622	048	0	1	01	01	H6622_048_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6622	048	0	1	01	01	H6622_048_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H6622	048	0	1	01	01	H6622_048_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6622	048	0	1	01	01	H6622_048_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6622	048	0	1	01	01	H6622_048_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6622	054	0	1	01	01	H6622_054_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H6622	054	0	1	01	01	H6622_054_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H6622	054	0	1	01	01	H6622_054_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6622	054	0	1	01	01	H6622_054_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6622	054	0	1	01	01	H6622_054_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6622	055	0	1	01	01	H6622_055_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6622	055	0	1	01	01	H6622_055_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H6622	055	0	1	01	01	H6622_055_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6622	055	0	1	01	01	H6622_055_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6622	055	0	1	01	01	H6622_055_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6622	056	0	1	01	01	H6622_056_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H6622	056	0	1	01	01	H6622_056_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H6622	056	0	1	01	01	H6622_056_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6622	056	0	1	01	01	H6622_056_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6622	056	0	1	01	01	H6622_056_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6622	057	0	1	02	01	H6622_057_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6622	057	0	1	02	01	H6622_057_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H6622	057	0	1	02	01	H6622_057_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6622	057	0	1	02	01	H6622_057_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6622	057	0	1	02	01	H6622_057_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6622	060	0	1	02	01	H6622_060_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6622	060	0	1	02	01	H6622_060_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H6622	060	0	1	02	01	H6622_060_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6622	060	0	1	02	01	H6622_060_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6622	060	0	1	02	01	H6622_060_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6622	061	0	1	02	01	H6622_061_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6622	061	0	1	02	01	H6622_061_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H6622	061	0	1	02	01	H6622_061_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6622	061	0	1	02	01	H6622_061_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6622	061	0	1	02	01	H6622_061_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6622	071	0	1	01	01	H6622_071_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H6622	071	0	1	01	01	H6622_071_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H6622	071	0	1	01	01	H6622_071_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H6622	071	0	1	01	01	H6622_071_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6622	071	0	1	01	01	H6622_071_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6622	071	0	1	01	01	H6622_071_0	2			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H6622	075	0	1	01	01	H6622_075_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H6622	075	0	1	01	01	H6622_075_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H6622	075	0	1	01	01	H6622_075_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6622	075	0	1	01	01	H6622_075_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6622	075	0	1	01	01	H6622_075_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6622	078	1	1	01	01	H6622_078_1	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6622	078	1	1	01	01	H6622_078_1	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H6622	078	1	1	01	01	H6622_078_1	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6622	078	1	1	01	01	H6622_078_1	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6622	078	1	1	01	01	H6622_078_1	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6622	078	2	1	01	01	H6622_078_2	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6622	078	2	1	01	01	H6622_078_2	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H6622	078	2	1	01	01	H6622_078_2	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6622	078	2	1	01	01	H6622_078_2	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6622	078	2	1	01	01	H6622_078_2	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6622	079	0	1	01	01	H6622_079_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H6622	079	0	1	01	01	H6622_079_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H6622	079	0	1	01	01	H6622_079_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6622	079	0	1	01	01	H6622_079_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6622	079	0	1	01	01	H6622_079_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6622	081	0	1	01	01	H6622_081_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6622	081	0	1	01	01	H6622_081_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H6622	081	0	1	01	01	H6622_081_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6622	081	0	1	01	01	H6622_081_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6622	081	0	1	01	01	H6622_081_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6622	082	0	1	01	01	H6622_082_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H6622	082	0	1	01	01	H6622_082_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H6622	082	0	1	01	01	H6622_082_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6622	082	0	1	01	01	H6622_082_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6622	082	0	1	01	01	H6622_082_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6622	083	0	1	01	01	H6622_083_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6622	083	0	1	01	01	H6622_083_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H6622	083	0	1	01	01	H6622_083_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6622	083	0	1	01	01	H6622_083_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6622	083	0	1	01	01	H6622_083_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6622	084	0	1	01	01	H6622_084_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H6622	084	0	1	01	01	H6622_084_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H6622	084	0	1	01	01	H6622_084_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H6622	084	0	1	01	01	H6622_084_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6622	084	0	1	01	01	H6622_084_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6622	084	0	1	01	01	H6622_084_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H6622	085	0	1	01	01	H6622_085_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6622	085	0	1	01	01	H6622_085_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H6622	085	0	1	01	01	H6622_085_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6622	085	0	1	01	01	H6622_085_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6622	085	0	1	01	01	H6622_085_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6622	087	0	1	01	01	H6622_087_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6622	087	0	1	01	01	H6622_087_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H6622	087	0	1	01	01	H6622_087_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6622	087	0	1	01	01	H6622_087_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6622	087	0	1	01	01	H6622_087_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6622	090	0	1	01	01	H6622_090_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6622	090	0	1	01	01	H6622_090_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H6622	090	0	1	01	01	H6622_090_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6622	090	0	1	01	01	H6622_090_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6622	090	0	1	01	01	H6622_090_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6622	091	0	1	01	01	H6622_091_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6622	091	0	1	01	01	H6622_091_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H6622	091	0	1	01	01	H6622_091_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6622	091	0	1	01	01	H6622_091_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6622	091	0	1	01	01	H6622_091_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6622	095	0	1	01	01	H6622_095_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6622	095	0	1	01	01	H6622_095_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H6622	095	0	1	01	01	H6622_095_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6622	095	0	1	01	01	H6622_095_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6622	095	0	1	01	01	H6622_095_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6622	097	0	1	01	01	H6622_097_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6622	097	0	1	01	01	H6622_097_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H6622	097	0	1	01	01	H6622_097_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6622	097	0	1	01	01	H6622_097_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6622	097	0	1	01	01	H6622_097_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6622	098	0	1	01	01	H6622_098_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H6622	098	0	1	01	01	H6622_098_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H6622	098	0	1	01	01	H6622_098_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H6622	098	0	1	01	01	H6622_098_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6622	098	0	1	01	01	H6622_098_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6622	098	0	1	01	01	H6622_098_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H6622	099	1	1	01	01	H6622_099_1	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H6622	099	1	1	01	01	H6622_099_1	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H6622	099	1	1	01	01	H6622_099_1	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6622	099	1	1	01	01	H6622_099_1	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6622	099	1	1	01	01	H6622_099_1	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6622	099	2	1	01	01	H6622_099_2	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H6622	099	2	1	01	01	H6622_099_2	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H6622	099	2	1	01	01	H6622_099_2	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6622	099	2	1	01	01	H6622_099_2	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6622	099	2	1	01	01	H6622_099_2	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6622	100	1	1	01	01	H6622_100_1	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H6622	100	1	1	01	01	H6622_100_1	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H6622	100	1	1	01	01	H6622_100_1	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6622	100	1	1	01	01	H6622_100_1	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6622	100	1	1	01	01	H6622_100_1	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6622	100	2	1	01	01	H6622_100_2	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H6622	100	2	1	01	01	H6622_100_2	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H6622	100	2	1	01	01	H6622_100_2	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6622	100	2	1	01	01	H6622_100_2	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6622	100	2	1	01	01	H6622_100_2	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6622	101	0	1	01	01	H6622_101_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H6622	101	0	1	01	01	H6622_101_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H6622	101	0	1	01	01	H6622_101_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6622	101	0	1	01	01	H6622_101_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6622	101	0	1	01	01	H6622_101_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6672	003	0	1	01	01	H6672_003_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H6672	003	0	1	01	01	H6672_003_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H6672	003	0	1	01	01	H6672_003_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H6672	003	0	1	01	01	H6672_003_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6672	003	0	1	01	01	H6672_003_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6672	003	0	1	01	01	H6672_003_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H6672	005	0	1	01	01	H6672_005_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H6672	005	0	1	01	01	H6672_005_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H6672	005	0	1	01	01	H6672_005_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H6672	005	0	1	01	01	H6672_005_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6672	005	0	1	01	01	H6672_005_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6672	005	0	1	01	01	H6672_005_0	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H6706	001	0	1	02	01	H6706_001_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H6706	001	0	1	02	01	H6706_001_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H6706	001	0	1	02	01	H6706_001_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6706	001	0	1	02	01	H6706_001_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6706	001	0	1	02	01	H6706_001_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6723	001	1	1	01	01	H6723_001_1	14			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H6723	001	1	1	01	01	H6723_001_1	14			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H6723	001	1	1	01	01	H6723_001_1	14			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H6723	001	1	1	01	01	H6723_001_1	14			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6723	001	1	1	01	01	H6723_001_1	14			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6723	001	1	1	01	01	H6723_001_1	14			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H6723	001	3	1	01	01	H6723_001_3	14			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H6723	001	3	1	01	01	H6723_001_3	14			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H6723	001	3	1	01	01	H6723_001_3	14			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H6723	001	3	1	01	01	H6723_001_3	14			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6723	001	3	1	01	01	H6723_001_3	14			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6723	001	3	1	01	01	H6723_001_3	14			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H6723	002	1	1	01	01	H6723_002_1	14			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H6723	002	1	1	01	01	H6723_002_1	14			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H6723	002	1	1	01	01	H6723_002_1	14			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H6723	002	1	1	01	01	H6723_002_1	14			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6723	002	1	1	01	01	H6723_002_1	14			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6723	002	1	1	01	01	H6723_002_1	14			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H6723	002	3	1	01	01	H6723_002_3	14			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H6723	002	3	1	01	01	H6723_002_3	14			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H6723	002	3	1	01	01	H6723_002_3	14			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H6723	002	3	1	01	01	H6723_002_3	14			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6723	002	3	1	01	01	H6723_002_3	14			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6723	002	3	1	01	01	H6723_002_3	14			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H6723	003	1	1	01	01	H6723_003_1	14			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H6723	003	1	1	01	01	H6723_003_1	14			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H6723	003	1	1	01	01	H6723_003_1	14			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H6723	003	1	1	01	01	H6723_003_1	14			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6723	003	1	1	01	01	H6723_003_1	14			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6723	003	1	1	01	01	H6723_003_1	14			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H6723	003	3	1	01	01	H6723_003_3	16			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H6723	003	3	1	01	01	H6723_003_3	16			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H6723	003	3	1	01	01	H6723_003_3	16			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H6723	003	3	1	01	01	H6723_003_3	16			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6723	003	3	1	01	01	H6723_003_3	16			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6723	003	3	1	01	01	H6723_003_3	16			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H6723	006	6	1	02	01	H6723_006_6	15			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H6723	006	6	1	02	01	H6723_006_6	15			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H6723	006	6	1	02	01	H6723_006_6	15			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H6723	006	6	1	02	01	H6723_006_6	15			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6723	006	6	1	02	01	H6723_006_6	15			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6723	006	6	1	02	01	H6723_006_6	15			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H6723	006	7	1	02	01	H6723_006_7	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H6723	006	7	1	02	01	H6723_006_7	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H6723	006	7	1	02	01	H6723_006_7	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H6723	006	7	1	02	01	H6723_006_7	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6723	006	7	1	02	01	H6723_006_7	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6723	006	7	1	02	01	H6723_006_7	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H6743	001	0	1	04	01	H6743_001_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H6743	001	0	1	04	01	H6743_001_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	3	2	0.00	
H6743	001	0	1	04	01	H6743_001_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H6743	001	0	1	04	01	H6743_001_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6743	001	0	1	04	01	H6743_001_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6743	001	0	1	04	01	H6743_001_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H6743	007	0	1	04	01	H6743_007_0	10			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H6743	007	0	1	04	01	H6743_007_0	10			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	3	2	0.00	
H6743	007	0	1	04	01	H6743_007_0	10			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H6743	007	0	1	04	01	H6743_007_0	10			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6743	007	0	1	04	01	H6743_007_0	10			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6743	007	0	1	04	01	H6743_007_0	10			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H6743	025	0	1	04	01	H6743_025_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H6743	025	0	1	04	01	H6743_025_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	3	2	0.00	
H6743	025	0	1	04	01	H6743_025_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H6743	025	0	1	04	01	H6743_025_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6743	025	0	1	04	01	H6743_025_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6743	025	0	1	04	01	H6743_025_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H6743	026	0	1	04	01	H6743_026_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H6743	026	0	1	04	01	H6743_026_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	3	2	0.00	
H6743	026	0	1	04	01	H6743_026_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H6743	026	0	1	04	01	H6743_026_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6743	026	0	1	04	01	H6743_026_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6743	026	0	1	04	01	H6743_026_0	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H6743	028	0	1	04	01	H6743_028_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H6743	028	0	1	04	01	H6743_028_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	3	2	0.00	
H6743	028	0	1	04	01	H6743_028_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H6743	028	0	1	04	01	H6743_028_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6743	028	0	1	04	01	H6743_028_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6743	028	0	1	04	01	H6743_028_0	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H6743	030	0	1	04	01	H6743_030_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H6743	030	0	1	04	01	H6743_030_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	3	2	0.00	
H6743	030	0	1	04	01	H6743_030_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H6743	030	0	1	04	01	H6743_030_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6743	030	0	1	04	01	H6743_030_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6743	030	0	1	04	01	H6743_030_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H6813	001	0	1	04	01	H6813_001_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6813	001	0	1	04	01	H6813_001_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	1.00	
H6813	001	0	1	04	01	H6813_001_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6813	001	0	1	04	01	H6813_001_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6813	001	0	1	04	01	H6813_001_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6815	038	0	1	02	01	H6815_038_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H6815	038	0	1	02	01	H6815_038_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H6815	038	0	1	02	01	H6815_038_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H6815	038	0	1	02	01	H6815_038_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6815	038	0	1	02	01	H6815_038_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6815	038	0	1	02	01	H6815_038_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H6815	039	0	1	02	01	H6815_039_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H6815	039	0	1	02	01	H6815_039_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H6815	039	0	1	02	01	H6815_039_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H6815	039	0	1	02	01	H6815_039_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6815	039	0	1	02	01	H6815_039_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6815	039	0	1	02	01	H6815_039_0	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H6815	040	0	1	02	01	H6815_040_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H6815	040	0	1	02	01	H6815_040_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H6815	040	0	1	02	01	H6815_040_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H6815	040	0	1	02	01	H6815_040_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6815	040	0	1	02	01	H6815_040_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6815	040	0	1	02	01	H6815_040_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H6824	001	0	1	04	01	H6824_001_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H6824	001	0	1	04	01	H6824_001_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H6824	001	0	1	04	01	H6824_001_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6824	001	0	1	04	01	H6824_001_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6824	001	0	1	04	01	H6824_001_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6824	002	0	1	04	01	H6824_002_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H6824	002	0	1	04	01	H6824_002_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H6824	002	0	1	04	01	H6824_002_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6824	002	0	1	04	01	H6824_002_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6824	002	0	1	04	01	H6824_002_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6832	004	0	1	02	01	H6832_004_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H6832	004	0	1	02	01	H6832_004_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H6832	004	0	1	02	01	H6832_004_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H6832	004	0	1	02	01	H6832_004_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	10	1	2	0.00	
H6832	004	0	1	02	01	H6832_004_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6847	001	0	1	02	01	H6847_001_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H6847	001	0	1	02	01	H6847_001_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	5.00	
H6847	001	0	1	02	01	H6847_001_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	3	2	47.00	
H6847	001	0	1	02	01	H6847_001_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	3	1		25
H6847	001	0	1	02	01	H6847_001_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6851	002	0	1	01	01	H6851_002_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H6851	002	0	1	01	01	H6851_002_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H6851	002	0	1	01	01	H6851_002_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6851	002	0	1	01	01	H6851_002_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6851	002	0	1	01	01	H6851_002_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6851	003	0	1	01	01	H6851_003_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H6851	003	0	1	01	01	H6851_003_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H6851	003	0	1	01	01	H6851_003_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6851	003	0	1	01	01	H6851_003_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6851	003	0	1	01	01	H6851_003_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6852	005	0	1	01	01	H6852_005_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H6852	005	0	1	01	01	H6852_005_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H6852	005	0	1	01	01	H6852_005_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H6852	005	0	1	01	01	H6852_005_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6852	005	0	1	01	01	H6852_005_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6852	005	0	1	01	01	H6852_005_0	5		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H6852	007	0	1	01	01	H6852_007_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H6852	007	0	1	01	01	H6852_007_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H6852	007	0	1	01	01	H6852_007_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H6852	007	0	1	01	01	H6852_007_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6852	007	0	1	01	01	H6852_007_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6852	007	0	1	01	01	H6852_007_0	5		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H6852	008	0	1	01	01	H6852_008_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6852	008	0	1	01	01	H6852_008_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H6852	008	0	1	01	01	H6852_008_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6852	008	0	1	01	01	H6852_008_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6852	008	0	1	01	01	H6852_008_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6852	009	0	1	01	01	H6852_009_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6852	009	0	1	01	01	H6852_009_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H6852	009	0	1	01	01	H6852_009_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6852	009	0	1	01	01	H6852_009_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6852	009	0	1	01	01	H6852_009_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6852	010	0	1	01	01	H6852_010_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6852	010	0	1	01	01	H6852_010_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H6852	010	0	1	01	01	H6852_010_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6852	010	0	1	01	01	H6852_010_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6852	010	0	1	01	01	H6852_010_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6852	011	0	1	01	01	H6852_011_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6852	011	0	1	01	01	H6852_011_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H6852	011	0	1	01	01	H6852_011_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6852	011	0	1	01	01	H6852_011_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6852	011	0	1	01	01	H6852_011_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6852	012	0	1	01	01	H6852_012_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6852	012	0	1	01	01	H6852_012_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H6852	012	0	1	01	01	H6852_012_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6852	012	0	1	01	01	H6852_012_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6852	012	0	1	01	01	H6852_012_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6852	013	0	1	01	01	H6852_013_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6852	013	0	1	01	01	H6852_013_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H6852	013	0	1	01	01	H6852_013_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6852	013	0	1	01	01	H6852_013_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6852	013	0	1	01	01	H6852_013_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6852	014	0	1	01	01	H6852_014_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6852	014	0	1	01	01	H6852_014_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H6852	014	0	1	01	01	H6852_014_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6852	014	0	1	01	01	H6852_014_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6852	014	0	1	01	01	H6852_014_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6852	015	0	1	01	01	H6852_015_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6852	015	0	1	01	01	H6852_015_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H6852	015	0	1	01	01	H6852_015_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6852	015	0	1	01	01	H6852_015_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6852	015	0	1	01	01	H6852_015_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6852	016	0	1	01	01	H6852_016_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H6852	016	0	1	01	01	H6852_016_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H6852	016	0	1	01	01	H6852_016_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H6852	016	0	1	01	01	H6852_016_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6852	016	0	1	01	01	H6852_016_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6852	016	0	1	01	01	H6852_016_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H6852	017	0	1	01	01	H6852_017_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H6852	017	0	1	01	01	H6852_017_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H6852	017	0	1	01	01	H6852_017_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H6852	017	0	1	01	01	H6852_017_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6852	017	0	1	01	01	H6852_017_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6852	017	0	1	01	01	H6852_017_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H6852	018	0	1	01	01	H6852_018_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H6852	018	0	1	01	01	H6852_018_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H6852	018	0	1	01	01	H6852_018_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H6852	018	0	1	01	01	H6852_018_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6852	018	0	1	01	01	H6852_018_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6852	018	0	1	01	01	H6852_018_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H6852	019	0	1	01	01	H6852_019_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H6852	019	0	1	01	01	H6852_019_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H6852	019	0	1	01	01	H6852_019_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H6852	019	0	1	01	01	H6852_019_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6852	019	0	1	01	01	H6852_019_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6852	019	0	1	01	01	H6852_019_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H6852	020	0	1	01	01	H6852_020_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H6852	020	0	1	01	01	H6852_020_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H6852	020	0	1	01	01	H6852_020_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H6852	020	0	1	01	01	H6852_020_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6852	020	0	1	01	01	H6852_020_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6852	020	0	1	01	01	H6852_020_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H6852	021	0	1	01	01	H6852_021_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H6852	021	0	1	01	01	H6852_021_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H6852	021	0	1	01	01	H6852_021_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H6852	021	0	1	01	01	H6852_021_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6852	021	0	1	01	01	H6852_021_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6852	021	0	1	01	01	H6852_021_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H6852	022	0	1	01	01	H6852_022_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H6852	022	0	1	01	01	H6852_022_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H6852	022	0	1	01	01	H6852_022_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H6852	022	0	1	01	01	H6852_022_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6852	022	0	1	01	01	H6852_022_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6852	022	0	1	01	01	H6852_022_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H6852	023	0	1	01	01	H6852_023_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6852	023	0	1	01	01	H6852_023_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	5.00	
H6852	023	0	1	01	01	H6852_023_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6852	023	0	1	01	01	H6852_023_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6852	023	0	1	01	01	H6852_023_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6852	025	0	1	01	01	H6852_025_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H6852	025	0	1	01	01	H6852_025_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H6852	025	0	1	01	01	H6852_025_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H6852	025	0	1	01	01	H6852_025_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6852	025	0	1	01	01	H6852_025_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6852	025	0	1	01	01	H6852_025_0	5		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H6852	026	0	1	01	01	H6852_026_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H6852	026	0	1	01	01	H6852_026_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H6852	026	0	1	01	01	H6852_026_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H6852	026	0	1	01	01	H6852_026_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6852	026	0	1	01	01	H6852_026_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6852	026	0	1	01	01	H6852_026_0	5		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H6874	001	0	1	04	01	H6874_001_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6874	001	0	1	04	01	H6874_001_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H6874	001	0	1	04	01	H6874_001_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6874	001	0	1	04	01	H6874_001_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6874	001	0	1	04	01	H6874_001_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6876	001	0	1	04	01	H6876_001_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6876	001	0	1	04	01	H6876_001_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H6876	001	0	1	04	01	H6876_001_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6876	001	0	1	04	01	H6876_001_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6876	001	0	1	04	01	H6876_001_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6876	003	0	1	04	01	H6876_003_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H6876	003	0	1	04	01	H6876_003_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	3	2	0.00	
H6876	003	0	1	04	01	H6876_003_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H6876	003	0	1	04	01	H6876_003_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6876	003	0	1	04	01	H6876_003_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6876	003	0	1	04	01	H6876_003_0	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H6876	004	0	1	04	01	H6876_004_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6876	004	0	1	04	01	H6876_004_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H6876	004	0	1	04	01	H6876_004_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6876	004	0	1	04	01	H6876_004_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6876	004	0	1	04	01	H6876_004_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6876	005	0	1	04	01	H6876_005_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H6876	005	0	1	04	01	H6876_005_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	3	2	0.00	
H6876	005	0	1	04	01	H6876_005_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H6876	005	0	1	04	01	H6876_005_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6876	005	0	1	04	01	H6876_005_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6876	005	0	1	04	01	H6876_005_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H6876	007	0	1	04	01	H6876_007_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H6876	007	0	1	04	01	H6876_007_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	3	2	0.00	
H6876	007	0	1	04	01	H6876_007_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H6876	007	0	1	04	01	H6876_007_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6876	007	0	1	04	01	H6876_007_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6876	007	0	1	04	01	H6876_007_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H6876	009	0	1	04	01	H6876_009_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6876	009	0	1	04	01	H6876_009_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H6876	009	0	1	04	01	H6876_009_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6876	009	0	1	04	01	H6876_009_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6876	009	0	1	04	01	H6876_009_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6910	001	0	1	01	01	H6910_001_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6910	001	0	1	01	01	H6910_001_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	20.00	
H6910	001	0	1	01	01	H6910_001_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6910	001	0	1	01	01	H6910_001_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6910	001	0	1	01	01	H6910_001_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6910	005	0	1	01	01	H6910_005_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6910	005	0	1	01	01	H6910_005_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	20.00	
H6910	005	0	1	01	01	H6910_005_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6910	005	0	1	01	01	H6910_005_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6910	005	0	1	01	01	H6910_005_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6959	002	0	1	01	01	H6959_002_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H6959	002	0	1	01	01	H6959_002_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H6959	002	0	1	01	01	H6959_002_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H6959	002	0	1	01	01	H6959_002_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	10	1	2	0.00	
H6959	002	0	1	01	01	H6959_002_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6971	001	0	1	01	01	H6971_001_0	7		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H6971	001	0	1	01	01	H6971_001_0	7		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H6971	001	0	1	01	01	H6971_001_0	7		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H6971	001	0	1	01	01	H6971_001_0	7		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6971	001	0	1	01	01	H6971_001_0	7		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6971	001	0	1	01	01	H6971_001_0	7		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H6988	004	0	1	01	01	H6988_004_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H6988	004	0	1	01	01	H6988_004_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H6988	004	0	1	01	01	H6988_004_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H6988	004	0	1	01	01	H6988_004_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6988	004	0	1	01	01	H6988_004_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6988	004	0	1	01	01	H6988_004_0	7		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H6988	006	0	1	02	01	H6988_006_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6988	006	0	1	02	01	H6988_006_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H6988	006	0	1	02	01	H6988_006_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6988	006	0	1	02	01	H6988_006_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6988	006	0	1	02	01	H6988_006_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6988	007	0	1	02	01	H6988_007_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6988	007	0	1	02	01	H6988_007_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H6988	007	0	1	02	01	H6988_007_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6988	007	0	1	02	01	H6988_007_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6988	007	0	1	02	01	H6988_007_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6988	009	0	1	02	01	H6988_009_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6988	009	0	1	02	01	H6988_009_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H6988	009	0	1	02	01	H6988_009_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6988	009	0	1	02	01	H6988_009_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6988	009	0	1	02	01	H6988_009_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6988	010	0	1	02	01	H6988_010_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6988	010	0	1	02	01	H6988_010_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H6988	010	0	1	02	01	H6988_010_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6988	010	0	1	02	01	H6988_010_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6988	010	0	1	02	01	H6988_010_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6994	001	0	1	01	01	H6994_001_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6994	001	0	1	01	01	H6994_001_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H6994	001	0	1	01	01	H6994_001_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6994	001	0	1	01	01	H6994_001_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6994	001	0	1	01	01	H6994_001_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6994	002	0	1	01	01	H6994_002_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6994	002	0	1	01	01	H6994_002_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H6994	002	0	1	01	01	H6994_002_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6994	002	0	1	01	01	H6994_002_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6994	002	0	1	01	01	H6994_002_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6994	003	0	1	01	01	H6994_003_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H6994	003	0	1	01	01	H6994_003_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H6994	003	0	1	01	01	H6994_003_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H6994	003	0	1	01	01	H6994_003_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6994	003	0	1	01	01	H6994_003_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6994	003	0	1	01	01	H6994_003_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H6994	004	0	1	01	01	H6994_004_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H6994	004	0	1	01	01	H6994_004_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H6994	004	0	1	01	01	H6994_004_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H6994	004	0	1	01	01	H6994_004_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6994	004	0	1	01	01	H6994_004_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6994	004	0	1	01	01	H6994_004_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H6994	008	0	1	01	01	H6994_008_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6994	008	0	1	01	01	H6994_008_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H6994	008	0	1	01	01	H6994_008_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6994	008	0	1	01	01	H6994_008_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6994	008	0	1	01	01	H6994_008_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6994	009	0	1	01	01	H6994_009_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6994	009	0	1	01	01	H6994_009_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H6994	009	0	1	01	01	H6994_009_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6994	009	0	1	01	01	H6994_009_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6994	009	0	1	01	01	H6994_009_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6994	010	0	1	01	01	H6994_010_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H6994	010	0	1	01	01	H6994_010_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H6994	010	0	1	01	01	H6994_010_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H6994	010	0	1	01	01	H6994_010_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6994	010	0	1	01	01	H6994_010_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6994	010	0	1	01	01	H6994_010_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H6994	011	0	1	01	01	H6994_011_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6994	011	0	1	01	01	H6994_011_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H6994	011	0	1	01	01	H6994_011_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6994	011	0	1	01	01	H6994_011_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6994	011	0	1	01	01	H6994_011_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6994	012	0	1	01	01	H6994_012_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H6994	012	0	1	01	01	H6994_012_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H6994	012	0	1	01	01	H6994_012_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H6994	012	0	1	01	01	H6994_012_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H6994	012	0	1	01	01	H6994_012_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H6994	013	0	1	01	01	H6994_013_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H6994	013	0	1	01	01	H6994_013_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H6994	013	0	1	01	01	H6994_013_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H6994	013	0	1	01	01	H6994_013_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H6994	013	0	1	01	01	H6994_013_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H6994	013	0	1	01	01	H6994_013_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H7006	007	0	1	04	01	H7006_007_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H7006	007	0	1	04	01	H7006_007_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	3	2	0.00	
H7006	007	0	1	04	01	H7006_007_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H7006	007	0	1	04	01	H7006_007_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7006	007	0	1	04	01	H7006_007_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7006	007	0	1	04	01	H7006_007_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H7006	018	0	1	04	01	H7006_018_0	10			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H7006	018	0	1	04	01	H7006_018_0	10			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	3	2	0.00	
H7006	018	0	1	04	01	H7006_018_0	10			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H7006	018	0	1	04	01	H7006_018_0	10			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7006	018	0	1	04	01	H7006_018_0	10			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7006	018	0	1	04	01	H7006_018_0	10			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H7006	022	0	1	04	01	H7006_022_0	10			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H7006	022	0	1	04	01	H7006_022_0	10			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	3	2	0.00	
H7006	022	0	1	04	01	H7006_022_0	10			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H7006	022	0	1	04	01	H7006_022_0	10			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7006	022	0	1	04	01	H7006_022_0	10			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7006	022	0	1	04	01	H7006_022_0	10			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H7020	010	1	1	01	01	H7020_010_1	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H7020	010	1	1	01	01	H7020_010_1	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7020	010	1	1	01	01	H7020_010_1	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7020	010	1	1	01	01	H7020_010_1	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7020	010	1	1	01	01	H7020_010_1	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7020	010	2	1	01	01	H7020_010_2	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H7020	010	2	1	01	01	H7020_010_2	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7020	010	2	1	01	01	H7020_010_2	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7020	010	2	1	01	01	H7020_010_2	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7020	010	2	1	01	01	H7020_010_2	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7020	010	3	1	01	01	H7020_010_3	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H7020	010	3	1	01	01	H7020_010_3	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7020	010	3	1	01	01	H7020_010_3	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7020	010	3	1	01	01	H7020_010_3	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7020	010	3	1	01	01	H7020_010_3	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7020	011	1	1	01	01	H7020_011_1	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H7020	011	1	1	01	01	H7020_011_1	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7020	011	1	1	01	01	H7020_011_1	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7020	011	1	1	01	01	H7020_011_1	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7020	011	1	1	01	01	H7020_011_1	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7020	011	2	1	01	01	H7020_011_2	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H7020	011	2	1	01	01	H7020_011_2	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7020	011	2	1	01	01	H7020_011_2	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7020	011	2	1	01	01	H7020_011_2	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7020	011	2	1	01	01	H7020_011_2	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7020	011	3	1	01	01	H7020_011_3	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H7020	011	3	1	01	01	H7020_011_3	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7020	011	3	1	01	01	H7020_011_3	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7020	011	3	1	01	01	H7020_011_3	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7020	011	3	1	01	01	H7020_011_3	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7028	001	0	1	04	01	H7028_001_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7028	001	0	1	04	01	H7028_001_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H7028	001	0	1	04	01	H7028_001_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7028	001	0	1	04	01	H7028_001_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7028	001	0	1	04	01	H7028_001_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7028	002	0	1	04	01	H7028_002_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7028	002	0	1	04	01	H7028_002_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H7028	002	0	1	04	01	H7028_002_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7028	002	0	1	04	01	H7028_002_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7028	002	0	1	04	01	H7028_002_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7028	004	0	1	04	01	H7028_004_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7028	004	0	1	04	01	H7028_004_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H7028	004	0	1	04	01	H7028_004_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7028	004	0	1	04	01	H7028_004_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7028	004	0	1	04	01	H7028_004_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7028	005	0	1	04	01	H7028_005_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7028	005	0	1	04	01	H7028_005_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7028	005	0	1	04	01	H7028_005_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7028	005	0	1	04	01	H7028_005_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7028	005	0	1	04	01	H7028_005_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7028	005	0	1	04	01	H7028_005_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H7028	006	0	1	04	01	H7028_006_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7028	006	0	1	04	01	H7028_006_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7028	006	0	1	04	01	H7028_006_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7028	006	0	1	04	01	H7028_006_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7028	006	0	1	04	01	H7028_006_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7028	006	0	1	04	01	H7028_006_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H7063	001	0	1	04	01	H7063_001_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H7063	001	0	1	04	01	H7063_001_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H7063	001	0	1	04	01	H7063_001_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H7063	001	0	1	04	01	H7063_001_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7063	001	0	1	04	01	H7063_001_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7063	006	0	1	04	01	H7063_006_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H7063	006	0	1	04	01	H7063_006_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H7063	006	0	1	04	01	H7063_006_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H7063	006	0	1	04	01	H7063_006_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7063	006	0	1	04	01	H7063_006_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7063	007	0	1	04	01	H7063_007_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H7063	007	0	1	04	01	H7063_007_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H7063	007	0	1	04	01	H7063_007_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H7063	007	0	1	04	01	H7063_007_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7063	007	0	1	04	01	H7063_007_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7063	012	0	1	04	01	H7063_012_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H7063	012	0	1	04	01	H7063_012_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H7063	012	0	1	04	01	H7063_012_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H7063	012	0	1	04	01	H7063_012_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7063	012	0	1	04	01	H7063_012_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7074	001	0	1	04	01	H7074_001_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7074	001	0	1	04	01	H7074_001_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7074	001	0	1	04	01	H7074_001_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	3	2	40.00	
H7074	001	0	1	04	01	H7074_001_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	3	1		40
H7074	001	0	1	04	01	H7074_001_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7074	001	0	1	04	01	H7074_001_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H7093	002	0	1	04	01	H7093_002_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H7093	002	0	1	04	01	H7093_002_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7093	002	0	1	04	01	H7093_002_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7093	002	0	1	04	01	H7093_002_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7093	002	0	1	04	01	H7093_002_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7093	002	0	1	04	01	H7093_002_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H7115	001	0	1	01	01	H7115_001_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H7115	001	0	1	01	01	H7115_001_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7115	001	0	1	01	01	H7115_001_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H7115	001	0	1	01	01	H7115_001_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7115	001	0	1	01	01	H7115_001_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7123	001	0	1	01	01	H7123_001_0	17		N	Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7123	001	0	1	01	01	H7123_001_0	17		N	Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7123	001	0	1	01	01	H7123_001_0	17		N	Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7123	001	0	1	01	01	H7123_001_0	17		N	Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7123	001	0	1	01	01	H7123_001_0	17		N	Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7147	001	0	1	01	01	H7147_001_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7147	001	0	1	01	01	H7147_001_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	5.00	
H7147	001	0	1	01	01	H7147_001_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7147	001	0	1	01	01	H7147_001_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7147	001	0	1	01	01	H7147_001_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7147	003	0	1	01	01	H7147_003_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7147	003	0	1	01	01	H7147_003_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7147	003	0	1	01	01	H7147_003_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7147	003	0	1	01	01	H7147_003_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7147	003	0	1	01	01	H7147_003_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7147	003	0	1	01	01	H7147_003_0	6		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H7147	004	0	1	01	01	H7147_004_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7147	004	0	1	01	01	H7147_004_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H7147	004	0	1	01	01	H7147_004_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7147	004	0	1	01	01	H7147_004_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7147	004	0	1	01	01	H7147_004_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7147	007	0	1	01	01	H7147_007_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7147	007	0	1	01	01	H7147_007_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7147	007	0	1	01	01	H7147_007_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7147	007	0	1	01	01	H7147_007_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7147	007	0	1	01	01	H7147_007_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7147	007	0	1	01	01	H7147_007_0	5		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H7147	009	0	1	01	01	H7147_009_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7147	009	0	1	01	01	H7147_009_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7147	009	0	1	01	01	H7147_009_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7147	009	0	1	01	01	H7147_009_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7147	009	0	1	01	01	H7147_009_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7147	009	0	1	01	01	H7147_009_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H7147	010	0	1	01	01	H7147_010_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7147	010	0	1	01	01	H7147_010_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7147	010	0	1	01	01	H7147_010_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7147	010	0	1	01	01	H7147_010_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7147	010	0	1	01	01	H7147_010_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7147	010	0	1	01	01	H7147_010_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H7147	011	0	1	01	01	H7147_011_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7147	011	0	1	01	01	H7147_011_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7147	011	0	1	01	01	H7147_011_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7147	011	0	1	01	01	H7147_011_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7147	011	0	1	01	01	H7147_011_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7147	011	0	1	01	01	H7147_011_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H7147	012	0	1	01	01	H7147_012_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7147	012	0	1	01	01	H7147_012_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7147	012	0	1	01	01	H7147_012_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7147	012	0	1	01	01	H7147_012_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7147	012	0	1	01	01	H7147_012_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7147	012	0	1	01	01	H7147_012_0	6		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H7147	013	0	1	01	01	H7147_013_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7147	013	0	1	01	01	H7147_013_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7147	013	0	1	01	01	H7147_013_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7147	013	0	1	01	01	H7147_013_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7147	013	0	1	01	01	H7147_013_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7147	013	0	1	01	01	H7147_013_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H7149	001	0	1	02	01	H7149_001_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7149	001	0	1	02	01	H7149_001_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7149	001	0	1	02	01	H7149_001_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7149	001	0	1	02	01	H7149_001_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7149	001	0	1	02	01	H7149_001_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7149	006	0	1	01	01	H7149_006_0	2		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7149	006	0	1	01	01	H7149_006_0	2		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7149	006	0	1	01	01	H7149_006_0	2		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7149	006	0	1	01	01	H7149_006_0	2		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7149	006	0	1	01	01	H7149_006_0	2		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7151	001	0	1	01	01	H7151_001_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7151	001	0	1	01	01	H7151_001_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H7151	001	0	1	01	01	H7151_001_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7151	001	0	1	01	01	H7151_001_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7151	001	0	1	01	01	H7151_001_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7151	003	0	1	01	01	H7151_003_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7151	003	0	1	01	01	H7151_003_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H7151	003	0	1	01	01	H7151_003_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7151	003	0	1	01	01	H7151_003_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7151	003	0	1	01	01	H7151_003_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7151	005	0	1	01	01	H7151_005_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7151	005	0	1	01	01	H7151_005_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7151	005	0	1	01	01	H7151_005_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7151	005	0	1	01	01	H7151_005_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7151	005	0	1	01	01	H7151_005_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7151	005	0	1	01	01	H7151_005_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H7151	006	0	1	01	01	H7151_006_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7151	006	0	1	01	01	H7151_006_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7151	006	0	1	01	01	H7151_006_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7151	006	0	1	01	01	H7151_006_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7151	006	0	1	01	01	H7151_006_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7151	006	0	1	01	01	H7151_006_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H7199	002	0	1	04	01	H7199_002_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7199	002	0	1	04	01	H7199_002_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H7199	002	0	1	04	01	H7199_002_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7199	002	0	1	04	01	H7199_002_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7199	002	0	1	04	01	H7199_002_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7220	004	0	1	02	01	H7220_004_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H7220	004	0	1	02	01	H7220_004_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7220	004	0	1	02	01	H7220_004_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7220	004	0	1	02	01	H7220_004_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7220	004	0	1	02	01	H7220_004_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7220	004	0	1	02	01	H7220_004_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H7220	009	1	1	01	01	H7220_009_1	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H7220	009	1	1	01	01	H7220_009_1	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7220	009	1	1	01	01	H7220_009_1	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7220	009	1	1	01	01	H7220_009_1	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7220	009	1	1	01	01	H7220_009_1	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7220	009	1	1	01	01	H7220_009_1	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H7220	009	2	1	01	01	H7220_009_2	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H7220	009	2	1	01	01	H7220_009_2	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7220	009	2	1	01	01	H7220_009_2	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7220	009	2	1	01	01	H7220_009_2	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7220	009	2	1	01	01	H7220_009_2	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7220	009	2	1	01	01	H7220_009_2	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H7220	010	0	1	01	01	H7220_010_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H7220	010	0	1	01	01	H7220_010_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7220	010	0	1	01	01	H7220_010_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7220	010	0	1	01	01	H7220_010_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7220	010	0	1	01	01	H7220_010_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7220	010	0	1	01	01	H7220_010_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H7239	001	0	1	01	01	H7239_001_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H7239	001	0	1	01	01	H7239_001_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H7239	001	0	1	01	01	H7239_001_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7239	001	0	1	01	01	H7239_001_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7239	001	0	1	01	01	H7239_001_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7239	001	0	1	01	01	H7239_001_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H7239	002	0	1	01	01	H7239_002_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H7239	002	0	1	01	01	H7239_002_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H7239	002	0	1	01	01	H7239_002_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7239	002	0	1	01	01	H7239_002_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7239	002	0	1	01	01	H7239_002_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7239	002	0	1	01	01	H7239_002_0	7		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H7239	003	0	1	01	01	H7239_003_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H7239	003	0	1	01	01	H7239_003_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H7239	003	0	1	01	01	H7239_003_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7239	003	0	1	01	01	H7239_003_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7239	003	0	1	01	01	H7239_003_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7239	003	0	1	01	01	H7239_003_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H7239	004	0	1	01	01	H7239_004_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H7239	004	0	1	01	01	H7239_004_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H7239	004	0	1	01	01	H7239_004_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7239	004	0	1	01	01	H7239_004_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7239	004	0	1	01	01	H7239_004_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7239	004	0	1	01	01	H7239_004_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H7239	005	0	1	01	01	H7239_005_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H7239	005	0	1	01	01	H7239_005_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H7239	005	0	1	01	01	H7239_005_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7239	005	0	1	01	01	H7239_005_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7239	005	0	1	01	01	H7239_005_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7239	005	0	1	01	01	H7239_005_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H7284	001	0	1	04	01	H7284_001_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H7284	001	0	1	04	01	H7284_001_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7284	001	0	1	04	01	H7284_001_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7284	001	0	1	04	01	H7284_001_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7284	001	0	1	04	01	H7284_001_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7284	008	0	1	04	01	H7284_008_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H7284	008	0	1	04	01	H7284_008_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7284	008	0	1	04	01	H7284_008_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7284	008	0	1	04	01	H7284_008_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7284	008	0	1	04	01	H7284_008_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7284	009	0	1	04	01	H7284_009_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H7284	009	0	1	04	01	H7284_009_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7284	009	0	1	04	01	H7284_009_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7284	009	0	1	04	01	H7284_009_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7284	009	0	1	04	01	H7284_009_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7284	010	0	1	04	01	H7284_010_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7284	010	0	1	04	01	H7284_010_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7284	010	0	1	04	01	H7284_010_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7284	010	0	1	04	01	H7284_010_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7284	010	0	1	04	01	H7284_010_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7301	002	0	1	04	01	H7301_002_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7301	002	0	1	04	01	H7301_002_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7301	002	0	1	04	01	H7301_002_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7301	002	0	1	04	01	H7301_002_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7301	002	0	1	04	01	H7301_002_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7301	006	0	1	04	01	H7301_006_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7301	006	0	1	04	01	H7301_006_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7301	006	0	1	04	01	H7301_006_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7301	006	0	1	04	01	H7301_006_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7301	006	0	1	04	01	H7301_006_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7301	007	0	1	04	01	H7301_007_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7301	007	0	1	04	01	H7301_007_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7301	007	0	1	04	01	H7301_007_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7301	007	0	1	04	01	H7301_007_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7301	007	0	1	04	01	H7301_007_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7301	009	0	1	04	01	H7301_009_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7301	009	0	1	04	01	H7301_009_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7301	009	0	1	04	01	H7301_009_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7301	009	0	1	04	01	H7301_009_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7301	009	0	1	04	01	H7301_009_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7301	013	0	1	04	01	H7301_013_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7301	013	0	1	04	01	H7301_013_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7301	013	0	1	04	01	H7301_013_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7301	013	0	1	04	01	H7301_013_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7301	013	0	1	04	01	H7301_013_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7301	021	0	1	04	01	H7301_021_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7301	021	0	1	04	01	H7301_021_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7301	021	0	1	04	01	H7301_021_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7301	021	0	1	04	01	H7301_021_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7301	021	0	1	04	01	H7301_021_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7301	027	0	1	04	01	H7301_027_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7301	027	0	1	04	01	H7301_027_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7301	027	0	1	04	01	H7301_027_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7301	027	0	1	04	01	H7301_027_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7301	027	0	1	04	01	H7301_027_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7301	032	0	1	04	01	H7301_032_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7301	032	0	1	04	01	H7301_032_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7301	032	0	1	04	01	H7301_032_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7301	032	0	1	04	01	H7301_032_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7301	032	0	1	04	01	H7301_032_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7301	033	0	1	04	01	H7301_033_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7301	033	0	1	04	01	H7301_033_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7301	033	0	1	04	01	H7301_033_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7301	033	0	1	04	01	H7301_033_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7301	033	0	1	04	01	H7301_033_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7301	034	0	1	04	01	H7301_034_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7301	034	0	1	04	01	H7301_034_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7301	034	0	1	04	01	H7301_034_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7301	034	0	1	04	01	H7301_034_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7301	034	0	1	04	01	H7301_034_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7323	007	0	1	04	01	H7323_007_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H7323	007	0	1	04	01	H7323_007_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7323	007	0	1	04	01	H7323_007_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7323	007	0	1	04	01	H7323_007_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7323	007	0	1	04	01	H7323_007_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7323	007	0	1	04	01	H7323_007_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H7323	012	0	1	04	01	H7323_012_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H7323	012	0	1	04	01	H7323_012_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7323	012	0	1	04	01	H7323_012_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7323	012	0	1	04	01	H7323_012_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7323	012	0	1	04	01	H7323_012_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7323	012	0	1	04	01	H7323_012_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H7326	001	0	1	04	01	H7326_001_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H7326	001	0	1	04	01	H7326_001_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7326	001	0	1	04	01	H7326_001_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7326	001	0	1	04	01	H7326_001_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7326	001	0	1	04	01	H7326_001_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7326	001	0	1	04	01	H7326_001_0	9			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H7326	007	0	1	04	01	H7326_007_0	8			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7326	007	0	1	04	01	H7326_007_0	8			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7326	007	0	1	04	01	H7326_007_0	8			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7326	007	0	1	04	01	H7326_007_0	8			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7326	007	0	1	04	01	H7326_007_0	8			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7326	007	0	1	04	01	H7326_007_0	8			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H7355	001	0	1	04	01	H7355_001_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7355	001	0	1	04	01	H7355_001_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H7355	001	0	1	04	01	H7355_001_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7355	001	0	1	04	01	H7355_001_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7355	001	0	1	04	01	H7355_001_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7355	002	0	1	04	01	H7355_002_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7355	002	0	1	04	01	H7355_002_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H7355	002	0	1	04	01	H7355_002_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7355	002	0	1	04	01	H7355_002_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7355	002	0	1	04	01	H7355_002_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7355	003	0	1	04	01	H7355_003_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7355	003	0	1	04	01	H7355_003_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7355	003	0	1	04	01	H7355_003_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7355	003	0	1	04	01	H7355_003_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7355	003	0	1	04	01	H7355_003_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7355	003	0	1	04	01	H7355_003_0	6		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H7355	004	0	1	04	01	H7355_004_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7355	004	0	1	04	01	H7355_004_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7355	004	0	1	04	01	H7355_004_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7355	004	0	1	04	01	H7355_004_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7355	004	0	1	04	01	H7355_004_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7355	004	0	1	04	01	H7355_004_0	6		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H7355	006	0	1	04	01	H7355_006_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7355	006	0	1	04	01	H7355_006_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H7355	006	0	1	04	01	H7355_006_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7355	006	0	1	04	01	H7355_006_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7355	006	0	1	04	01	H7355_006_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7355	007	0	1	04	01	H7355_007_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7355	007	0	1	04	01	H7355_007_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7355	007	0	1	04	01	H7355_007_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7355	007	0	1	04	01	H7355_007_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7355	007	0	1	04	01	H7355_007_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7355	007	0	1	04	01	H7355_007_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H7355	009	0	1	04	01	H7355_009_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7355	009	0	1	04	01	H7355_009_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7355	009	0	1	04	01	H7355_009_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7355	009	0	1	04	01	H7355_009_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7355	009	0	1	04	01	H7355_009_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7355	009	0	1	04	01	H7355_009_0	6		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H7355	010	0	1	04	01	H7355_010_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7355	010	0	1	04	01	H7355_010_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7355	010	0	1	04	01	H7355_010_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7355	010	0	1	04	01	H7355_010_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7355	010	0	1	04	01	H7355_010_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7355	010	0	1	04	01	H7355_010_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H7379	001	0	1	04	01	H7379_001_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7379	001	0	1	04	01	H7379_001_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7379	001	0	1	04	01	H7379_001_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7379	001	0	1	04	01	H7379_001_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7379	001	0	1	04	01	H7379_001_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7379	002	0	1	04	01	H7379_002_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7379	002	0	1	04	01	H7379_002_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7379	002	0	1	04	01	H7379_002_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7379	002	0	1	04	01	H7379_002_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7379	002	0	1	04	01	H7379_002_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7397	001	0	1	04	01	H7397_001_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7397	001	0	1	04	01	H7397_001_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H7397	001	0	1	04	01	H7397_001_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7397	001	0	1	04	01	H7397_001_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7397	001	0	1	04	01	H7397_001_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7397	002	0	1	04	01	H7397_002_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7397	002	0	1	04	01	H7397_002_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H7397	002	0	1	04	01	H7397_002_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7397	002	0	1	04	01	H7397_002_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7397	002	0	1	04	01	H7397_002_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7397	003	0	1	04	01	H7397_003_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7397	003	0	1	04	01	H7397_003_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7397	003	0	1	04	01	H7397_003_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7397	003	0	1	04	01	H7397_003_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7397	003	0	1	04	01	H7397_003_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7397	003	0	1	04	01	H7397_003_0	5		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H7397	004	0	1	04	01	H7397_004_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7397	004	0	1	04	01	H7397_004_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7397	004	0	1	04	01	H7397_004_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7397	004	0	1	04	01	H7397_004_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7397	004	0	1	04	01	H7397_004_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7397	004	0	1	04	01	H7397_004_0	6		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H7397	006	0	1	04	01	H7397_006_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7397	006	0	1	04	01	H7397_006_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H7397	006	0	1	04	01	H7397_006_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7397	006	0	1	04	01	H7397_006_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7397	006	0	1	04	01	H7397_006_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7397	007	0	1	04	01	H7397_007_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7397	007	0	1	04	01	H7397_007_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7397	007	0	1	04	01	H7397_007_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7397	007	0	1	04	01	H7397_007_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7397	007	0	1	04	01	H7397_007_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7397	007	0	1	04	01	H7397_007_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H7397	009	0	1	04	01	H7397_009_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7397	009	0	1	04	01	H7397_009_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7397	009	0	1	04	01	H7397_009_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7397	009	0	1	04	01	H7397_009_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7397	009	0	1	04	01	H7397_009_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7397	009	0	1	04	01	H7397_009_0	5		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H7397	010	0	1	04	01	H7397_010_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7397	010	0	1	04	01	H7397_010_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7397	010	0	1	04	01	H7397_010_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7397	010	0	1	04	01	H7397_010_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7397	010	0	1	04	01	H7397_010_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7397	010	0	1	04	01	H7397_010_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H7435	001	0	1	01	01	H7435_001_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7435	001	0	1	01	01	H7435_001_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7435	001	0	1	01	01	H7435_001_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7435	001	0	1	01	01	H7435_001_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7435	001	0	1	01	01	H7435_001_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7435	001	0	1	01	01	H7435_001_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H7464	008	1	1	01	01	H7464_008_1	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H7464	008	1	1	01	01	H7464_008_1	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7464	008	1	1	01	01	H7464_008_1	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7464	008	1	1	01	01	H7464_008_1	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7464	008	1	1	01	01	H7464_008_1	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7464	008	2	1	01	01	H7464_008_2	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H7464	008	2	1	01	01	H7464_008_2	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7464	008	2	1	01	01	H7464_008_2	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7464	008	2	1	01	01	H7464_008_2	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7464	008	2	1	01	01	H7464_008_2	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7464	012	0	1	02	01	H7464_012_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H7464	012	0	1	02	01	H7464_012_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7464	012	0	1	02	01	H7464_012_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7464	012	0	1	02	01	H7464_012_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7464	012	0	1	02	01	H7464_012_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7471	001	0	1	04	01	H7471_001_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7471	001	0	1	04	01	H7471_001_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H7471	001	0	1	04	01	H7471_001_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7471	001	0	1	04	01	H7471_001_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7471	001	0	1	04	01	H7471_001_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7471	002	0	1	04	01	H7471_002_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7471	002	0	1	04	01	H7471_002_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H7471	002	0	1	04	01	H7471_002_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7471	002	0	1	04	01	H7471_002_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7471	002	0	1	04	01	H7471_002_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7471	004	0	1	04	01	H7471_004_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7471	004	0	1	04	01	H7471_004_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H7471	004	0	1	04	01	H7471_004_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7471	004	0	1	04	01	H7471_004_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7471	004	0	1	04	01	H7471_004_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7471	005	0	1	04	01	H7471_005_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7471	005	0	1	04	01	H7471_005_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H7471	005	0	1	04	01	H7471_005_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7471	005	0	1	04	01	H7471_005_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7471	005	0	1	04	01	H7471_005_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7471	006	0	1	04	01	H7471_006_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7471	006	0	1	04	01	H7471_006_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H7471	006	0	1	04	01	H7471_006_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7471	006	0	1	04	01	H7471_006_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7471	006	0	1	04	01	H7471_006_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7471	007	0	1	04	01	H7471_007_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7471	007	0	1	04	01	H7471_007_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H7471	007	0	1	04	01	H7471_007_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7471	007	0	1	04	01	H7471_007_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7471	007	0	1	04	01	H7471_007_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7471	008	0	1	04	01	H7471_008_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7471	008	0	1	04	01	H7471_008_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H7471	008	0	1	04	01	H7471_008_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7471	008	0	1	04	01	H7471_008_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7471	008	0	1	04	01	H7471_008_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7471	009	0	1	04	01	H7471_009_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7471	009	0	1	04	01	H7471_009_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H7471	009	0	1	04	01	H7471_009_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7471	009	0	1	04	01	H7471_009_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7471	009	0	1	04	01	H7471_009_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7471	011	0	1	04	01	H7471_011_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7471	011	0	1	04	01	H7471_011_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H7471	011	0	1	04	01	H7471_011_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7471	011	0	1	04	01	H7471_011_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7471	011	0	1	04	01	H7471_011_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7471	012	0	1	04	01	H7471_012_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7471	012	0	1	04	01	H7471_012_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H7471	012	0	1	04	01	H7471_012_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7471	012	0	1	04	01	H7471_012_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7471	012	0	1	04	01	H7471_012_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7471	013	0	1	04	01	H7471_013_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7471	013	0	1	04	01	H7471_013_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7471	013	0	1	04	01	H7471_013_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7471	013	0	1	04	01	H7471_013_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7471	013	0	1	04	01	H7471_013_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7471	013	0	1	04	01	H7471_013_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H7471	014	0	1	04	01	H7471_014_0	7			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7471	014	0	1	04	01	H7471_014_0	7			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7471	014	0	1	04	01	H7471_014_0	7			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7471	014	0	1	04	01	H7471_014_0	7			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7471	014	0	1	04	01	H7471_014_0	7			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7471	014	0	1	04	01	H7471_014_0	7			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H7471	015	0	1	04	01	H7471_015_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7471	015	0	1	04	01	H7471_015_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7471	015	0	1	04	01	H7471_015_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7471	015	0	1	04	01	H7471_015_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7471	015	0	1	04	01	H7471_015_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7471	015	0	1	04	01	H7471_015_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H7471	016	0	1	04	01	H7471_016_0	7			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7471	016	0	1	04	01	H7471_016_0	7			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7471	016	0	1	04	01	H7471_016_0	7			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7471	016	0	1	04	01	H7471_016_0	7			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7471	016	0	1	04	01	H7471_016_0	7			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7471	016	0	1	04	01	H7471_016_0	7			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H7471	017	0	1	04	01	H7471_017_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7471	017	0	1	04	01	H7471_017_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7471	017	0	1	04	01	H7471_017_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7471	017	0	1	04	01	H7471_017_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7471	017	0	1	04	01	H7471_017_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7471	017	0	1	04	01	H7471_017_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H7511	002	0	1	01	01	H7511_002_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H7511	002	0	1	01	01	H7511_002_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H7511	002	0	1	01	01	H7511_002_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H7511	002	0	1	01	01	H7511_002_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	10	1	2	0.00	
H7511	002	0	1	01	01	H7511_002_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7511	002	0	1	01	01	H7511_002_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H7518	001	0	1	04	01	H7518_001_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H7518	001	0	1	04	01	H7518_001_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7518	001	0	1	04	01	H7518_001_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7518	001	0	1	04	01	H7518_001_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7518	001	0	1	04	01	H7518_001_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7518	001	0	1	04	01	H7518_001_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H7518	003	0	1	04	01	H7518_003_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7518	003	0	1	04	01	H7518_003_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7518	003	0	1	04	01	H7518_003_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7518	003	0	1	04	01	H7518_003_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7518	003	0	1	04	01	H7518_003_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7518	003	0	1	04	01	H7518_003_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H7524	001	0	1	01	01	H7524_001_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H7524	001	0	1	01	01	H7524_001_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7524	001	0	1	01	01	H7524_001_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7524	001	0	1	01	01	H7524_001_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7524	001	0	1	01	01	H7524_001_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7524	002	0	1	01	01	H7524_002_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H7524	002	0	1	01	01	H7524_002_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7524	002	0	1	01	01	H7524_002_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7524	002	0	1	01	01	H7524_002_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7524	002	0	1	01	01	H7524_002_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7524	003	0	1	01	01	H7524_003_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H7524	003	0	1	01	01	H7524_003_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7524	003	0	1	01	01	H7524_003_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7524	003	0	1	01	01	H7524_003_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7524	003	0	1	01	01	H7524_003_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7524	004	0	1	01	01	H7524_004_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H7524	004	0	1	01	01	H7524_004_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7524	004	0	1	01	01	H7524_004_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7524	004	0	1	01	01	H7524_004_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7524	004	0	1	01	01	H7524_004_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7598	004	0	1	01	01	H7598_004_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7598	004	0	1	01	01	H7598_004_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7598	004	0	1	01	01	H7598_004_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7598	004	0	1	01	01	H7598_004_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7598	004	0	1	01	01	H7598_004_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7605	001	0	1	01	01	H7605_001_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7605	001	0	1	01	01	H7605_001_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	5.00	
H7605	001	0	1	01	01	H7605_001_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7605	001	0	1	01	01	H7605_001_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7605	001	0	1	01	01	H7605_001_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7605	002	0	1	01	01	H7605_002_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7605	002	0	1	01	01	H7605_002_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H7605	002	0	1	01	01	H7605_002_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7605	002	0	1	01	01	H7605_002_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7605	002	0	1	01	01	H7605_002_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7605	004	0	1	01	01	H7605_004_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7605	004	0	1	01	01	H7605_004_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H7605	004	0	1	01	01	H7605_004_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7605	004	0	1	01	01	H7605_004_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7605	004	0	1	01	01	H7605_004_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7605	005	0	1	01	01	H7605_005_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7605	005	0	1	01	01	H7605_005_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H7605	005	0	1	01	01	H7605_005_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7605	005	0	1	01	01	H7605_005_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7605	005	0	1	01	01	H7605_005_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7605	007	0	1	01	01	H7605_007_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7605	007	0	1	01	01	H7605_007_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	5.00	
H7605	007	0	1	01	01	H7605_007_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7605	007	0	1	01	01	H7605_007_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7605	007	0	1	01	01	H7605_007_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7605	008	0	1	01	01	H7605_008_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7605	008	0	1	01	01	H7605_008_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H7605	008	0	1	01	01	H7605_008_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7605	008	0	1	01	01	H7605_008_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7605	008	0	1	01	01	H7605_008_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7605	009	0	1	01	01	H7605_009_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7605	009	0	1	01	01	H7605_009_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	5.00	
H7605	009	0	1	01	01	H7605_009_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7605	009	0	1	01	01	H7605_009_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7605	009	0	1	01	01	H7605_009_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7605	010	0	1	01	01	H7605_010_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7605	010	0	1	01	01	H7605_010_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	5.00	
H7605	010	0	1	01	01	H7605_010_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7605	010	0	1	01	01	H7605_010_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7605	010	0	1	01	01	H7605_010_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7605	016	0	1	01	01	H7605_016_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7605	016	0	1	01	01	H7605_016_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7605	016	0	1	01	01	H7605_016_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7605	016	0	1	01	01	H7605_016_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7605	016	0	1	01	01	H7605_016_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7605	016	0	1	01	01	H7605_016_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H7607	014	0	1	01	01	H7607_014_0	12			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7607	014	0	1	01	01	H7607_014_0	12			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7607	014	0	1	01	01	H7607_014_0	12			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7607	014	0	1	01	01	H7607_014_0	12			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7607	014	0	1	01	01	H7607_014_0	12			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7607	014	0	1	01	01	H7607_014_0	12			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H7607	015	0	1	01	01	H7607_015_0	12			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7607	015	0	1	01	01	H7607_015_0	12			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7607	015	0	1	01	01	H7607_015_0	12			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7607	015	0	1	01	01	H7607_015_0	12			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7607	015	0	1	01	01	H7607_015_0	12			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7607	015	0	1	01	01	H7607_015_0	12			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H7607	016	0	1	01	01	H7607_016_0	11			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7607	016	0	1	01	01	H7607_016_0	11			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7607	016	0	1	01	01	H7607_016_0	11			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7607	016	0	1	01	01	H7607_016_0	11			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7607	016	0	1	01	01	H7607_016_0	11			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7607	016	0	1	01	01	H7607_016_0	11			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H7607	017	0	1	01	01	H7607_017_0	11			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7607	017	0	1	01	01	H7607_017_0	11			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7607	017	0	1	01	01	H7607_017_0	11			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7607	017	0	1	01	01	H7607_017_0	11			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7607	017	0	1	01	01	H7607_017_0	11			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7607	017	0	1	01	01	H7607_017_0	11			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H7617	003	0	1	04	01	H7617_003_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7617	003	0	1	04	01	H7617_003_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	003	0	1	04	01	H7617_003_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	003	0	1	04	01	H7617_003_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	003	0	1	04	01	H7617_003_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	004	0	1	04	01	H7617_004_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7617	004	0	1	04	01	H7617_004_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	004	0	1	04	01	H7617_004_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	004	0	1	04	01	H7617_004_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	004	0	1	04	01	H7617_004_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	005	0	1	04	01	H7617_005_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7617	005	0	1	04	01	H7617_005_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	005	0	1	04	01	H7617_005_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	005	0	1	04	01	H7617_005_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	005	0	1	04	01	H7617_005_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	006	0	1	04	01	H7617_006_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H7617	006	0	1	04	01	H7617_006_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	006	0	1	04	01	H7617_006_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	006	0	1	04	01	H7617_006_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	006	0	1	04	01	H7617_006_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	007	0	1	04	01	H7617_007_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H7617	007	0	1	04	01	H7617_007_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	007	0	1	04	01	H7617_007_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	007	0	1	04	01	H7617_007_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	007	0	1	04	01	H7617_007_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	008	0	1	04	01	H7617_008_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H7617	008	0	1	04	01	H7617_008_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	008	0	1	04	01	H7617_008_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	008	0	1	04	01	H7617_008_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	008	0	1	04	01	H7617_008_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	009	0	1	04	01	H7617_009_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H7617	009	0	1	04	01	H7617_009_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	009	0	1	04	01	H7617_009_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	009	0	1	04	01	H7617_009_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	009	0	1	04	01	H7617_009_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	010	0	1	04	01	H7617_010_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H7617	010	0	1	04	01	H7617_010_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	010	0	1	04	01	H7617_010_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	010	0	1	04	01	H7617_010_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	010	0	1	04	01	H7617_010_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	011	0	1	04	01	H7617_011_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H7617	011	0	1	04	01	H7617_011_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	011	0	1	04	01	H7617_011_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	011	0	1	04	01	H7617_011_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	011	0	1	04	01	H7617_011_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	013	0	1	04	01	H7617_013_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H7617	013	0	1	04	01	H7617_013_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	013	0	1	04	01	H7617_013_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	013	0	1	04	01	H7617_013_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	013	0	1	04	01	H7617_013_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	014	0	1	04	01	H7617_014_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H7617	014	0	1	04	01	H7617_014_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	014	0	1	04	01	H7617_014_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	014	0	1	04	01	H7617_014_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	014	0	1	04	01	H7617_014_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	015	0	1	04	01	H7617_015_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H7617	015	0	1	04	01	H7617_015_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	015	0	1	04	01	H7617_015_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	015	0	1	04	01	H7617_015_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	015	0	1	04	01	H7617_015_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	016	0	1	04	01	H7617_016_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7617	016	0	1	04	01	H7617_016_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	016	0	1	04	01	H7617_016_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	016	0	1	04	01	H7617_016_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	016	0	1	04	01	H7617_016_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	017	0	1	04	01	H7617_017_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H7617	017	0	1	04	01	H7617_017_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	017	0	1	04	01	H7617_017_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	017	0	1	04	01	H7617_017_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	017	0	1	04	01	H7617_017_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	018	0	1	04	01	H7617_018_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H7617	018	0	1	04	01	H7617_018_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	018	0	1	04	01	H7617_018_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	018	0	1	04	01	H7617_018_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	018	0	1	04	01	H7617_018_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	019	0	1	04	01	H7617_019_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7617	019	0	1	04	01	H7617_019_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	019	0	1	04	01	H7617_019_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	019	0	1	04	01	H7617_019_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	019	0	1	04	01	H7617_019_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	020	0	1	04	01	H7617_020_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H7617	020	0	1	04	01	H7617_020_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	020	0	1	04	01	H7617_020_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	020	0	1	04	01	H7617_020_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	020	0	1	04	01	H7617_020_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	023	0	1	04	01	H7617_023_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H7617	023	0	1	04	01	H7617_023_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	023	0	1	04	01	H7617_023_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	023	0	1	04	01	H7617_023_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	023	0	1	04	01	H7617_023_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	024	0	1	04	01	H7617_024_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7617	024	0	1	04	01	H7617_024_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	024	0	1	04	01	H7617_024_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	024	0	1	04	01	H7617_024_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	024	0	1	04	01	H7617_024_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	025	0	1	04	01	H7617_025_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7617	025	0	1	04	01	H7617_025_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	025	0	1	04	01	H7617_025_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	025	0	1	04	01	H7617_025_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	025	0	1	04	01	H7617_025_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	026	0	1	04	01	H7617_026_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7617	026	0	1	04	01	H7617_026_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	026	0	1	04	01	H7617_026_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	026	0	1	04	01	H7617_026_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	026	0	1	04	01	H7617_026_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	027	0	1	04	01	H7617_027_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7617	027	0	1	04	01	H7617_027_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	027	0	1	04	01	H7617_027_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	027	0	1	04	01	H7617_027_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	027	0	1	04	01	H7617_027_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	028	0	1	04	01	H7617_028_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7617	028	0	1	04	01	H7617_028_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	028	0	1	04	01	H7617_028_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	028	0	1	04	01	H7617_028_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	028	0	1	04	01	H7617_028_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	029	0	1	04	01	H7617_029_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7617	029	0	1	04	01	H7617_029_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	029	0	1	04	01	H7617_029_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	029	0	1	04	01	H7617_029_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	029	0	1	04	01	H7617_029_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	030	0	1	04	01	H7617_030_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7617	030	0	1	04	01	H7617_030_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	030	0	1	04	01	H7617_030_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	030	0	1	04	01	H7617_030_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	030	0	1	04	01	H7617_030_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	031	0	1	04	01	H7617_031_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7617	031	0	1	04	01	H7617_031_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	031	0	1	04	01	H7617_031_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	031	0	1	04	01	H7617_031_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	031	0	1	04	01	H7617_031_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	032	0	1	04	01	H7617_032_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7617	032	0	1	04	01	H7617_032_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	032	0	1	04	01	H7617_032_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	032	0	1	04	01	H7617_032_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	032	0	1	04	01	H7617_032_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	033	0	1	04	01	H7617_033_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7617	033	0	1	04	01	H7617_033_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7617	033	0	1	04	01	H7617_033_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7617	033	0	1	04	01	H7617_033_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7617	033	0	1	04	01	H7617_033_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7617	033	0	1	04	01	H7617_033_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H7617	034	0	1	04	01	H7617_034_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H7617	034	0	1	04	01	H7617_034_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7617	034	0	1	04	01	H7617_034_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7617	034	0	1	04	01	H7617_034_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7617	034	0	1	04	01	H7617_034_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7617	034	0	1	04	01	H7617_034_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H7617	035	0	1	04	01	H7617_035_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7617	035	0	1	04	01	H7617_035_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	035	0	1	04	01	H7617_035_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	035	0	1	04	01	H7617_035_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	035	0	1	04	01	H7617_035_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	036	0	1	04	01	H7617_036_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7617	036	0	1	04	01	H7617_036_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	036	0	1	04	01	H7617_036_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	036	0	1	04	01	H7617_036_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	036	0	1	04	01	H7617_036_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	037	0	1	04	01	H7617_037_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7617	037	0	1	04	01	H7617_037_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	037	0	1	04	01	H7617_037_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	037	0	1	04	01	H7617_037_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	037	0	1	04	01	H7617_037_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	038	0	1	04	01	H7617_038_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7617	038	0	1	04	01	H7617_038_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	038	0	1	04	01	H7617_038_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	038	0	1	04	01	H7617_038_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	038	0	1	04	01	H7617_038_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	039	0	1	04	01	H7617_039_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7617	039	0	1	04	01	H7617_039_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	039	0	1	04	01	H7617_039_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	039	0	1	04	01	H7617_039_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	039	0	1	04	01	H7617_039_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	040	0	1	04	01	H7617_040_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7617	040	0	1	04	01	H7617_040_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	040	0	1	04	01	H7617_040_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	040	0	1	04	01	H7617_040_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	040	0	1	04	01	H7617_040_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	041	0	1	04	01	H7617_041_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7617	041	0	1	04	01	H7617_041_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	041	0	1	04	01	H7617_041_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	041	0	1	04	01	H7617_041_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	041	0	1	04	01	H7617_041_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	042	0	1	04	01	H7617_042_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7617	042	0	1	04	01	H7617_042_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	042	0	1	04	01	H7617_042_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	042	0	1	04	01	H7617_042_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	042	0	1	04	01	H7617_042_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	043	0	1	04	01	H7617_043_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7617	043	0	1	04	01	H7617_043_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	043	0	1	04	01	H7617_043_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	043	0	1	04	01	H7617_043_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	043	0	1	04	01	H7617_043_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	044	0	1	04	01	H7617_044_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H7617	044	0	1	04	01	H7617_044_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	044	0	1	04	01	H7617_044_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	044	0	1	04	01	H7617_044_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	044	0	1	04	01	H7617_044_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	045	0	1	04	01	H7617_045_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H7617	045	0	1	04	01	H7617_045_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	045	0	1	04	01	H7617_045_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	045	0	1	04	01	H7617_045_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	045	0	1	04	01	H7617_045_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	046	0	1	04	01	H7617_046_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7617	046	0	1	04	01	H7617_046_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	046	0	1	04	01	H7617_046_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	046	0	1	04	01	H7617_046_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	046	0	1	04	01	H7617_046_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	048	0	1	04	01	H7617_048_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7617	048	0	1	04	01	H7617_048_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	048	0	1	04	01	H7617_048_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	048	0	1	04	01	H7617_048_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	048	0	1	04	01	H7617_048_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	049	0	1	04	01	H7617_049_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7617	049	0	1	04	01	H7617_049_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	049	0	1	04	01	H7617_049_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	049	0	1	04	01	H7617_049_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	049	0	1	04	01	H7617_049_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	050	0	1	04	01	H7617_050_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7617	050	0	1	04	01	H7617_050_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	050	0	1	04	01	H7617_050_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	050	0	1	04	01	H7617_050_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	050	0	1	04	01	H7617_050_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	051	0	1	04	01	H7617_051_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H7617	051	0	1	04	01	H7617_051_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	051	0	1	04	01	H7617_051_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	051	0	1	04	01	H7617_051_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	051	0	1	04	01	H7617_051_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	052	0	1	04	01	H7617_052_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7617	052	0	1	04	01	H7617_052_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	052	0	1	04	01	H7617_052_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	052	0	1	04	01	H7617_052_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	052	0	1	04	01	H7617_052_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	053	0	1	04	01	H7617_053_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7617	053	0	1	04	01	H7617_053_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	053	0	1	04	01	H7617_053_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	053	0	1	04	01	H7617_053_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	053	0	1	04	01	H7617_053_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	055	0	1	04	01	H7617_055_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7617	055	0	1	04	01	H7617_055_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	055	0	1	04	01	H7617_055_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	055	0	1	04	01	H7617_055_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	055	0	1	04	01	H7617_055_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	056	0	1	04	01	H7617_056_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7617	056	0	1	04	01	H7617_056_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	056	0	1	04	01	H7617_056_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	056	0	1	04	01	H7617_056_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	056	0	1	04	01	H7617_056_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	057	0	1	04	01	H7617_057_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7617	057	0	1	04	01	H7617_057_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	057	0	1	04	01	H7617_057_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	057	0	1	04	01	H7617_057_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	057	0	1	04	01	H7617_057_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	058	0	1	04	01	H7617_058_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7617	058	0	1	04	01	H7617_058_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	058	0	1	04	01	H7617_058_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	058	0	1	04	01	H7617_058_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	058	0	1	04	01	H7617_058_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	059	0	1	04	01	H7617_059_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7617	059	0	1	04	01	H7617_059_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	059	0	1	04	01	H7617_059_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	059	0	1	04	01	H7617_059_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	059	0	1	04	01	H7617_059_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	060	0	1	04	01	H7617_060_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7617	060	0	1	04	01	H7617_060_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	060	0	1	04	01	H7617_060_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	060	0	1	04	01	H7617_060_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	060	0	1	04	01	H7617_060_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	061	0	1	04	01	H7617_061_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H7617	061	0	1	04	01	H7617_061_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	061	0	1	04	01	H7617_061_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	061	0	1	04	01	H7617_061_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	061	0	1	04	01	H7617_061_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	063	0	1	04	01	H7617_063_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7617	063	0	1	04	01	H7617_063_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	063	0	1	04	01	H7617_063_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	063	0	1	04	01	H7617_063_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	063	0	1	04	01	H7617_063_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	064	0	1	04	01	H7617_064_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H7617	064	0	1	04	01	H7617_064_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	064	0	1	04	01	H7617_064_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	064	0	1	04	01	H7617_064_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	064	0	1	04	01	H7617_064_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	065	0	1	04	01	H7617_065_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7617	065	0	1	04	01	H7617_065_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	065	0	1	04	01	H7617_065_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	065	0	1	04	01	H7617_065_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	065	0	1	04	01	H7617_065_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	066	0	1	04	01	H7617_066_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7617	066	0	1	04	01	H7617_066_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	066	0	1	04	01	H7617_066_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	066	0	1	04	01	H7617_066_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	066	0	1	04	01	H7617_066_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	067	0	1	04	01	H7617_067_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H7617	067	0	1	04	01	H7617_067_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	067	0	1	04	01	H7617_067_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	067	0	1	04	01	H7617_067_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	067	0	1	04	01	H7617_067_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	068	0	1	04	01	H7617_068_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H7617	068	0	1	04	01	H7617_068_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	068	0	1	04	01	H7617_068_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	068	0	1	04	01	H7617_068_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	068	0	1	04	01	H7617_068_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	069	0	1	04	01	H7617_069_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H7617	069	0	1	04	01	H7617_069_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	069	0	1	04	01	H7617_069_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	069	0	1	04	01	H7617_069_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	069	0	1	04	01	H7617_069_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	070	0	1	04	01	H7617_070_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H7617	070	0	1	04	01	H7617_070_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	070	0	1	04	01	H7617_070_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	070	0	1	04	01	H7617_070_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	070	0	1	04	01	H7617_070_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	071	0	1	04	01	H7617_071_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7617	071	0	1	04	01	H7617_071_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	071	0	1	04	01	H7617_071_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	071	0	1	04	01	H7617_071_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	071	0	1	04	01	H7617_071_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	072	0	1	04	01	H7617_072_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7617	072	0	1	04	01	H7617_072_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	072	0	1	04	01	H7617_072_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	072	0	1	04	01	H7617_072_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	072	0	1	04	01	H7617_072_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	074	0	1	04	01	H7617_074_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7617	074	0	1	04	01	H7617_074_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	074	0	1	04	01	H7617_074_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	074	0	1	04	01	H7617_074_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	074	0	1	04	01	H7617_074_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	075	0	1	04	01	H7617_075_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7617	075	0	1	04	01	H7617_075_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	075	0	1	04	01	H7617_075_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	075	0	1	04	01	H7617_075_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	075	0	1	04	01	H7617_075_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	076	0	1	04	01	H7617_076_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7617	076	0	1	04	01	H7617_076_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	076	0	1	04	01	H7617_076_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	076	0	1	04	01	H7617_076_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	076	0	1	04	01	H7617_076_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	077	0	1	04	01	H7617_077_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7617	077	0	1	04	01	H7617_077_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7617	077	0	1	04	01	H7617_077_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7617	077	0	1	04	01	H7617_077_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7617	077	0	1	04	01	H7617_077_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7617	077	0	1	04	01	H7617_077_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H7617	078	0	1	04	01	H7617_078_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7617	078	0	1	04	01	H7617_078_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7617	078	0	1	04	01	H7617_078_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7617	078	0	1	04	01	H7617_078_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7617	078	0	1	04	01	H7617_078_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7617	078	0	1	04	01	H7617_078_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H7617	079	0	1	04	01	H7617_079_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7617	079	0	1	04	01	H7617_079_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	079	0	1	04	01	H7617_079_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	079	0	1	04	01	H7617_079_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	079	0	1	04	01	H7617_079_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	080	0	1	04	01	H7617_080_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7617	080	0	1	04	01	H7617_080_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	080	0	1	04	01	H7617_080_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	080	0	1	04	01	H7617_080_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	080	0	1	04	01	H7617_080_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	082	0	1	04	01	H7617_082_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7617	082	0	1	04	01	H7617_082_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	082	0	1	04	01	H7617_082_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	082	0	1	04	01	H7617_082_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	082	0	1	04	01	H7617_082_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	083	0	1	04	01	H7617_083_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7617	083	0	1	04	01	H7617_083_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	083	0	1	04	01	H7617_083_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	083	0	1	04	01	H7617_083_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	083	0	1	04	01	H7617_083_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	084	0	1	04	01	H7617_084_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7617	084	0	1	04	01	H7617_084_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	084	0	1	04	01	H7617_084_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	084	0	1	04	01	H7617_084_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	084	0	1	04	01	H7617_084_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	085	0	1	04	01	H7617_085_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7617	085	0	1	04	01	H7617_085_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	085	0	1	04	01	H7617_085_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	085	0	1	04	01	H7617_085_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	085	0	1	04	01	H7617_085_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	090	0	1	04	01	H7617_090_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H7617	090	0	1	04	01	H7617_090_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	090	0	1	04	01	H7617_090_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	090	0	1	04	01	H7617_090_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	090	0	1	04	01	H7617_090_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	091	0	1	04	01	H7617_091_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H7617	091	0	1	04	01	H7617_091_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	091	0	1	04	01	H7617_091_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	091	0	1	04	01	H7617_091_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	091	0	1	04	01	H7617_091_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	092	0	1	04	01	H7617_092_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H7617	092	0	1	04	01	H7617_092_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	092	0	1	04	01	H7617_092_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	092	0	1	04	01	H7617_092_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	092	0	1	04	01	H7617_092_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	093	0	1	04	01	H7617_093_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7617	093	0	1	04	01	H7617_093_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	093	0	1	04	01	H7617_093_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	093	0	1	04	01	H7617_093_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	093	0	1	04	01	H7617_093_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	094	0	1	04	01	H7617_094_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H7617	094	0	1	04	01	H7617_094_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	094	0	1	04	01	H7617_094_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	094	0	1	04	01	H7617_094_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	094	0	1	04	01	H7617_094_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	095	0	1	04	01	H7617_095_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H7617	095	0	1	04	01	H7617_095_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	095	0	1	04	01	H7617_095_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	095	0	1	04	01	H7617_095_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	095	0	1	04	01	H7617_095_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	098	0	1	04	01	H7617_098_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7617	098	0	1	04	01	H7617_098_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	098	0	1	04	01	H7617_098_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	098	0	1	04	01	H7617_098_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	098	0	1	04	01	H7617_098_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	100	0	1	04	01	H7617_100_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7617	100	0	1	04	01	H7617_100_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	100	0	1	04	01	H7617_100_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	100	0	1	04	01	H7617_100_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	100	0	1	04	01	H7617_100_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	107	0	1	04	01	H7617_107_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H7617	107	0	1	04	01	H7617_107_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	107	0	1	04	01	H7617_107_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	107	0	1	04	01	H7617_107_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	107	0	1	04	01	H7617_107_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	109	0	1	04	01	H7617_109_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H7617	109	0	1	04	01	H7617_109_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	109	0	1	04	01	H7617_109_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	109	0	1	04	01	H7617_109_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	109	0	1	04	01	H7617_109_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	110	0	1	04	01	H7617_110_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H7617	110	0	1	04	01	H7617_110_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	110	0	1	04	01	H7617_110_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	110	0	1	04	01	H7617_110_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	110	0	1	04	01	H7617_110_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	111	0	1	04	01	H7617_111_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H7617	111	0	1	04	01	H7617_111_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	111	0	1	04	01	H7617_111_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	111	0	1	04	01	H7617_111_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	111	0	1	04	01	H7617_111_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	112	0	1	04	01	H7617_112_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H7617	112	0	1	04	01	H7617_112_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	112	0	1	04	01	H7617_112_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	112	0	1	04	01	H7617_112_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	112	0	1	04	01	H7617_112_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7617	113	0	1	04	01	H7617_113_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7617	113	0	1	04	01	H7617_113_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7617	113	0	1	04	01	H7617_113_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7617	113	0	1	04	01	H7617_113_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7617	113	0	1	04	01	H7617_113_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7620	001	0	1	01	01	H7620_001_0	10		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H7620	001	0	1	01	01	H7620_001_0	10		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H7620	001	0	1	01	01	H7620_001_0	10		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7620	001	0	1	01	01	H7620_001_0	10		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7620	001	0	1	01	01	H7620_001_0	10		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7620	001	0	1	01	01	H7620_001_0	10		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H7635	001	0	1	01	01	H7635_001_0	12		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H7635	001	0	1	01	01	H7635_001_0	12		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7635	001	0	1	01	01	H7635_001_0	12		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H7635	001	0	1	01	01	H7635_001_0	12		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7635	001	0	1	01	01	H7635_001_0	12		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7670	001	0	1	01	01	H7670_001_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H7670	001	0	1	01	01	H7670_001_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7670	001	0	1	01	01	H7670_001_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7670	001	0	1	01	01	H7670_001_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7670	001	0	1	01	01	H7670_001_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7670	002	0	1	01	01	H7670_002_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H7670	002	0	1	01	01	H7670_002_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7670	002	0	1	01	01	H7670_002_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7670	002	0	1	01	01	H7670_002_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7670	002	0	1	01	01	H7670_002_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7678	006	1	1	01	01	H7678_006_1	8		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7678	006	1	1	01	01	H7678_006_1	8		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7678	006	1	1	01	01	H7678_006_1	8		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7678	006	1	1	01	01	H7678_006_1	8		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7678	006	1	1	01	01	H7678_006_1	8		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7678	006	1	1	01	01	H7678_006_1	8		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H7678	006	2	1	01	01	H7678_006_2	8		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7678	006	2	1	01	01	H7678_006_2	8		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7678	006	2	1	01	01	H7678_006_2	8		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7678	006	2	1	01	01	H7678_006_2	8		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7678	006	2	1	01	01	H7678_006_2	8		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7678	006	2	1	01	01	H7678_006_2	8		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H7680	001	0	1	01	01	H7680_001_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H7680	001	0	1	01	01	H7680_001_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H7680	001	0	1	01	01	H7680_001_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7680	001	0	1	01	01	H7680_001_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7680	001	0	1	01	01	H7680_001_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7680	001	0	1	01	01	H7680_001_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H7680	002	0	1	01	01	H7680_002_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H7680	002	0	1	01	01	H7680_002_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H7680	002	0	1	01	01	H7680_002_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7680	002	0	1	01	01	H7680_002_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7680	002	0	1	01	01	H7680_002_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7680	002	0	1	01	01	H7680_002_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H7680	007	0	1	01	01	H7680_007_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H7680	007	0	1	01	01	H7680_007_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H7680	007	0	1	01	01	H7680_007_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7680	007	0	1	01	01	H7680_007_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7680	007	0	1	01	01	H7680_007_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7680	007	0	1	01	01	H7680_007_0	5		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H7680	009	0	1	01	01	H7680_009_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H7680	009	0	1	01	01	H7680_009_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H7680	009	0	1	01	01	H7680_009_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7680	009	0	1	01	01	H7680_009_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7680	009	0	1	01	01	H7680_009_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7680	009	0	1	01	01	H7680_009_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H7680	011	0	1	01	01	H7680_011_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H7680	011	0	1	01	01	H7680_011_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H7680	011	0	1	01	01	H7680_011_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7680	011	0	1	01	01	H7680_011_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7680	011	0	1	01	01	H7680_011_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7680	011	0	1	01	01	H7680_011_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H7680	012	0	1	01	01	H7680_012_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H7680	012	0	1	01	01	H7680_012_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H7680	012	0	1	01	01	H7680_012_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7680	012	0	1	01	01	H7680_012_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7680	012	0	1	01	01	H7680_012_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7680	012	0	1	01	01	H7680_012_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H7680	014	0	1	01	01	H7680_014_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H7680	014	0	1	01	01	H7680_014_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H7680	014	0	1	01	01	H7680_014_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7680	014	0	1	01	01	H7680_014_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7680	014	0	1	01	01	H7680_014_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7680	014	0	1	01	01	H7680_014_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H7680	015	0	1	01	01	H7680_015_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H7680	015	0	1	01	01	H7680_015_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H7680	015	0	1	01	01	H7680_015_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7680	015	0	1	01	01	H7680_015_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7680	015	0	1	01	01	H7680_015_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7680	015	0	1	01	01	H7680_015_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H7680	016	0	1	01	01	H7680_016_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H7680	016	0	1	01	01	H7680_016_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H7680	016	0	1	01	01	H7680_016_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7680	016	0	1	01	01	H7680_016_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7680	016	0	1	01	01	H7680_016_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7680	016	0	1	01	01	H7680_016_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H7680	017	0	1	01	01	H7680_017_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H7680	017	0	1	01	01	H7680_017_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H7680	017	0	1	01	01	H7680_017_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7680	017	0	1	01	01	H7680_017_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7680	017	0	1	01	01	H7680_017_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7680	017	0	1	01	01	H7680_017_0	5		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H7680	018	0	1	01	01	H7680_018_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H7680	018	0	1	01	01	H7680_018_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H7680	018	0	1	01	01	H7680_018_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7680	018	0	1	01	01	H7680_018_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7680	018	0	1	01	01	H7680_018_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7680	018	0	1	01	01	H7680_018_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H7680	019	0	1	02	01	H7680_019_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H7680	019	0	1	02	01	H7680_019_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H7680	019	0	1	02	01	H7680_019_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7680	019	0	1	02	01	H7680_019_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7680	019	0	1	02	01	H7680_019_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7680	019	0	1	02	01	H7680_019_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H7680	020	0	1	01	01	H7680_020_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H7680	020	0	1	01	01	H7680_020_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H7680	020	0	1	01	01	H7680_020_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7680	020	0	1	01	01	H7680_020_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7680	020	0	1	01	01	H7680_020_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7680	020	0	1	01	01	H7680_020_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H7766	001	0	1	04	01	H7766_001_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7766	001	0	1	04	01	H7766_001_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H7766	001	0	1	04	01	H7766_001_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7766	001	0	1	04	01	H7766_001_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7766	001	0	1	04	01	H7766_001_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7766	002	0	1	04	01	H7766_002_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7766	002	0	1	04	01	H7766_002_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H7766	002	0	1	04	01	H7766_002_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7766	002	0	1	04	01	H7766_002_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7766	002	0	1	04	01	H7766_002_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7766	004	0	1	04	01	H7766_004_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7766	004	0	1	04	01	H7766_004_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7766	004	0	1	04	01	H7766_004_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7766	004	0	1	04	01	H7766_004_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7766	004	0	1	04	01	H7766_004_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7766	004	0	1	04	01	H7766_004_0	6		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H7766	005	0	1	04	01	H7766_005_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7766	005	0	1	04	01	H7766_005_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H7766	005	0	1	04	01	H7766_005_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7766	005	0	1	04	01	H7766_005_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7766	005	0	1	04	01	H7766_005_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7766	006	0	1	04	01	H7766_006_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7766	006	0	1	04	01	H7766_006_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H7766	006	0	1	04	01	H7766_006_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7766	006	0	1	04	01	H7766_006_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7766	006	0	1	04	01	H7766_006_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7766	012	0	1	04	01	H7766_012_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7766	012	0	1	04	01	H7766_012_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7766	012	0	1	04	01	H7766_012_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7766	012	0	1	04	01	H7766_012_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7766	012	0	1	04	01	H7766_012_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7766	012	0	1	04	01	H7766_012_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H7766	013	0	1	04	01	H7766_013_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7766	013	0	1	04	01	H7766_013_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7766	013	0	1	04	01	H7766_013_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7766	013	0	1	04	01	H7766_013_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7766	013	0	1	04	01	H7766_013_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7766	013	0	1	04	01	H7766_013_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H7766	014	0	1	04	01	H7766_014_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7766	014	0	1	04	01	H7766_014_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7766	014	0	1	04	01	H7766_014_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7766	014	0	1	04	01	H7766_014_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7766	014	0	1	04	01	H7766_014_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7766	014	0	1	04	01	H7766_014_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H7766	015	0	1	04	01	H7766_015_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7766	015	0	1	04	01	H7766_015_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7766	015	0	1	04	01	H7766_015_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7766	015	0	1	04	01	H7766_015_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7766	015	0	1	04	01	H7766_015_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7766	015	0	1	04	01	H7766_015_0	6		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H7787	001	0	1	04	01	H7787_001_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	9.00	
H7787	001	0	1	04	01	H7787_001_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7787	001	0	1	04	01	H7787_001_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7787	001	0	1	04	01	H7787_001_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7787	001	0	1	04	01	H7787_001_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7849	002	0	1	04	01	H7849_002_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H7849	002	0	1	04	01	H7849_002_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7849	002	0	1	04	01	H7849_002_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7849	002	0	1	04	01	H7849_002_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7849	002	0	1	04	01	H7849_002_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7849	015	0	1	04	01	H7849_015_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H7849	015	0	1	04	01	H7849_015_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7849	015	0	1	04	01	H7849_015_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7849	015	0	1	04	01	H7849_015_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7849	015	0	1	04	01	H7849_015_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7849	024	0	1	04	01	H7849_024_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H7849	024	0	1	04	01	H7849_024_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7849	024	0	1	04	01	H7849_024_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7849	024	0	1	04	01	H7849_024_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7849	024	0	1	04	01	H7849_024_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7849	029	0	1	04	01	H7849_029_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H7849	029	0	1	04	01	H7849_029_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7849	029	0	1	04	01	H7849_029_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7849	029	0	1	04	01	H7849_029_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7849	029	0	1	04	01	H7849_029_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7849	059	0	1	04	01	H7849_059_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H7849	059	0	1	04	01	H7849_059_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7849	059	0	1	04	01	H7849_059_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7849	059	0	1	04	01	H7849_059_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7849	059	0	1	04	01	H7849_059_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7849	065	0	1	04	01	H7849_065_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H7849	065	0	1	04	01	H7849_065_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7849	065	0	1	04	01	H7849_065_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7849	065	0	1	04	01	H7849_065_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7849	065	0	1	04	01	H7849_065_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7849	070	0	1	04	01	H7849_070_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	9.00	
H7849	070	0	1	04	01	H7849_070_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7849	070	0	1	04	01	H7849_070_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7849	070	0	1	04	01	H7849_070_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7849	070	0	1	04	01	H7849_070_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7849	077	0	1	04	01	H7849_077_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H7849	077	0	1	04	01	H7849_077_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7849	077	0	1	04	01	H7849_077_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7849	077	0	1	04	01	H7849_077_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7849	077	0	1	04	01	H7849_077_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7849	080	0	1	04	01	H7849_080_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	5.00	
H7849	080	0	1	04	01	H7849_080_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7849	080	0	1	04	01	H7849_080_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7849	080	0	1	04	01	H7849_080_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7849	080	0	1	04	01	H7849_080_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7849	088	0	1	04	01	H7849_088_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H7849	088	0	1	04	01	H7849_088_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7849	088	0	1	04	01	H7849_088_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7849	088	0	1	04	01	H7849_088_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7849	088	0	1	04	01	H7849_088_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7849	102	1	1	04	01	H7849_102_1	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H7849	102	1	1	04	01	H7849_102_1	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7849	102	1	1	04	01	H7849_102_1	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7849	102	1	1	04	01	H7849_102_1	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7849	102	1	1	04	01	H7849_102_1	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7849	102	2	1	04	01	H7849_102_2	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H7849	102	2	1	04	01	H7849_102_2	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7849	102	2	1	04	01	H7849_102_2	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7849	102	2	1	04	01	H7849_102_2	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7849	102	2	1	04	01	H7849_102_2	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7849	102	3	1	04	01	H7849_102_3	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H7849	102	3	1	04	01	H7849_102_3	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7849	102	3	1	04	01	H7849_102_3	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7849	102	3	1	04	01	H7849_102_3	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7849	102	3	1	04	01	H7849_102_3	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7849	106	0	1	04	01	H7849_106_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H7849	106	0	1	04	01	H7849_106_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7849	106	0	1	04	01	H7849_106_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7849	106	0	1	04	01	H7849_106_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7849	106	0	1	04	01	H7849_106_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7849	113	1	1	04	01	H7849_113_1	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H7849	113	1	1	04	01	H7849_113_1	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7849	113	1	1	04	01	H7849_113_1	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7849	113	1	1	04	01	H7849_113_1	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7849	113	1	1	04	01	H7849_113_1	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7849	113	2	1	04	01	H7849_113_2	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H7849	113	2	1	04	01	H7849_113_2	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7849	113	2	1	04	01	H7849_113_2	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7849	113	2	1	04	01	H7849_113_2	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7849	113	2	1	04	01	H7849_113_2	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7849	113	3	1	04	01	H7849_113_3	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H7849	113	3	1	04	01	H7849_113_3	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7849	113	3	1	04	01	H7849_113_3	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7849	113	3	1	04	01	H7849_113_3	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7849	113	3	1	04	01	H7849_113_3	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7849	113	4	1	04	01	H7849_113_4	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H7849	113	4	1	04	01	H7849_113_4	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7849	113	4	1	04	01	H7849_113_4	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7849	113	4	1	04	01	H7849_113_4	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7849	113	4	1	04	01	H7849_113_4	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7849	114	0	1	04	01	H7849_114_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H7849	114	0	1	04	01	H7849_114_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7849	114	0	1	04	01	H7849_114_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7849	114	0	1	04	01	H7849_114_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7849	114	0	1	04	01	H7849_114_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7849	135	0	1	04	01	H7849_135_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H7849	135	0	1	04	01	H7849_135_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7849	135	0	1	04	01	H7849_135_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7849	135	0	1	04	01	H7849_135_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7849	135	0	1	04	01	H7849_135_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7849	136	1	1	04	01	H7849_136_1	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H7849	136	1	1	04	01	H7849_136_1	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7849	136	1	1	04	01	H7849_136_1	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7849	136	1	1	04	01	H7849_136_1	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7849	136	1	1	04	01	H7849_136_1	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7849	136	2	1	04	01	H7849_136_2	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H7849	136	2	1	04	01	H7849_136_2	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7849	136	2	1	04	01	H7849_136_2	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7849	136	2	1	04	01	H7849_136_2	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7849	136	2	1	04	01	H7849_136_2	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7849	136	3	1	04	01	H7849_136_3	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H7849	136	3	1	04	01	H7849_136_3	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7849	136	3	1	04	01	H7849_136_3	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7849	136	3	1	04	01	H7849_136_3	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7849	136	3	1	04	01	H7849_136_3	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7849	142	0	1	04	01	H7849_142_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	9.00	
H7849	142	0	1	04	01	H7849_142_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7849	142	0	1	04	01	H7849_142_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7849	142	0	1	04	01	H7849_142_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7849	142	0	1	04	01	H7849_142_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7849	143	0	1	04	01	H7849_143_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H7849	143	0	1	04	01	H7849_143_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7849	143	0	1	04	01	H7849_143_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7849	143	0	1	04	01	H7849_143_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7849	143	0	1	04	01	H7849_143_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7849	144	0	1	04	01	H7849_144_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H7849	144	0	1	04	01	H7849_144_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7849	144	0	1	04	01	H7849_144_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7849	144	0	1	04	01	H7849_144_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7849	144	0	1	04	01	H7849_144_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7849	145	0	1	04	01	H7849_145_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H7849	145	0	1	04	01	H7849_145_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7849	145	0	1	04	01	H7849_145_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7849	145	0	1	04	01	H7849_145_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7849	145	0	1	04	01	H7849_145_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7849	146	0	1	04	01	H7849_146_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H7849	146	0	1	04	01	H7849_146_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7849	146	0	1	04	01	H7849_146_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7849	146	0	1	04	01	H7849_146_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7849	146	0	1	04	01	H7849_146_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7849	147	0	1	04	01	H7849_147_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H7849	147	0	1	04	01	H7849_147_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7849	147	0	1	04	01	H7849_147_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7849	147	0	1	04	01	H7849_147_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7849	147	0	1	04	01	H7849_147_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7849	148	0	1	04	01	H7849_148_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H7849	148	0	1	04	01	H7849_148_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7849	148	0	1	04	01	H7849_148_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7849	148	0	1	04	01	H7849_148_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7849	148	0	1	04	01	H7849_148_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7849	149	0	1	04	01	H7849_149_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H7849	149	0	1	04	01	H7849_149_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7849	149	0	1	04	01	H7849_149_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7849	149	0	1	04	01	H7849_149_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7849	149	0	1	04	01	H7849_149_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7849	150	0	1	04	01	H7849_150_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H7849	150	0	1	04	01	H7849_150_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7849	150	0	1	04	01	H7849_150_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7849	150	0	1	04	01	H7849_150_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7849	150	0	1	04	01	H7849_150_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7849	151	0	1	04	01	H7849_151_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H7849	151	0	1	04	01	H7849_151_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7849	151	0	1	04	01	H7849_151_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7849	151	0	1	04	01	H7849_151_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7849	151	0	1	04	01	H7849_151_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7849	152	0	1	04	01	H7849_152_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H7849	152	0	1	04	01	H7849_152_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7849	152	0	1	04	01	H7849_152_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7849	152	0	1	04	01	H7849_152_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7849	152	0	1	04	01	H7849_152_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7849	153	0	1	04	01	H7849_153_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H7849	153	0	1	04	01	H7849_153_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7849	153	0	1	04	01	H7849_153_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7849	153	0	1	04	01	H7849_153_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7849	153	0	1	04	01	H7849_153_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7849	154	0	1	04	01	H7849_154_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H7849	154	0	1	04	01	H7849_154_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7849	154	0	1	04	01	H7849_154_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7849	154	0	1	04	01	H7849_154_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7849	154	0	1	04	01	H7849_154_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7849	155	0	1	04	01	H7849_155_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H7849	155	0	1	04	01	H7849_155_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7849	155	0	1	04	01	H7849_155_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7849	155	0	1	04	01	H7849_155_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7849	155	0	1	04	01	H7849_155_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7917	009	0	1	04	01	H7917_009_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7917	009	0	1	04	01	H7917_009_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7917	009	0	1	04	01	H7917_009_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7917	009	0	1	04	01	H7917_009_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7917	009	0	1	04	01	H7917_009_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7917	010	0	1	04	01	H7917_010_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7917	010	0	1	04	01	H7917_010_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7917	010	0	1	04	01	H7917_010_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7917	010	0	1	04	01	H7917_010_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7917	010	0	1	04	01	H7917_010_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7917	011	0	1	04	01	H7917_011_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7917	011	0	1	04	01	H7917_011_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7917	011	0	1	04	01	H7917_011_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7917	011	0	1	04	01	H7917_011_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7917	011	0	1	04	01	H7917_011_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7917	012	0	1	04	01	H7917_012_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7917	012	0	1	04	01	H7917_012_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7917	012	0	1	04	01	H7917_012_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7917	012	0	1	04	01	H7917_012_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7917	012	0	1	04	01	H7917_012_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7917	013	0	1	04	01	H7917_013_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7917	013	0	1	04	01	H7917_013_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7917	013	0	1	04	01	H7917_013_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7917	013	0	1	04	01	H7917_013_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7917	013	0	1	04	01	H7917_013_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7917	014	0	1	04	01	H7917_014_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7917	014	0	1	04	01	H7917_014_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7917	014	0	1	04	01	H7917_014_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7917	014	0	1	04	01	H7917_014_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7917	014	0	1	04	01	H7917_014_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7917	015	0	1	04	01	H7917_015_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7917	015	0	1	04	01	H7917_015_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7917	015	0	1	04	01	H7917_015_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7917	015	0	1	04	01	H7917_015_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7917	015	0	1	04	01	H7917_015_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7917	030	0	1	04	01	H7917_030_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7917	030	0	1	04	01	H7917_030_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7917	030	0	1	04	01	H7917_030_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7917	030	0	1	04	01	H7917_030_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7917	030	0	1	04	01	H7917_030_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7917	031	0	1	04	01	H7917_031_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7917	031	0	1	04	01	H7917_031_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7917	031	0	1	04	01	H7917_031_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7917	031	0	1	04	01	H7917_031_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7917	031	0	1	04	01	H7917_031_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7917	032	0	1	04	01	H7917_032_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7917	032	0	1	04	01	H7917_032_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7917	032	0	1	04	01	H7917_032_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7917	032	0	1	04	01	H7917_032_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7917	032	0	1	04	01	H7917_032_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7917	033	0	1	04	01	H7917_033_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7917	033	0	1	04	01	H7917_033_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7917	033	0	1	04	01	H7917_033_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7917	033	0	1	04	01	H7917_033_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7917	033	0	1	04	01	H7917_033_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7917	038	0	1	04	01	H7917_038_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7917	038	0	1	04	01	H7917_038_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7917	038	0	1	04	01	H7917_038_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7917	038	0	1	04	01	H7917_038_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7917	038	0	1	04	01	H7917_038_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7917	040	0	1	04	01	H7917_040_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7917	040	0	1	04	01	H7917_040_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7917	040	0	1	04	01	H7917_040_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7917	040	0	1	04	01	H7917_040_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7917	040	0	1	04	01	H7917_040_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7917	044	0	1	04	01	H7917_044_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7917	044	0	1	04	01	H7917_044_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7917	044	0	1	04	01	H7917_044_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7917	044	0	1	04	01	H7917_044_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7917	044	0	1	04	01	H7917_044_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7917	045	0	1	04	01	H7917_045_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7917	045	0	1	04	01	H7917_045_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H7917	045	0	1	04	01	H7917_045_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7917	045	0	1	04	01	H7917_045_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7917	045	0	1	04	01	H7917_045_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7980	001	0	1	04	01	H7980_001_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H7980	001	0	1	04	01	H7980_001_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H7980	001	0	1	04	01	H7980_001_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7980	001	0	1	04	01	H7980_001_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7980	001	0	1	04	01	H7980_001_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7993	001	0	1	01	01	H7993_001_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7993	001	0	1	01	01	H7993_001_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H7993	001	0	1	01	01	H7993_001_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7993	001	0	1	01	01	H7993_001_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7993	001	0	1	01	01	H7993_001_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7993	002	0	1	01	01	H7993_002_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7993	002	0	1	01	01	H7993_002_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H7993	002	0	1	01	01	H7993_002_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7993	002	0	1	01	01	H7993_002_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7993	002	0	1	01	01	H7993_002_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7993	003	0	1	01	01	H7993_003_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7993	003	0	1	01	01	H7993_003_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H7993	003	0	1	01	01	H7993_003_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7993	003	0	1	01	01	H7993_003_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7993	003	0	1	01	01	H7993_003_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7993	004	0	1	01	01	H7993_004_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7993	004	0	1	01	01	H7993_004_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H7993	004	0	1	01	01	H7993_004_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7993	004	0	1	01	01	H7993_004_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7993	004	0	1	01	01	H7993_004_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7993	006	0	1	01	01	H7993_006_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7993	006	0	1	01	01	H7993_006_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H7993	006	0	1	01	01	H7993_006_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7993	006	0	1	01	01	H7993_006_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7993	006	0	1	01	01	H7993_006_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7993	007	0	1	01	01	H7993_007_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7993	007	0	1	01	01	H7993_007_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H7993	007	0	1	01	01	H7993_007_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7993	007	0	1	01	01	H7993_007_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7993	007	0	1	01	01	H7993_007_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7993	008	0	1	01	01	H7993_008_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7993	008	0	1	01	01	H7993_008_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H7993	008	0	1	01	01	H7993_008_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7993	008	0	1	01	01	H7993_008_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7993	008	0	1	01	01	H7993_008_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7993	010	0	1	01	01	H7993_010_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7993	010	0	1	01	01	H7993_010_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7993	010	0	1	01	01	H7993_010_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7993	010	0	1	01	01	H7993_010_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7993	010	0	1	01	01	H7993_010_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7993	010	0	1	01	01	H7993_010_0	6		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H7993	012	0	1	01	01	H7993_012_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7993	012	0	1	01	01	H7993_012_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7993	012	0	1	01	01	H7993_012_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7993	012	0	1	01	01	H7993_012_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7993	012	0	1	01	01	H7993_012_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7993	012	0	1	01	01	H7993_012_0	6		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H7993	014	0	1	01	01	H7993_014_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7993	014	0	1	01	01	H7993_014_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H7993	014	0	1	01	01	H7993_014_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7993	014	0	1	01	01	H7993_014_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7993	014	0	1	01	01	H7993_014_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7993	015	0	1	01	01	H7993_015_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7993	015	0	1	01	01	H7993_015_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7993	015	0	1	01	01	H7993_015_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7993	015	0	1	01	01	H7993_015_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7993	015	0	1	01	01	H7993_015_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7993	015	0	1	01	01	H7993_015_0	6		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H7993	017	0	1	01	01	H7993_017_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7993	017	0	1	01	01	H7993_017_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7993	017	0	1	01	01	H7993_017_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7993	017	0	1	01	01	H7993_017_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7993	017	0	1	01	01	H7993_017_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7993	017	0	1	01	01	H7993_017_0	5		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H7993	019	0	1	01	01	H7993_019_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7993	019	0	1	01	01	H7993_019_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H7993	019	0	1	01	01	H7993_019_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7993	019	0	1	01	01	H7993_019_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7993	019	0	1	01	01	H7993_019_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7993	021	0	1	01	01	H7993_021_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7993	021	0	1	01	01	H7993_021_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H7993	021	0	1	01	01	H7993_021_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7993	021	0	1	01	01	H7993_021_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7993	021	0	1	01	01	H7993_021_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7993	023	0	1	01	01	H7993_023_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7993	023	0	1	01	01	H7993_023_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7993	023	0	1	01	01	H7993_023_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7993	023	0	1	01	01	H7993_023_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7993	023	0	1	01	01	H7993_023_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7993	023	0	1	01	01	H7993_023_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H7993	024	0	1	01	01	H7993_024_0	5			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7993	024	0	1	01	01	H7993_024_0	5			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7993	024	0	1	01	01	H7993_024_0	5			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7993	024	0	1	01	01	H7993_024_0	5			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7993	024	0	1	01	01	H7993_024_0	5			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7993	024	0	1	01	01	H7993_024_0	5			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H7993	027	0	1	01	01	H7993_027_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7993	027	0	1	01	01	H7993_027_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H7993	027	0	1	01	01	H7993_027_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7993	027	0	1	01	01	H7993_027_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7993	027	0	1	01	01	H7993_027_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7993	028	0	1	01	01	H7993_028_0	5			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7993	028	0	1	01	01	H7993_028_0	5			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7993	028	0	1	01	01	H7993_028_0	5			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7993	028	0	1	01	01	H7993_028_0	5			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7993	028	0	1	01	01	H7993_028_0	5			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7993	028	0	1	01	01	H7993_028_0	5			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H7993	029	0	1	01	01	H7993_029_0	5			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7993	029	0	1	01	01	H7993_029_0	5			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7993	029	0	1	01	01	H7993_029_0	5			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7993	029	0	1	01	01	H7993_029_0	5			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7993	029	0	1	01	01	H7993_029_0	5			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7993	029	0	1	01	01	H7993_029_0	5			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H7993	030	0	1	01	01	H7993_030_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7993	030	0	1	01	01	H7993_030_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7993	030	0	1	01	01	H7993_030_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7993	030	0	1	01	01	H7993_030_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7993	030	0	1	01	01	H7993_030_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7993	030	0	1	01	01	H7993_030_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H7993	031	0	1	01	01	H7993_031_0	5			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7993	031	0	1	01	01	H7993_031_0	5			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7993	031	0	1	01	01	H7993_031_0	5			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7993	031	0	1	01	01	H7993_031_0	5			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7993	031	0	1	01	01	H7993_031_0	5			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7993	031	0	1	01	01	H7993_031_0	5			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H7993	033	0	1	01	01	H7993_033_0	5			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7993	033	0	1	01	01	H7993_033_0	5			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7993	033	0	1	01	01	H7993_033_0	5			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7993	033	0	1	01	01	H7993_033_0	5			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7993	033	0	1	01	01	H7993_033_0	5			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7993	033	0	1	01	01	H7993_033_0	5			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H7993	034	0	1	01	01	H7993_034_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7993	034	0	1	01	01	H7993_034_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H7993	034	0	1	01	01	H7993_034_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7993	034	0	1	01	01	H7993_034_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7993	034	0	1	01	01	H7993_034_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7993	035	0	1	01	01	H7993_035_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7993	035	0	1	01	01	H7993_035_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H7993	035	0	1	01	01	H7993_035_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7993	035	0	1	01	01	H7993_035_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7993	035	0	1	01	01	H7993_035_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7993	036	0	1	01	01	H7993_036_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7993	036	0	1	01	01	H7993_036_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7993	036	0	1	01	01	H7993_036_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7993	036	0	1	01	01	H7993_036_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7993	036	0	1	01	01	H7993_036_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7993	036	0	1	01	01	H7993_036_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H7993	037	0	1	01	01	H7993_037_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7993	037	0	1	01	01	H7993_037_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7993	037	0	1	01	01	H7993_037_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7993	037	0	1	01	01	H7993_037_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7993	037	0	1	01	01	H7993_037_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7993	037	0	1	01	01	H7993_037_0	6		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H7993	038	0	1	01	01	H7993_038_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7993	038	0	1	01	01	H7993_038_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7993	038	0	1	01	01	H7993_038_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7993	038	0	1	01	01	H7993_038_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7993	038	0	1	01	01	H7993_038_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7993	038	0	1	01	01	H7993_038_0	5		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H7993	040	0	1	01	01	H7993_040_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7993	040	0	1	01	01	H7993_040_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7993	040	0	1	01	01	H7993_040_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7993	040	0	1	01	01	H7993_040_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7993	040	0	1	01	01	H7993_040_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7993	040	0	1	01	01	H7993_040_0	5		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H7993	041	0	1	01	01	H7993_041_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H7993	041	0	1	01	01	H7993_041_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H7993	041	0	1	01	01	H7993_041_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H7993	041	0	1	01	01	H7993_041_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H7993	041	0	1	01	01	H7993_041_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H7993	041	0	1	01	01	H7993_041_0	5		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H7993	046	0	1	01	01	H7993_046_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7993	046	0	1	01	01	H7993_046_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H7993	046	0	1	01	01	H7993_046_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7993	046	0	1	01	01	H7993_046_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7993	046	0	1	01	01	H7993_046_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H7993	048	0	1	01	01	H7993_048_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H7993	048	0	1	01	01	H7993_048_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H7993	048	0	1	01	01	H7993_048_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H7993	048	0	1	01	01	H7993_048_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H7993	048	0	1	01	01	H7993_048_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8003	001	0	1	04	01	H8003_001_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H8003	001	0	1	04	01	H8003_001_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H8003	001	0	1	04	01	H8003_001_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H8003	001	0	1	04	01	H8003_001_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H8003	001	0	1	04	01	H8003_001_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H8003	001	0	1	04	01	H8003_001_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H8003	002	0	1	04	01	H8003_002_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H8003	002	0	1	04	01	H8003_002_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H8003	002	0	1	04	01	H8003_002_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H8003	002	0	1	04	01	H8003_002_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H8003	002	0	1	04	01	H8003_002_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H8003	002	0	1	04	01	H8003_002_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H8003	003	0	1	04	01	H8003_003_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H8003	003	0	1	04	01	H8003_003_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H8003	003	0	1	04	01	H8003_003_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H8003	003	0	1	04	01	H8003_003_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H8003	003	0	1	04	01	H8003_003_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H8003	003	0	1	04	01	H8003_003_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H8003	004	0	1	04	01	H8003_004_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H8003	004	0	1	04	01	H8003_004_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H8003	004	0	1	04	01	H8003_004_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H8003	004	0	1	04	01	H8003_004_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H8003	004	0	1	04	01	H8003_004_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H8003	004	0	1	04	01	H8003_004_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H8003	005	0	1	04	01	H8003_005_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H8003	005	0	1	04	01	H8003_005_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H8003	005	0	1	04	01	H8003_005_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H8003	005	0	1	04	01	H8003_005_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H8003	005	0	1	04	01	H8003_005_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H8003	005	0	1	04	01	H8003_005_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H8003	006	0	1	04	01	H8003_006_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H8003	006	0	1	04	01	H8003_006_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H8003	006	0	1	04	01	H8003_006_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H8003	006	0	1	04	01	H8003_006_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H8003	006	0	1	04	01	H8003_006_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H8003	006	0	1	04	01	H8003_006_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H8010	002	0	1	01	01	H8010_002_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8010	002	0	1	01	01	H8010_002_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H8010	002	0	1	01	01	H8010_002_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8010	002	0	1	01	01	H8010_002_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8010	002	0	1	01	01	H8010_002_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8010	003	0	1	01	01	H8010_003_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8010	003	0	1	01	01	H8010_003_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H8010	003	0	1	01	01	H8010_003_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8010	003	0	1	01	01	H8010_003_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8010	003	0	1	01	01	H8010_003_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8051	001	0	1	01	01	H8051_001_0	10		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H8051	001	0	1	01	01	H8051_001_0	10		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H8051	001	0	1	01	01	H8051_001_0	10		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H8051	001	0	1	01	01	H8051_001_0	10		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H8051	001	0	1	01	01	H8051_001_0	10		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H8051	001	0	1	01	01	H8051_001_0	10		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H8133	001	0	1	01	01	H8133_001_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8133	001	0	1	01	01	H8133_001_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H8133	001	0	1	01	01	H8133_001_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8133	001	0	1	01	01	H8133_001_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8133	001	0	1	01	01	H8133_001_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8133	005	0	1	01	01	H8133_005_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8133	005	0	1	01	01	H8133_005_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H8133	005	0	1	01	01	H8133_005_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8133	005	0	1	01	01	H8133_005_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8133	005	0	1	01	01	H8133_005_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8142	001	0	1	02	01	H8142_001_0	11			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8142	001	0	1	02	01	H8142_001_0	11			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H8142	001	0	1	02	01	H8142_001_0	11			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8142	001	0	1	02	01	H8142_001_0	11			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8142	001	0	1	02	01	H8142_001_0	11			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8142	002	0	1	02	01	H8142_002_0	11			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8142	002	0	1	02	01	H8142_002_0	11			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H8142	002	0	1	02	01	H8142_002_0	11			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8142	002	0	1	02	01	H8142_002_0	11			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8142	002	0	1	02	01	H8142_002_0	11			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8142	003	0	1	02	01	H8142_003_0	11			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8142	003	0	1	02	01	H8142_003_0	11			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H8142	003	0	1	02	01	H8142_003_0	11			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8142	003	0	1	02	01	H8142_003_0	11			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8142	003	0	1	02	01	H8142_003_0	11			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8142	007	0	1	02	01	H8142_007_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8142	007	0	1	02	01	H8142_007_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H8142	007	0	1	02	01	H8142_007_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8142	007	0	1	02	01	H8142_007_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8142	007	0	1	02	01	H8142_007_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8145	004	0	1	09	04	H8145_004_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8145	004	0	1	09	04	H8145_004_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H8145	004	0	1	09	04	H8145_004_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8145	004	0	1	09	04	H8145_004_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8145	004	0	1	09	04	H8145_004_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8145	006	0	1	09	04	H8145_006_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H8145	006	0	1	09	04	H8145_006_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H8145	006	0	1	09	04	H8145_006_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8145	006	0	1	09	04	H8145_006_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8145	006	0	1	09	04	H8145_006_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8145	032	0	1	09	04	H8145_032_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8145	032	0	1	09	04	H8145_032_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H8145	032	0	1	09	04	H8145_032_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8145	032	0	1	09	04	H8145_032_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8145	032	0	1	09	04	H8145_032_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8145	052	0	1	09	04	H8145_052_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8145	052	0	1	09	04	H8145_052_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H8145	052	0	1	09	04	H8145_052_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8145	052	0	1	09	04	H8145_052_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8145	052	0	1	09	04	H8145_052_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8145	069	0	1	09	04	H8145_069_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8145	069	0	1	09	04	H8145_069_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H8145	069	0	1	09	04	H8145_069_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8145	069	0	1	09	04	H8145_069_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8145	069	0	1	09	04	H8145_069_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8145	084	0	1	09	04	H8145_084_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8145	084	0	1	09	04	H8145_084_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H8145	084	0	1	09	04	H8145_084_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8145	084	0	1	09	04	H8145_084_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8145	084	0	1	09	04	H8145_084_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8145	091	0	1	09	04	H8145_091_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8145	091	0	1	09	04	H8145_091_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H8145	091	0	1	09	04	H8145_091_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8145	091	0	1	09	04	H8145_091_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8145	091	0	1	09	04	H8145_091_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8166	005	0	1	04	01	H8166_005_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8166	005	0	1	04	01	H8166_005_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H8166	005	0	1	04	01	H8166_005_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8166	005	0	1	04	01	H8166_005_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8166	005	0	1	04	01	H8166_005_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8166	006	0	1	04	01	H8166_006_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8166	006	0	1	04	01	H8166_006_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H8166	006	0	1	04	01	H8166_006_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8166	006	0	1	04	01	H8166_006_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8166	006	0	1	04	01	H8166_006_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8173	001	0	1	01	01	H8173_001_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8173	001	0	1	01	01	H8173_001_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	5.00	
H8173	001	0	1	01	01	H8173_001_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8173	001	0	1	01	01	H8173_001_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8173	001	0	1	01	01	H8173_001_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8173	007	0	1	01	01	H8173_007_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8173	007	0	1	01	01	H8173_007_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	5.00	
H8173	007	0	1	01	01	H8173_007_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8173	007	0	1	01	01	H8173_007_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8173	007	0	1	01	01	H8173_007_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8173	011	0	1	01	01	H8173_011_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8173	011	0	1	01	01	H8173_011_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	10.00	
H8173	011	0	1	01	01	H8173_011_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8173	011	0	1	01	01	H8173_011_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8173	011	0	1	01	01	H8173_011_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8173	013	0	1	01	01	H8173_013_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8173	013	0	1	01	01	H8173_013_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H8173	013	0	1	01	01	H8173_013_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8173	013	0	1	01	01	H8173_013_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8173	013	0	1	01	01	H8173_013_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8173	014	0	1	01	01	H8173_014_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H8173	014	0	1	01	01	H8173_014_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H8173	014	0	1	01	01	H8173_014_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H8173	014	0	1	01	01	H8173_014_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H8173	014	0	1	01	01	H8173_014_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H8173	014	0	1	01	01	H8173_014_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H8173	016	0	1	01	01	H8173_016_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8173	016	0	1	01	01	H8173_016_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	5.00	
H8173	016	0	1	01	01	H8173_016_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8173	016	0	1	01	01	H8173_016_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8173	016	0	1	01	01	H8173_016_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8173	019	0	1	01	01	H8173_019_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8173	019	0	1	01	01	H8173_019_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H8173	019	0	1	01	01	H8173_019_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8173	019	0	1	01	01	H8173_019_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8173	019	0	1	01	01	H8173_019_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8173	020	0	1	01	01	H8173_020_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8173	020	0	1	01	01	H8173_020_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H8173	020	0	1	01	01	H8173_020_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8173	020	0	1	01	01	H8173_020_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8173	020	0	1	01	01	H8173_020_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8173	021	0	1	01	01	H8173_021_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8173	021	0	1	01	01	H8173_021_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H8173	021	0	1	01	01	H8173_021_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8173	021	0	1	01	01	H8173_021_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8173	021	0	1	01	01	H8173_021_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8173	022	0	1	01	01	H8173_022_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H8173	022	0	1	01	01	H8173_022_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H8173	022	0	1	01	01	H8173_022_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H8173	022	0	1	01	01	H8173_022_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H8173	022	0	1	01	01	H8173_022_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H8173	022	0	1	01	01	H8173_022_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H8173	023	0	1	01	01	H8173_023_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8173	023	0	1	01	01	H8173_023_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H8173	023	0	1	01	01	H8173_023_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8173	023	0	1	01	01	H8173_023_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8173	023	0	1	01	01	H8173_023_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8173	024	0	1	01	01	H8173_024_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H8173	024	0	1	01	01	H8173_024_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H8173	024	0	1	01	01	H8173_024_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H8173	024	0	1	01	01	H8173_024_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H8173	024	0	1	01	01	H8173_024_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H8173	024	0	1	01	01	H8173_024_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H8173	025	0	1	01	01	H8173_025_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H8173	025	0	1	01	01	H8173_025_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H8173	025	0	1	01	01	H8173_025_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H8173	025	0	1	01	01	H8173_025_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H8173	025	0	1	01	01	H8173_025_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H8173	025	0	1	01	01	H8173_025_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H8173	027	0	1	01	01	H8173_027_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H8173	027	0	1	01	01	H8173_027_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H8173	027	0	1	01	01	H8173_027_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H8173	027	0	1	01	01	H8173_027_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H8173	027	0	1	01	01	H8173_027_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H8173	027	0	1	01	01	H8173_027_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H8176	004	1	1	01	01	H8176_004_1	9		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H8176	004	1	1	01	01	H8176_004_1	9		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H8176	004	1	1	01	01	H8176_004_1	9		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H8176	004	1	1	01	01	H8176_004_1	9		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H8176	004	1	1	01	01	H8176_004_1	9		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H8176	004	1	1	01	01	H8176_004_1	9		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H8176	004	2	1	01	01	H8176_004_2	9		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H8176	004	2	1	01	01	H8176_004_2	9		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H8176	004	2	1	01	01	H8176_004_2	9		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H8176	004	2	1	01	01	H8176_004_2	9		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H8176	004	2	1	01	01	H8176_004_2	9		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H8176	004	2	1	01	01	H8176_004_2	9		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H8181	001	0	1	04	01	H8181_001_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	0.00	
H8181	001	0	1	04	01	H8181_001_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H8181	001	0	1	04	01	H8181_001_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8181	001	0	1	04	01	H8181_001_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8181	001	0	1	04	01	H8181_001_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8181	002	0	1	04	01	H8181_002_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	0.00	
H8181	002	0	1	04	01	H8181_002_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H8181	002	0	1	04	01	H8181_002_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8181	002	0	1	04	01	H8181_002_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8181	002	0	1	04	01	H8181_002_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8181	003	0	1	04	01	H8181_003_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	0.00	
H8181	003	0	1	04	01	H8181_003_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H8181	003	0	1	04	01	H8181_003_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8181	003	0	1	04	01	H8181_003_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8181	003	0	1	04	01	H8181_003_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8189	001	0	1	02	01	H8189_001_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H8189	001	0	1	02	01	H8189_001_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H8189	001	0	1	02	01	H8189_001_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H8189	001	0	1	02	01	H8189_001_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H8189	001	0	1	02	01	H8189_001_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H8189	001	0	1	02	01	H8189_001_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H8189	007	0	1	02	01	H8189_007_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H8189	007	0	1	02	01	H8189_007_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H8189	007	0	1	02	01	H8189_007_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H8189	007	0	1	02	01	H8189_007_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H8189	007	0	1	02	01	H8189_007_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H8189	007	0	1	02	01	H8189_007_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H8189	008	0	1	02	01	H8189_008_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H8189	008	0	1	02	01	H8189_008_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H8189	008	0	1	02	01	H8189_008_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H8189	008	0	1	02	01	H8189_008_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H8189	008	0	1	02	01	H8189_008_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H8189	008	0	1	02	01	H8189_008_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H8211	001	0	1	04	01	H8211_001_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8211	001	0	1	04	01	H8211_001_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H8211	001	0	1	04	01	H8211_001_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8211	001	0	1	04	01	H8211_001_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8211	001	0	1	04	01	H8211_001_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8211	006	0	1	04	01	H8211_006_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8211	006	0	1	04	01	H8211_006_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H8211	006	0	1	04	01	H8211_006_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8211	006	0	1	04	01	H8211_006_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8211	006	0	1	04	01	H8211_006_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8211	007	0	1	04	01	H8211_007_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8211	007	0	1	04	01	H8211_007_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H8211	007	0	1	04	01	H8211_007_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8211	007	0	1	04	01	H8211_007_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8211	007	0	1	04	01	H8211_007_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8211	009	0	1	04	01	H8211_009_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8211	009	0	1	04	01	H8211_009_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H8211	009	0	1	04	01	H8211_009_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8211	009	0	1	04	01	H8211_009_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8211	009	0	1	04	01	H8211_009_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8211	011	0	1	04	01	H8211_011_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8211	011	0	1	04	01	H8211_011_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H8211	011	0	1	04	01	H8211_011_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8211	011	0	1	04	01	H8211_011_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8211	011	0	1	04	01	H8211_011_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8211	012	0	1	04	01	H8211_012_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8211	012	0	1	04	01	H8211_012_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H8211	012	0	1	04	01	H8211_012_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8211	012	0	1	04	01	H8211_012_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8211	012	0	1	04	01	H8211_012_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8212	001	0	1	01	01	H8212_001_0	9		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H8212	001	0	1	01	01	H8212_001_0	9		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H8212	001	0	1	01	01	H8212_001_0	9		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H8212	001	0	1	01	01	H8212_001_0	9		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H8212	001	0	1	01	01	H8212_001_0	9		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H8212	001	0	1	01	01	H8212_001_0	9		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H8320	001	0	1	04	01	H8320_001_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8320	001	0	1	04	01	H8320_001_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H8320	001	0	1	04	01	H8320_001_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8320	001	0	1	04	01	H8320_001_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8320	001	0	1	04	01	H8320_001_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8320	002	0	1	04	01	H8320_002_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8320	002	0	1	04	01	H8320_002_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H8320	002	0	1	04	01	H8320_002_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8320	002	0	1	04	01	H8320_002_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8320	002	0	1	04	01	H8320_002_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8320	003	0	1	04	01	H8320_003_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8320	003	0	1	04	01	H8320_003_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H8320	003	0	1	04	01	H8320_003_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8320	003	0	1	04	01	H8320_003_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8320	003	0	1	04	01	H8320_003_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8320	004	0	1	04	01	H8320_004_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8320	004	0	1	04	01	H8320_004_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H8320	004	0	1	04	01	H8320_004_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8320	004	0	1	04	01	H8320_004_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8320	004	0	1	04	01	H8320_004_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8320	005	0	1	04	01	H8320_005_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8320	005	0	1	04	01	H8320_005_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H8320	005	0	1	04	01	H8320_005_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8320	005	0	1	04	01	H8320_005_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8320	005	0	1	04	01	H8320_005_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8320	006	0	1	04	01	H8320_006_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8320	006	0	1	04	01	H8320_006_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H8320	006	0	1	04	01	H8320_006_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8320	006	0	1	04	01	H8320_006_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8320	006	0	1	04	01	H8320_006_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8320	011	0	1	04	01	H8320_011_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H8320	011	0	1	04	01	H8320_011_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H8320	011	0	1	04	01	H8320_011_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H8320	011	0	1	04	01	H8320_011_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H8320	011	0	1	04	01	H8320_011_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H8320	011	0	1	04	01	H8320_011_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H8320	012	0	1	04	01	H8320_012_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H8320	012	0	1	04	01	H8320_012_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H8320	012	0	1	04	01	H8320_012_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H8320	012	0	1	04	01	H8320_012_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H8320	012	0	1	04	01	H8320_012_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H8320	012	0	1	04	01	H8320_012_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H8320	013	0	1	04	01	H8320_013_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H8320	013	0	1	04	01	H8320_013_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H8320	013	0	1	04	01	H8320_013_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H8320	013	0	1	04	01	H8320_013_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H8320	013	0	1	04	01	H8320_013_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H8320	013	0	1	04	01	H8320_013_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H8320	014	0	1	04	01	H8320_014_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H8320	014	0	1	04	01	H8320_014_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H8320	014	0	1	04	01	H8320_014_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H8320	014	0	1	04	01	H8320_014_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H8320	014	0	1	04	01	H8320_014_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H8320	014	0	1	04	01	H8320_014_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H8330	002	0	1	01	01	H8330_002_0	11		N	Single Tier	4	Single Tier	1	2	11	1	2	0.00	
H8332	004	0	1	01	01	H8332_004_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8332	004	0	1	01	01	H8332_004_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H8332	004	0	1	01	01	H8332_004_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8332	004	0	1	01	01	H8332_004_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8332	004	0	1	01	01	H8332_004_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8379	001	0	1	01	01	H8379_001_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8379	001	0	1	01	01	H8379_001_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H8379	001	0	1	01	01	H8379_001_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8379	001	0	1	01	01	H8379_001_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8379	001	0	1	01	01	H8379_001_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8379	003	1	1	01	01	H8379_003_1	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8379	003	1	1	01	01	H8379_003_1	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H8379	003	1	1	01	01	H8379_003_1	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8379	003	1	1	01	01	H8379_003_1	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8379	003	1	1	01	01	H8379_003_1	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8379	003	2	1	01	01	H8379_003_2	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8379	003	2	1	01	01	H8379_003_2	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H8379	003	2	1	01	01	H8379_003_2	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8379	003	2	1	01	01	H8379_003_2	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8379	003	2	1	01	01	H8379_003_2	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8379	003	3	1	01	01	H8379_003_3	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8379	003	3	1	01	01	H8379_003_3	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H8379	003	3	1	01	01	H8379_003_3	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8379	003	3	1	01	01	H8379_003_3	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8379	003	3	1	01	01	H8379_003_3	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8379	003	4	1	01	01	H8379_003_4	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8379	003	4	1	01	01	H8379_003_4	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H8379	003	4	1	01	01	H8379_003_4	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8379	003	4	1	01	01	H8379_003_4	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8379	003	4	1	01	01	H8379_003_4	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8385	001	0	1	04	01	H8385_001_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H8385	001	0	1	04	01	H8385_001_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H8385	001	0	1	04	01	H8385_001_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H8385	001	0	1	04	01	H8385_001_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	10	1	2	0.00	
H8385	001	0	1	04	01	H8385_001_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H8385	001	0	1	04	01	H8385_001_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H8385	002	0	1	04	01	H8385_002_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H8385	002	0	1	04	01	H8385_002_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H8385	002	0	1	04	01	H8385_002_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H8385	002	0	1	04	01	H8385_002_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	10	1	2	0.00	
H8385	002	0	1	04	01	H8385_002_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H8385	002	0	1	04	01	H8385_002_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H8385	003	0	1	04	01	H8385_003_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H8385	003	0	1	04	01	H8385_003_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H8385	003	0	1	04	01	H8385_003_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H8385	003	0	1	04	01	H8385_003_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	10	1	2	0.00	
H8385	003	0	1	04	01	H8385_003_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H8385	003	0	1	04	01	H8385_003_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H8385	004	0	1	04	01	H8385_004_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H8385	004	0	1	04	01	H8385_004_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H8385	004	0	1	04	01	H8385_004_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H8385	004	0	1	04	01	H8385_004_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	10	1	2	0.00	
H8385	004	0	1	04	01	H8385_004_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H8385	004	0	1	04	01	H8385_004_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H8390	017	0	1	01	01	H8390_017_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8390	017	0	1	01	01	H8390_017_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H8390	017	0	1	01	01	H8390_017_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8390	017	0	1	01	01	H8390_017_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8390	017	0	1	01	01	H8390_017_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8432	009	0	1	01	01	H8432_009_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8432	009	0	1	01	01	H8432_009_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H8432	009	0	1	01	01	H8432_009_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8432	009	0	1	01	01	H8432_009_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8432	009	0	1	01	01	H8432_009_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8432	010	0	1	01	01	H8432_010_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8432	010	0	1	01	01	H8432_010_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H8432	010	0	1	01	01	H8432_010_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8432	010	0	1	01	01	H8432_010_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8432	010	0	1	01	01	H8432_010_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8432	011	0	1	01	01	H8432_011_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8432	011	0	1	01	01	H8432_011_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H8432	011	0	1	01	01	H8432_011_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8432	011	0	1	01	01	H8432_011_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8432	011	0	1	01	01	H8432_011_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8432	016	0	1	02	01	H8432_016_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8432	016	0	1	02	01	H8432_016_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H8432	016	0	1	02	01	H8432_016_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8432	016	0	1	02	01	H8432_016_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8432	016	0	1	02	01	H8432_016_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8432	040	0	1	02	01	H8432_040_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8432	040	0	1	02	01	H8432_040_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H8432	040	0	1	02	01	H8432_040_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8432	040	0	1	02	01	H8432_040_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8432	040	0	1	02	01	H8432_040_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8432	041	0	1	01	01	H8432_041_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H8432	041	0	1	01	01	H8432_041_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H8432	041	0	1	01	01	H8432_041_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H8432	041	0	1	01	01	H8432_041_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H8432	041	0	1	01	01	H8432_041_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H8432	041	0	1	01	01	H8432_041_0	6		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H8432	042	0	1	01	01	H8432_042_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H8432	042	0	1	01	01	H8432_042_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H8432	042	0	1	01	01	H8432_042_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H8432	042	0	1	01	01	H8432_042_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H8432	042	0	1	01	01	H8432_042_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H8432	042	0	1	01	01	H8432_042_0	5		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H8481	001	0	1	04	01	H8481_001_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8481	001	0	1	04	01	H8481_001_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H8481	001	0	1	04	01	H8481_001_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H8481	001	0	1	04	01	H8481_001_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8481	001	0	1	04	01	H8481_001_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8547	001	0	1	01	01	H8547_001_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8547	001	0	1	01	01	H8547_001_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H8547	001	0	1	01	01	H8547_001_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8547	001	0	1	01	01	H8547_001_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8547	001	0	1	01	01	H8547_001_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8552	028	0	1	04	01	H8552_028_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H8552	028	0	1	04	01	H8552_028_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H8552	028	0	1	04	01	H8552_028_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H8552	028	0	1	04	01	H8552_028_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H8552	028	0	1	04	01	H8552_028_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H8552	028	0	1	04	01	H8552_028_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H8554	001	0	1	01	01	H8554_001_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8554	001	0	1	01	01	H8554_001_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H8554	001	0	1	01	01	H8554_001_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8554	001	0	1	01	01	H8554_001_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8554	001	0	1	01	01	H8554_001_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8578	001	0	1	01	01	H8578_001_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8578	001	0	1	01	01	H8578_001_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H8578	001	0	1	01	01	H8578_001_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8578	001	0	1	01	01	H8578_001_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8578	001	0	1	01	01	H8578_001_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8578	004	0	1	01	01	H8578_004_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8578	004	0	1	01	01	H8578_004_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H8578	004	0	1	01	01	H8578_004_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8578	004	0	1	01	01	H8578_004_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8578	004	0	1	01	01	H8578_004_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8578	012	0	1	01	01	H8578_012_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8578	012	0	1	01	01	H8578_012_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H8578	012	0	1	01	01	H8578_012_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8578	012	0	1	01	01	H8578_012_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8578	012	0	1	01	01	H8578_012_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8597	001	0	1	01	01	H8597_001_0	3		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8597	001	0	1	01	01	H8597_001_0	3		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H8597	001	0	1	01	01	H8597_001_0	3		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8597	001	0	1	01	01	H8597_001_0	3		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8597	001	0	1	01	01	H8597_001_0	3		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8597	002	0	1	01	01	H8597_002_0	3		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8597	002	0	1	01	01	H8597_002_0	3		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H8597	002	0	1	01	01	H8597_002_0	3		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8597	002	0	1	01	01	H8597_002_0	3		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8597	002	0	1	01	01	H8597_002_0	3		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8597	003	0	1	01	01	H8597_003_0	3		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8597	003	0	1	01	01	H8597_003_0	3		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H8597	003	0	1	01	01	H8597_003_0	3		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8597	003	0	1	01	01	H8597_003_0	3		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8597	003	0	1	01	01	H8597_003_0	3		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8604	011	0	1	04	01	H8604_011_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8604	011	0	1	04	01	H8604_011_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H8604	011	0	1	04	01	H8604_011_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8604	011	0	1	04	01	H8604_011_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8604	011	0	1	04	01	H8604_011_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8604	014	1	1	04	01	H8604_014_1	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8604	014	1	1	04	01	H8604_014_1	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H8604	014	1	1	04	01	H8604_014_1	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8604	014	1	1	04	01	H8604_014_1	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8604	014	1	1	04	01	H8604_014_1	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8604	014	2	1	04	01	H8604_014_2	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8604	014	2	1	04	01	H8604_014_2	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H8604	014	2	1	04	01	H8604_014_2	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8604	014	2	1	04	01	H8604_014_2	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8604	014	2	1	04	01	H8604_014_2	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8604	015	0	1	04	01	H8604_015_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8604	015	0	1	04	01	H8604_015_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H8604	015	0	1	04	01	H8604_015_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8604	015	0	1	04	01	H8604_015_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8604	015	0	1	04	01	H8604_015_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8634	003	0	1	04	01	H8634_003_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8634	003	0	1	04	01	H8634_003_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H8634	003	0	1	04	01	H8634_003_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8634	003	0	1	04	01	H8634_003_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8634	003	0	1	04	01	H8634_003_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8634	004	0	1	04	01	H8634_004_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8634	004	0	1	04	01	H8634_004_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H8634	004	0	1	04	01	H8634_004_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8634	004	0	1	04	01	H8634_004_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8634	004	0	1	04	01	H8634_004_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8634	008	0	1	04	01	H8634_008_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8634	008	0	1	04	01	H8634_008_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H8634	008	0	1	04	01	H8634_008_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8634	008	0	1	04	01	H8634_008_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8634	008	0	1	04	01	H8634_008_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8634	010	0	1	04	01	H8634_010_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8634	010	0	1	04	01	H8634_010_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H8634	010	0	1	04	01	H8634_010_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8634	010	0	1	04	01	H8634_010_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8634	010	0	1	04	01	H8634_010_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8634	012	0	1	04	01	H8634_012_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8634	012	0	1	04	01	H8634_012_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H8634	012	0	1	04	01	H8634_012_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8634	012	0	1	04	01	H8634_012_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8634	012	0	1	04	01	H8634_012_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8634	018	0	1	04	01	H8634_018_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8634	018	0	1	04	01	H8634_018_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H8634	018	0	1	04	01	H8634_018_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8634	018	0	1	04	01	H8634_018_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8634	018	0	1	04	01	H8634_018_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8634	021	0	1	04	01	H8634_021_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8634	021	0	1	04	01	H8634_021_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H8634	021	0	1	04	01	H8634_021_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8634	021	0	1	04	01	H8634_021_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8634	021	0	1	04	01	H8634_021_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8634	022	0	1	04	01	H8634_022_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8634	022	0	1	04	01	H8634_022_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H8634	022	0	1	04	01	H8634_022_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8634	022	0	1	04	01	H8634_022_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8634	022	0	1	04	01	H8634_022_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8634	023	0	1	04	01	H8634_023_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8634	023	0	1	04	01	H8634_023_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H8634	023	0	1	04	01	H8634_023_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8634	023	0	1	04	01	H8634_023_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8634	023	0	1	04	01	H8634_023_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8634	024	0	1	04	01	H8634_024_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8634	024	0	1	04	01	H8634_024_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H8634	024	0	1	04	01	H8634_024_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8634	024	0	1	04	01	H8634_024_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8634	024	0	1	04	01	H8634_024_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8634	025	0	1	04	01	H8634_025_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8634	025	0	1	04	01	H8634_025_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H8634	025	0	1	04	01	H8634_025_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8634	025	0	1	04	01	H8634_025_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8634	025	0	1	04	01	H8634_025_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8634	027	0	1	04	01	H8634_027_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8634	027	0	1	04	01	H8634_027_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H8634	027	0	1	04	01	H8634_027_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8634	027	0	1	04	01	H8634_027_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8634	027	0	1	04	01	H8634_027_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8634	029	0	1	04	01	H8634_029_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8634	029	0	1	04	01	H8634_029_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H8634	029	0	1	04	01	H8634_029_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8634	029	0	1	04	01	H8634_029_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8634	029	0	1	04	01	H8634_029_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8634	030	0	1	04	01	H8634_030_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8634	030	0	1	04	01	H8634_030_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H8634	030	0	1	04	01	H8634_030_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8634	030	0	1	04	01	H8634_030_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8634	030	0	1	04	01	H8634_030_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8634	031	0	1	04	01	H8634_031_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8634	031	0	1	04	01	H8634_031_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H8634	031	0	1	04	01	H8634_031_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8634	031	0	1	04	01	H8634_031_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8634	031	0	1	04	01	H8634_031_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8634	032	0	1	04	01	H8634_032_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8634	032	0	1	04	01	H8634_032_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H8634	032	0	1	04	01	H8634_032_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8634	032	0	1	04	01	H8634_032_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8634	032	0	1	04	01	H8634_032_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8634	033	0	1	04	01	H8634_033_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8634	033	0	1	04	01	H8634_033_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H8634	033	0	1	04	01	H8634_033_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8634	033	0	1	04	01	H8634_033_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8634	033	0	1	04	01	H8634_033_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8649	010	0	1	01	01	H8649_010_0	2		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8649	010	0	1	01	01	H8649_010_0	2		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H8649	010	0	1	01	01	H8649_010_0	2		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8649	010	0	1	01	01	H8649_010_0	2		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8649	010	0	1	01	01	H8649_010_0	2		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8649	013	0	1	01	01	H8649_013_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8649	013	0	1	01	01	H8649_013_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H8649	013	0	1	01	01	H8649_013_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8649	013	0	1	01	01	H8649_013_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8649	013	0	1	01	01	H8649_013_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8764	001	0	1	01	01	H8764_001_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H8764	001	0	1	01	01	H8764_001_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H8764	001	0	1	01	01	H8764_001_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H8764	001	0	1	01	01	H8764_001_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H8764	001	0	1	01	01	H8764_001_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H8764	001	0	1	01	01	H8764_001_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H8764	002	0	1	02	01	H8764_002_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H8764	002	0	1	02	01	H8764_002_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H8764	002	0	1	02	01	H8764_002_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H8764	002	0	1	02	01	H8764_002_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H8764	002	0	1	02	01	H8764_002_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H8764	002	0	1	02	01	H8764_002_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H8764	003	0	1	01	01	H8764_003_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H8764	003	0	1	01	01	H8764_003_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H8764	003	0	1	01	01	H8764_003_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H8764	003	0	1	01	01	H8764_003_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H8764	003	0	1	01	01	H8764_003_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H8764	003	0	1	01	01	H8764_003_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H8764	004	0	1	01	01	H8764_004_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H8764	004	0	1	01	01	H8764_004_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H8764	004	0	1	01	01	H8764_004_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H8764	004	0	1	01	01	H8764_004_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H8764	004	0	1	01	01	H8764_004_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H8764	004	0	1	01	01	H8764_004_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H8768	005	0	1	04	01	H8768_005_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8768	005	0	1	04	01	H8768_005_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H8768	005	0	1	04	01	H8768_005_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8768	005	0	1	04	01	H8768_005_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8768	005	0	1	04	01	H8768_005_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8768	007	0	1	04	01	H8768_007_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8768	007	0	1	04	01	H8768_007_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H8768	007	0	1	04	01	H8768_007_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8768	007	0	1	04	01	H8768_007_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8768	007	0	1	04	01	H8768_007_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8768	008	0	1	04	01	H8768_008_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8768	008	0	1	04	01	H8768_008_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H8768	008	0	1	04	01	H8768_008_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8768	008	0	1	04	01	H8768_008_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8768	008	0	1	04	01	H8768_008_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8768	009	0	1	04	01	H8768_009_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8768	009	0	1	04	01	H8768_009_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H8768	009	0	1	04	01	H8768_009_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8768	009	0	1	04	01	H8768_009_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8768	009	0	1	04	01	H8768_009_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8768	010	0	1	04	01	H8768_010_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8768	010	0	1	04	01	H8768_010_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H8768	010	0	1	04	01	H8768_010_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8768	010	0	1	04	01	H8768_010_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8768	010	0	1	04	01	H8768_010_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8768	011	0	1	04	01	H8768_011_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8768	011	0	1	04	01	H8768_011_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H8768	011	0	1	04	01	H8768_011_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8768	011	0	1	04	01	H8768_011_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8768	011	0	1	04	01	H8768_011_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8768	013	0	1	04	01	H8768_013_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8768	013	0	1	04	01	H8768_013_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H8768	013	0	1	04	01	H8768_013_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8768	013	0	1	04	01	H8768_013_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8768	013	0	1	04	01	H8768_013_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8768	016	0	1	04	01	H8768_016_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8768	016	0	1	04	01	H8768_016_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H8768	016	0	1	04	01	H8768_016_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8768	016	0	1	04	01	H8768_016_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8768	016	0	1	04	01	H8768_016_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8768	017	1	1	04	01	H8768_017_1	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8768	017	1	1	04	01	H8768_017_1	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H8768	017	1	1	04	01	H8768_017_1	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8768	017	1	1	04	01	H8768_017_1	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8768	017	1	1	04	01	H8768_017_1	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8768	017	2	1	04	01	H8768_017_2	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8768	017	2	1	04	01	H8768_017_2	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H8768	017	2	1	04	01	H8768_017_2	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8768	017	2	1	04	01	H8768_017_2	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8768	017	2	1	04	01	H8768_017_2	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8768	022	0	1	04	01	H8768_022_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8768	022	0	1	04	01	H8768_022_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H8768	022	0	1	04	01	H8768_022_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8768	022	0	1	04	01	H8768_022_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8768	022	0	1	04	01	H8768_022_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8768	023	0	1	04	01	H8768_023_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8768	023	0	1	04	01	H8768_023_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H8768	023	0	1	04	01	H8768_023_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8768	023	0	1	04	01	H8768_023_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8768	023	0	1	04	01	H8768_023_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8768	024	0	1	04	01	H8768_024_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8768	024	0	1	04	01	H8768_024_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H8768	024	0	1	04	01	H8768_024_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8768	024	0	1	04	01	H8768_024_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8768	024	0	1	04	01	H8768_024_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8768	026	0	1	04	01	H8768_026_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8768	026	0	1	04	01	H8768_026_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H8768	026	0	1	04	01	H8768_026_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8768	026	0	1	04	01	H8768_026_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8768	026	0	1	04	01	H8768_026_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8768	027	0	1	04	01	H8768_027_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8768	027	0	1	04	01	H8768_027_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H8768	027	0	1	04	01	H8768_027_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8768	027	0	1	04	01	H8768_027_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8768	027	0	1	04	01	H8768_027_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8768	030	0	1	04	01	H8768_030_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8768	030	0	1	04	01	H8768_030_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H8768	030	0	1	04	01	H8768_030_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8768	030	0	1	04	01	H8768_030_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8768	030	0	1	04	01	H8768_030_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8768	034	0	1	04	01	H8768_034_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8768	034	0	1	04	01	H8768_034_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H8768	034	0	1	04	01	H8768_034_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8768	034	0	1	04	01	H8768_034_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8768	034	0	1	04	01	H8768_034_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8768	035	0	1	04	01	H8768_035_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8768	035	0	1	04	01	H8768_035_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H8768	035	0	1	04	01	H8768_035_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8768	035	0	1	04	01	H8768_035_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8768	035	0	1	04	01	H8768_035_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8768	037	1	1	04	01	H8768_037_1	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8768	037	1	1	04	01	H8768_037_1	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H8768	037	1	1	04	01	H8768_037_1	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8768	037	1	1	04	01	H8768_037_1	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8768	037	1	1	04	01	H8768_037_1	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8768	037	2	1	04	01	H8768_037_2	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8768	037	2	1	04	01	H8768_037_2	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H8768	037	2	1	04	01	H8768_037_2	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8768	037	2	1	04	01	H8768_037_2	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8768	037	2	1	04	01	H8768_037_2	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8768	039	0	1	04	01	H8768_039_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8768	039	0	1	04	01	H8768_039_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
H8768	039	0	1	04	01	H8768_039_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8768	039	0	1	04	01	H8768_039_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8768	039	0	1	04	01	H8768_039_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8768	040	0	1	04	01	H8768_040_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8768	040	0	1	04	01	H8768_040_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H8768	040	0	1	04	01	H8768_040_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8768	040	0	1	04	01	H8768_040_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8768	040	0	1	04	01	H8768_040_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8768	046	0	1	04	01	H8768_046_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8768	046	0	1	04	01	H8768_046_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	10.00	
H8768	046	0	1	04	01	H8768_046_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8768	046	0	1	04	01	H8768_046_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8768	046	0	1	04	01	H8768_046_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8768	055	1	1	04	01	H8768_055_1	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8768	055	1	1	04	01	H8768_055_1	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H8768	055	1	1	04	01	H8768_055_1	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8768	055	1	1	04	01	H8768_055_1	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8768	055	1	1	04	01	H8768_055_1	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8768	055	2	1	04	01	H8768_055_2	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8768	055	2	1	04	01	H8768_055_2	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H8768	055	2	1	04	01	H8768_055_2	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8768	055	2	1	04	01	H8768_055_2	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8768	055	2	1	04	01	H8768_055_2	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8768	058	0	1	04	01	H8768_058_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8768	058	0	1	04	01	H8768_058_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
H8768	058	0	1	04	01	H8768_058_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8768	058	0	1	04	01	H8768_058_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8768	058	0	1	04	01	H8768_058_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8768	061	0	1	04	01	H8768_061_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8768	061	0	1	04	01	H8768_061_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H8768	061	0	1	04	01	H8768_061_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8768	061	0	1	04	01	H8768_061_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8768	061	0	1	04	01	H8768_061_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8768	062	0	1	04	01	H8768_062_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8768	062	0	1	04	01	H8768_062_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H8768	062	0	1	04	01	H8768_062_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8768	062	0	1	04	01	H8768_062_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8768	062	0	1	04	01	H8768_062_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8768	063	0	1	04	01	H8768_063_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8768	063	0	1	04	01	H8768_063_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
H8768	063	0	1	04	01	H8768_063_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8768	063	0	1	04	01	H8768_063_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8768	063	0	1	04	01	H8768_063_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8794	001	0	1	01	01	H8794_001_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H8794	001	0	1	01	01	H8794_001_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H8794	001	0	1	01	01	H8794_001_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H8794	001	0	1	01	01	H8794_001_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H8794	001	0	1	01	01	H8794_001_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H8794	001	0	1	01	01	H8794_001_0	5		N	Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H8794	002	0	1	01	01	H8794_002_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H8794	002	0	1	01	01	H8794_002_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H8794	002	0	1	01	01	H8794_002_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H8794	002	0	1	01	01	H8794_002_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H8794	002	0	1	01	01	H8794_002_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H8794	002	0	1	01	01	H8794_002_0	7		N	Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H8794	006	0	1	01	01	H8794_006_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H8794	006	0	1	01	01	H8794_006_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H8794	006	0	1	01	01	H8794_006_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H8794	006	0	1	01	01	H8794_006_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H8794	006	0	1	01	01	H8794_006_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H8794	006	0	1	01	01	H8794_006_0	6		N	Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H8794	007	0	1	01	01	H8794_007_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H8794	007	0	1	01	01	H8794_007_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H8794	007	0	1	01	01	H8794_007_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H8794	007	0	1	01	01	H8794_007_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H8794	007	0	1	01	01	H8794_007_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H8794	007	0	1	01	01	H8794_007_0	5		N	Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H8794	009	0	1	01	01	H8794_009_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H8794	009	0	1	01	01	H8794_009_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H8794	009	0	1	01	01	H8794_009_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H8794	009	0	1	01	01	H8794_009_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H8794	009	0	1	01	01	H8794_009_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H8794	009	0	1	01	01	H8794_009_0	6		N	Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H8794	010	0	1	01	01	H8794_010_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H8794	010	0	1	01	01	H8794_010_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H8794	010	0	1	01	01	H8794_010_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H8794	010	0	1	01	01	H8794_010_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H8794	010	0	1	01	01	H8794_010_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H8794	010	0	1	01	01	H8794_010_0	6		N	Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H8794	011	0	1	01	01	H8794_011_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H8794	011	0	1	01	01	H8794_011_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H8794	011	0	1	01	01	H8794_011_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H8794	011	0	1	01	01	H8794_011_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H8794	011	0	1	01	01	H8794_011_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H8794	011	0	1	01	01	H8794_011_0	7		N	Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H8794	016	0	1	01	01	H8794_016_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H8794	016	0	1	01	01	H8794_016_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H8794	016	0	1	01	01	H8794_016_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H8794	016	0	1	01	01	H8794_016_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H8794	016	0	1	01	01	H8794_016_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H8794	016	0	1	01	01	H8794_016_0	6		N	Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H8794	017	0	1	01	01	H8794_017_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H8794	017	0	1	01	01	H8794_017_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H8794	017	0	1	01	01	H8794_017_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H8794	017	0	1	01	01	H8794_017_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H8794	017	0	1	01	01	H8794_017_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H8794	017	0	1	01	01	H8794_017_0	5		N	Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H8794	018	0	1	01	01	H8794_018_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H8794	018	0	1	01	01	H8794_018_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H8794	018	0	1	01	01	H8794_018_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H8794	018	0	1	01	01	H8794_018_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H8794	018	0	1	01	01	H8794_018_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H8794	018	0	1	01	01	H8794_018_0	5		N	Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H8794	019	0	1	01	01	H8794_019_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H8794	019	0	1	01	01	H8794_019_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H8794	019	0	1	01	01	H8794_019_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H8794	019	0	1	01	01	H8794_019_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H8794	019	0	1	01	01	H8794_019_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H8794	019	0	1	01	01	H8794_019_0	5		N	Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H8794	020	0	1	01	01	H8794_020_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H8794	020	0	1	01	01	H8794_020_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H8794	020	0	1	01	01	H8794_020_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H8794	020	0	1	01	01	H8794_020_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H8794	020	0	1	01	01	H8794_020_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H8794	020	0	1	01	01	H8794_020_0	6		N	Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H8794	021	0	1	01	01	H8794_021_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H8794	021	0	1	01	01	H8794_021_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H8794	021	0	1	01	01	H8794_021_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H8794	021	0	1	01	01	H8794_021_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H8794	021	0	1	01	01	H8794_021_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H8794	021	0	1	01	01	H8794_021_0	6		N	Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H8794	022	0	1	01	01	H8794_022_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H8794	022	0	1	01	01	H8794_022_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H8794	022	0	1	01	01	H8794_022_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H8794	022	0	1	01	01	H8794_022_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H8794	022	0	1	01	01	H8794_022_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H8794	022	0	1	01	01	H8794_022_0	6		N	Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H8794	023	0	1	01	01	H8794_023_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H8794	023	0	1	01	01	H8794_023_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H8794	023	0	1	01	01	H8794_023_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H8794	023	0	1	01	01	H8794_023_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H8794	023	0	1	01	01	H8794_023_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H8794	023	0	1	01	01	H8794_023_0	6		N	Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H8794	024	0	1	01	01	H8794_024_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H8794	024	0	1	01	01	H8794_024_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H8794	024	0	1	01	01	H8794_024_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H8794	024	0	1	01	01	H8794_024_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H8794	024	0	1	01	01	H8794_024_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H8794	024	0	1	01	01	H8794_024_0	6		N	Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H8794	025	0	1	01	01	H8794_025_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H8794	025	0	1	01	01	H8794_025_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H8794	025	0	1	01	01	H8794_025_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H8794	025	0	1	01	01	H8794_025_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H8794	025	0	1	01	01	H8794_025_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H8794	025	0	1	01	01	H8794_025_0	6		N	Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H8797	003	0	1	02	01	H8797_003_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8797	003	0	1	02	01	H8797_003_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H8797	003	0	1	02	01	H8797_003_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H8797	003	0	1	02	01	H8797_003_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	10	1	2	0.00	
H8797	003	0	1	02	01	H8797_003_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8797	004	0	1	02	01	H8797_004_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8797	004	0	1	02	01	H8797_004_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H8797	004	0	1	02	01	H8797_004_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H8797	004	0	1	02	01	H8797_004_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	10	1	2	0.00	
H8797	004	0	1	02	01	H8797_004_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8832	001	0	1	04	01	H8832_001_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H8832	001	0	1	04	01	H8832_001_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H8832	001	0	1	04	01	H8832_001_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	3	2	40.00	
H8832	001	0	1	04	01	H8832_001_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	3	1		32
H8832	001	0	1	04	01	H8832_001_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H8832	001	0	1	04	01	H8832_001_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H8832	002	0	1	04	01	H8832_002_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H8832	002	0	1	04	01	H8832_002_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H8832	002	0	1	04	01	H8832_002_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	3	2	40.00	
H8832	002	0	1	04	01	H8832_002_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	3	1		32
H8832	002	0	1	04	01	H8832_002_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H8832	002	0	1	04	01	H8832_002_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H8832	003	0	1	04	01	H8832_003_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H8832	003	0	1	04	01	H8832_003_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H8832	003	0	1	04	01	H8832_003_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H8832	003	0	1	04	01	H8832_003_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H8832	003	0	1	04	01	H8832_003_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H8832	003	0	1	04	01	H8832_003_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H8845	001	0	1	01	01	H8845_001_0	8		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H8845	001	0	1	01	01	H8845_001_0	8		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H8845	001	0	1	01	01	H8845_001_0	8		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H8845	001	0	1	01	01	H8845_001_0	8		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H8845	001	0	1	01	01	H8845_001_0	8		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H8845	001	0	1	01	01	H8845_001_0	8		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H8845	004	0	1	01	01	H8845_004_0	9		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H8845	004	0	1	01	01	H8845_004_0	9		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H8845	004	0	1	01	01	H8845_004_0	9		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H8845	004	0	1	01	01	H8845_004_0	9		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H8845	004	0	1	01	01	H8845_004_0	9		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H8845	004	0	1	01	01	H8845_004_0	9		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H8845	005	0	1	01	01	H8845_005_0	9		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H8845	005	0	1	01	01	H8845_005_0	9		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H8845	005	0	1	01	01	H8845_005_0	9		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H8845	005	0	1	01	01	H8845_005_0	9		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H8845	005	0	1	01	01	H8845_005_0	9		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H8845	005	0	1	01	01	H8845_005_0	9		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H8845	007	1	1	01	01	H8845_007_1	9		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H8845	007	1	1	01	01	H8845_007_1	9		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H8845	007	1	1	01	01	H8845_007_1	9		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H8845	007	1	1	01	01	H8845_007_1	9		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H8845	007	1	1	01	01	H8845_007_1	9		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H8845	007	1	1	01	01	H8845_007_1	9		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H8845	007	2	1	01	01	H8845_007_2	9		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H8845	007	2	1	01	01	H8845_007_2	9		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H8845	007	2	1	01	01	H8845_007_2	9		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H8845	007	2	1	01	01	H8845_007_2	9		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H8845	007	2	1	01	01	H8845_007_2	9		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H8845	007	2	1	01	01	H8845_007_2	9		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H8849	001	0	1	02	01	H8849_001_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H8849	001	0	1	02	01	H8849_001_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H8849	001	0	1	02	01	H8849_001_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H8849	001	0	1	02	01	H8849_001_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H8849	001	0	1	02	01	H8849_001_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H8849	001	0	1	02	01	H8849_001_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H8849	003	0	1	02	01	H8849_003_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H8849	003	0	1	02	01	H8849_003_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H8849	003	0	1	02	01	H8849_003_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H8849	003	0	1	02	01	H8849_003_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H8849	003	0	1	02	01	H8849_003_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H8849	003	0	1	02	01	H8849_003_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H8849	005	0	1	02	01	H8849_005_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H8849	005	0	1	02	01	H8849_005_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H8849	005	0	1	02	01	H8849_005_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H8849	005	0	1	02	01	H8849_005_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H8849	005	0	1	02	01	H8849_005_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H8849	005	0	1	02	01	H8849_005_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H8849	006	0	1	02	01	H8849_006_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H8849	006	0	1	02	01	H8849_006_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H8849	006	0	1	02	01	H8849_006_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H8849	006	0	1	02	01	H8849_006_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H8849	006	0	1	02	01	H8849_006_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H8849	006	0	1	02	01	H8849_006_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H8849	009	0	1	02	01	H8849_009_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H8849	009	0	1	02	01	H8849_009_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H8849	009	0	1	02	01	H8849_009_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H8849	009	0	1	02	01	H8849_009_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H8849	009	0	1	02	01	H8849_009_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H8849	009	0	1	02	01	H8849_009_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H8849	010	1	1	01	01	H8849_010_1	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H8849	010	1	1	01	01	H8849_010_1	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H8849	010	1	1	01	01	H8849_010_1	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H8849	010	1	1	01	01	H8849_010_1	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H8849	010	1	1	01	01	H8849_010_1	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H8849	010	1	1	01	01	H8849_010_1	7		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H8849	010	2	1	01	01	H8849_010_2	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H8849	010	2	1	01	01	H8849_010_2	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H8849	010	2	1	01	01	H8849_010_2	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H8849	010	2	1	01	01	H8849_010_2	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H8849	010	2	1	01	01	H8849_010_2	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H8849	010	2	1	01	01	H8849_010_2	7		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H8849	010	4	1	01	01	H8849_010_4	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H8849	010	4	1	01	01	H8849_010_4	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H8849	010	4	1	01	01	H8849_010_4	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H8849	010	4	1	01	01	H8849_010_4	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H8849	010	4	1	01	01	H8849_010_4	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H8849	010	4	1	01	01	H8849_010_4	7		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H8849	010	5	1	01	01	H8849_010_5	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H8849	010	5	1	01	01	H8849_010_5	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H8849	010	5	1	01	01	H8849_010_5	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H8849	010	5	1	01	01	H8849_010_5	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H8849	010	5	1	01	01	H8849_010_5	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H8849	010	5	1	01	01	H8849_010_5	7		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H8849	011	1	1	01	01	H8849_011_1	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H8849	011	1	1	01	01	H8849_011_1	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H8849	011	1	1	01	01	H8849_011_1	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H8849	011	1	1	01	01	H8849_011_1	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H8849	011	1	1	01	01	H8849_011_1	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H8849	011	1	1	01	01	H8849_011_1	7		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H8849	011	2	1	01	01	H8849_011_2	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H8849	011	2	1	01	01	H8849_011_2	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H8849	011	2	1	01	01	H8849_011_2	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H8849	011	2	1	01	01	H8849_011_2	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H8849	011	2	1	01	01	H8849_011_2	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H8849	011	2	1	01	01	H8849_011_2	7		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H8849	011	3	1	01	01	H8849_011_3	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H8849	011	3	1	01	01	H8849_011_3	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H8849	011	3	1	01	01	H8849_011_3	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H8849	011	3	1	01	01	H8849_011_3	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H8849	011	3	1	01	01	H8849_011_3	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H8849	011	3	1	01	01	H8849_011_3	7		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H8849	011	4	1	01	01	H8849_011_4	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H8849	011	4	1	01	01	H8849_011_4	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H8849	011	4	1	01	01	H8849_011_4	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H8849	011	4	1	01	01	H8849_011_4	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H8849	011	4	1	01	01	H8849_011_4	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H8849	011	4	1	01	01	H8849_011_4	7		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H8849	011	5	1	01	01	H8849_011_5	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H8849	011	5	1	01	01	H8849_011_5	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H8849	011	5	1	01	01	H8849_011_5	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H8849	011	5	1	01	01	H8849_011_5	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H8849	011	5	1	01	01	H8849_011_5	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H8849	011	5	1	01	01	H8849_011_5	7		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H8854	002	0	1	01	01	H8854_002_0	7		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8854	002	0	1	01	01	H8854_002_0	7		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H8854	002	0	1	01	01	H8854_002_0	7		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H8854	002	0	1	01	01	H8854_002_0	7		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8854	002	0	1	01	01	H8854_002_0	7		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8879	001	0	1	02	01	H8879_001_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8879	001	0	1	02	01	H8879_001_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H8879	001	0	1	02	01	H8879_001_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H8879	001	0	1	02	01	H8879_001_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8879	001	0	1	02	01	H8879_001_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8889	001	0	1	04	01	H8889_001_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8889	001	0	1	04	01	H8889_001_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H8889	001	0	1	04	01	H8889_001_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8889	001	0	1	04	01	H8889_001_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8889	001	0	1	04	01	H8889_001_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8889	002	0	1	04	01	H8889_002_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8889	002	0	1	04	01	H8889_002_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H8889	002	0	1	04	01	H8889_002_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8889	002	0	1	04	01	H8889_002_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8889	002	0	1	04	01	H8889_002_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8889	003	0	1	04	01	H8889_003_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8889	003	0	1	04	01	H8889_003_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H8889	003	0	1	04	01	H8889_003_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8889	003	0	1	04	01	H8889_003_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8889	003	0	1	04	01	H8889_003_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8889	004	0	1	04	01	H8889_004_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8889	004	0	1	04	01	H8889_004_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H8889	004	0	1	04	01	H8889_004_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8889	004	0	1	04	01	H8889_004_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8889	004	0	1	04	01	H8889_004_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8889	005	0	1	04	01	H8889_005_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8889	005	0	1	04	01	H8889_005_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H8889	005	0	1	04	01	H8889_005_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8889	005	0	1	04	01	H8889_005_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8889	005	0	1	04	01	H8889_005_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8889	008	0	1	04	01	H8889_008_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8889	008	0	1	04	01	H8889_008_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H8889	008	0	1	04	01	H8889_008_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8889	008	0	1	04	01	H8889_008_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8889	008	0	1	04	01	H8889_008_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8889	010	0	1	04	01	H8889_010_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8889	010	0	1	04	01	H8889_010_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H8889	010	0	1	04	01	H8889_010_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8889	010	0	1	04	01	H8889_010_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8889	010	0	1	04	01	H8889_010_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8889	011	0	1	04	01	H8889_011_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8889	011	0	1	04	01	H8889_011_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H8889	011	0	1	04	01	H8889_011_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8889	011	0	1	04	01	H8889_011_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8889	011	0	1	04	01	H8889_011_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8889	012	0	1	04	01	H8889_012_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8889	012	0	1	04	01	H8889_012_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H8889	012	0	1	04	01	H8889_012_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8889	012	0	1	04	01	H8889_012_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8889	012	0	1	04	01	H8889_012_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8889	013	0	1	04	01	H8889_013_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8889	013	0	1	04	01	H8889_013_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H8889	013	0	1	04	01	H8889_013_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8889	013	0	1	04	01	H8889_013_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8889	013	0	1	04	01	H8889_013_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8889	014	0	1	04	01	H8889_014_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8889	014	0	1	04	01	H8889_014_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H8889	014	0	1	04	01	H8889_014_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8889	014	0	1	04	01	H8889_014_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8889	014	0	1	04	01	H8889_014_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8889	015	0	1	04	01	H8889_015_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8889	015	0	1	04	01	H8889_015_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H8889	015	0	1	04	01	H8889_015_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8889	015	0	1	04	01	H8889_015_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8889	015	0	1	04	01	H8889_015_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8889	017	0	1	04	01	H8889_017_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8889	017	0	1	04	01	H8889_017_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H8889	017	0	1	04	01	H8889_017_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8889	017	0	1	04	01	H8889_017_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8889	017	0	1	04	01	H8889_017_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8889	018	0	1	04	01	H8889_018_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H8889	018	0	1	04	01	H8889_018_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H8889	018	0	1	04	01	H8889_018_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8889	018	0	1	04	01	H8889_018_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8889	018	0	1	04	01	H8889_018_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8894	001	0	1	01	01	H8894_001_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H8894	001	0	1	01	01	H8894_001_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H8894	001	0	1	01	01	H8894_001_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H8894	001	0	1	01	01	H8894_001_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H8894	001	0	1	01	01	H8894_001_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H8894	001	0	1	01	01	H8894_001_0	6		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H8902	002	0	1	01	01	H8902_002_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8902	002	0	1	01	01	H8902_002_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H8902	002	0	1	01	01	H8902_002_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8902	002	0	1	01	01	H8902_002_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8902	002	0	1	01	01	H8902_002_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8902	009	0	1	01	01	H8902_009_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8902	009	0	1	01	01	H8902_009_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H8902	009	0	1	01	01	H8902_009_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8902	009	0	1	01	01	H8902_009_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8902	009	0	1	01	01	H8902_009_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8902	010	0	1	01	01	H8902_010_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H8902	010	0	1	01	01	H8902_010_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H8902	010	0	1	01	01	H8902_010_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8902	010	0	1	01	01	H8902_010_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8902	010	0	1	01	01	H8902_010_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8902	011	0	1	01	01	H8902_011_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H8902	011	0	1	01	01	H8902_011_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H8902	011	0	1	01	01	H8902_011_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8902	011	0	1	01	01	H8902_011_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8902	011	0	1	01	01	H8902_011_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8908	001	0	1	02	01	H8908_001_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8908	001	0	1	02	01	H8908_001_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H8908	001	0	1	02	01	H8908_001_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8908	001	0	1	02	01	H8908_001_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8908	001	0	1	02	01	H8908_001_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8908	004	0	1	02	01	H8908_004_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8908	004	0	1	02	01	H8908_004_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H8908	004	0	1	02	01	H8908_004_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8908	004	0	1	02	01	H8908_004_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8908	004	0	1	02	01	H8908_004_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8908	005	0	1	01	01	H8908_005_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8908	005	0	1	01	01	H8908_005_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H8908	005	0	1	01	01	H8908_005_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8908	005	0	1	01	01	H8908_005_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8908	005	0	1	01	01	H8908_005_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8908	006	0	1	01	01	H8908_006_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H8908	006	0	1	01	01	H8908_006_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H8908	006	0	1	01	01	H8908_006_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H8908	006	0	1	01	01	H8908_006_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H8908	006	0	1	01	01	H8908_006_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H8908	006	0	1	01	01	H8908_006_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H8908	007	0	1	01	01	H8908_007_0	3		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8908	007	0	1	01	01	H8908_007_0	3		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H8908	007	0	1	01	01	H8908_007_0	3		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8908	007	0	1	01	01	H8908_007_0	3		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8908	007	0	1	01	01	H8908_007_0	3		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8917	001	0	1	04	01	H8917_001_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8917	001	0	1	04	01	H8917_001_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H8917	001	0	1	04	01	H8917_001_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8917	001	0	1	04	01	H8917_001_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8917	001	0	1	04	01	H8917_001_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8917	002	0	1	04	01	H8917_002_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8917	002	0	1	04	01	H8917_002_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H8917	002	0	1	04	01	H8917_002_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8917	002	0	1	04	01	H8917_002_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8917	002	0	1	04	01	H8917_002_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8917	005	0	1	04	01	H8917_005_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H8917	005	0	1	04	01	H8917_005_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H8917	005	0	1	04	01	H8917_005_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H8917	005	0	1	04	01	H8917_005_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H8917	005	0	1	04	01	H8917_005_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H8917	005	0	1	04	01	H8917_005_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H8917	006	0	1	04	01	H8917_006_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H8917	006	0	1	04	01	H8917_006_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H8917	006	0	1	04	01	H8917_006_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H8917	006	0	1	04	01	H8917_006_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H8917	006	0	1	04	01	H8917_006_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H8917	006	0	1	04	01	H8917_006_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H8947	001	1	1	04	01	H8947_001_1	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8947	001	1	1	04	01	H8947_001_1	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H8947	001	1	1	04	01	H8947_001_1	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8947	001	1	1	04	01	H8947_001_1	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8947	001	1	1	04	01	H8947_001_1	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8947	001	2	1	04	01	H8947_001_2	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8947	001	2	1	04	01	H8947_001_2	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H8947	001	2	1	04	01	H8947_001_2	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8947	001	2	1	04	01	H8947_001_2	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8947	001	2	1	04	01	H8947_001_2	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8947	001	3	1	04	01	H8947_001_3	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8947	001	3	1	04	01	H8947_001_3	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H8947	001	3	1	04	01	H8947_001_3	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8947	001	3	1	04	01	H8947_001_3	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8947	001	3	1	04	01	H8947_001_3	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8947	001	4	1	04	01	H8947_001_4	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8947	001	4	1	04	01	H8947_001_4	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H8947	001	4	1	04	01	H8947_001_4	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8947	001	4	1	04	01	H8947_001_4	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8947	001	4	1	04	01	H8947_001_4	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8947	002	1	1	04	01	H8947_002_1	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8947	002	1	1	04	01	H8947_002_1	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H8947	002	1	1	04	01	H8947_002_1	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8947	002	1	1	04	01	H8947_002_1	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8947	002	1	1	04	01	H8947_002_1	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8947	002	2	1	04	01	H8947_002_2	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8947	002	2	1	04	01	H8947_002_2	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H8947	002	2	1	04	01	H8947_002_2	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8947	002	2	1	04	01	H8947_002_2	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8947	002	2	1	04	01	H8947_002_2	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8947	002	3	1	04	01	H8947_002_3	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8947	002	3	1	04	01	H8947_002_3	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H8947	002	3	1	04	01	H8947_002_3	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8947	002	3	1	04	01	H8947_002_3	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8947	002	3	1	04	01	H8947_002_3	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8947	002	4	1	04	01	H8947_002_4	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H8947	002	4	1	04	01	H8947_002_4	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H8947	002	4	1	04	01	H8947_002_4	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H8947	002	4	1	04	01	H8947_002_4	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H8947	002	4	1	04	01	H8947_002_4	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H8967	002	0	1	01	01	H8967_002_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H8967	002	0	1	01	01	H8967_002_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H8967	002	0	1	01	01	H8967_002_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H8967	002	0	1	01	01	H8967_002_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	10	1	2	0.00	
H8967	002	0	1	01	01	H8967_002_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H8967	002	0	1	01	01	H8967_002_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9001	030	15	1	01	01	H9001_030_15	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H9001	030	15	1	01	01	H9001_030_15	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9001	030	15	1	01	01	H9001_030_15	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9001	030	15	1	01	01	H9001_030_15	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9001	030	15	1	01	01	H9001_030_15	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9001	030	15	1	01	01	H9001_030_15	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9001	030	16	1	01	01	H9001_030_16	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H9001	030	16	1	01	01	H9001_030_16	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9001	030	16	1	01	01	H9001_030_16	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9001	030	16	1	01	01	H9001_030_16	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9001	030	16	1	01	01	H9001_030_16	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9001	030	16	1	01	01	H9001_030_16	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9001	030	18	1	01	01	H9001_030_18	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H9001	030	18	1	01	01	H9001_030_18	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9001	030	18	1	01	01	H9001_030_18	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9001	030	18	1	01	01	H9001_030_18	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9001	030	18	1	01	01	H9001_030_18	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9001	030	18	1	01	01	H9001_030_18	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9001	031	15	1	01	01	H9001_031_15	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H9001	031	15	1	01	01	H9001_031_15	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9001	031	15	1	01	01	H9001_031_15	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9001	031	15	1	01	01	H9001_031_15	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9001	031	15	1	01	01	H9001_031_15	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9001	031	15	1	01	01	H9001_031_15	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9001	031	16	1	01	01	H9001_031_16	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H9001	031	16	1	01	01	H9001_031_16	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9001	031	16	1	01	01	H9001_031_16	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9001	031	16	1	01	01	H9001_031_16	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9001	031	16	1	01	01	H9001_031_16	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9001	031	16	1	01	01	H9001_031_16	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9001	031	18	1	01	01	H9001_031_18	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H9001	031	18	1	01	01	H9001_031_18	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9001	031	18	1	01	01	H9001_031_18	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9001	031	18	1	01	01	H9001_031_18	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9001	031	18	1	01	01	H9001_031_18	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9001	031	18	1	01	01	H9001_031_18	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9001	038	0	1	01	01	H9001_038_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H9001	038	0	1	01	01	H9001_038_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9001	038	0	1	01	01	H9001_038_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9001	038	0	1	01	01	H9001_038_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9001	038	0	1	01	01	H9001_038_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9001	038	0	1	01	01	H9001_038_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9003	001	0	1	02	01	H9003_001_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H9003	001	0	1	02	01	H9003_001_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H9003	001	0	1	02	01	H9003_001_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H9003	001	0	1	02	01	H9003_001_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H9003	001	0	1	02	01	H9003_001_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H9003	001	0	1	02	01	H9003_001_0	4			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H9003	006	0	1	02	01	H9003_006_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H9003	006	0	1	02	01	H9003_006_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H9003	006	0	1	02	01	H9003_006_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H9003	006	0	1	02	01	H9003_006_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H9003	006	0	1	02	01	H9003_006_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H9003	006	0	1	02	01	H9003_006_0	4			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H9003	008	0	1	02	01	H9003_008_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H9003	008	0	1	02	01	H9003_008_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H9003	008	0	1	02	01	H9003_008_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H9003	008	0	1	02	01	H9003_008_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H9003	008	0	1	02	01	H9003_008_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H9003	008	0	1	02	01	H9003_008_0	4			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H9003	009	0	1	02	01	H9003_009_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	11	1	2	0.00	
H9003	009	0	1	02	01	H9003_009_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H9003	009	0	1	02	01	H9003_009_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H9003	009	0	1	02	01	H9003_009_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H9003	009	0	1	02	01	H9003_009_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H9003	009	0	1	02	01	H9003_009_0	4			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	10	1	2	0.00	
H9042	004	0	1	04	01	H9042_004_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H9042	004	0	1	04	01	H9042_004_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9042	004	0	1	04	01	H9042_004_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9042	004	0	1	04	01	H9042_004_0	7			Non-Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9042	004	0	1	04	01	H9042_004_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9042	004	0	1	04	01	H9042_004_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9042	007	0	1	04	01	H9042_007_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H9042	007	0	1	04	01	H9042_007_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9042	007	0	1	04	01	H9042_007_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9042	007	0	1	04	01	H9042_007_0	7			Non-Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9042	007	0	1	04	01	H9042_007_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9042	007	0	1	04	01	H9042_007_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Brand, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9047	013	0	2	01	01	H9047_013_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H9047	013	0	2	01	01	H9047_013_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H9047	013	0	2	01	01	H9047_013_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9047	013	0	2	01	01	H9047_013_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9047	013	0	2	01	01	H9047_013_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9047	037	0	1	01	01	H9047_037_0	10			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H9047	037	0	1	01	01	H9047_037_0	10			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H9047	037	0	1	01	01	H9047_037_0	10			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9047	037	0	1	01	01	H9047_037_0	10			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9047	037	0	1	01	01	H9047_037_0	10			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9047	054	0	1	01	01	H9047_054_0	10			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H9047	054	0	1	01	01	H9047_054_0	10			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H9047	054	0	1	01	01	H9047_054_0	10			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9047	054	0	1	01	01	H9047_054_0	10			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9047	054	0	1	01	01	H9047_054_0	10			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9047	063	0	1	01	01	H9047_063_0	11			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H9047	063	0	1	01	01	H9047_063_0	11			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H9047	063	0	1	01	01	H9047_063_0	11			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9047	063	0	1	01	01	H9047_063_0	11			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9047	063	0	1	01	01	H9047_063_0	11			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9047	064	0	1	01	01	H9047_064_0	10			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H9047	064	0	1	01	01	H9047_064_0	10			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H9047	064	0	1	01	01	H9047_064_0	10			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9047	064	0	1	01	01	H9047_064_0	10			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9047	064	0	1	01	01	H9047_064_0	10			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9047	066	0	1	01	01	H9047_066_0	10			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H9047	066	0	1	01	01	H9047_066_0	10			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H9047	066	0	1	01	01	H9047_066_0	10			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	3	2	0.00	
H9047	066	0	1	01	01	H9047_066_0	10			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9047	066	0	1	01	01	H9047_066_0	10			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9065	001	0	1	01	01	H9065_001_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H9065	001	0	1	01	01	H9065_001_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9065	001	0	1	01	01	H9065_001_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9065	001	0	1	01	01	H9065_001_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9065	001	0	1	01	01	H9065_001_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9065	001	0	1	01	01	H9065_001_0	6		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9065	002	0	1	02	01	H9065_002_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	3	2	5.00	
H9065	002	0	1	02	01	H9065_002_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9065	002	0	1	02	01	H9065_002_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9065	002	0	1	02	01	H9065_002_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9065	002	0	1	02	01	H9065_002_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9065	002	0	1	02	01	H9065_002_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9065	003	0	1	02	01	H9065_003_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	3	2	5.00	
H9065	003	0	1	02	01	H9065_003_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9065	003	0	1	02	01	H9065_003_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9065	003	0	1	02	01	H9065_003_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9065	003	0	1	02	01	H9065_003_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9065	003	0	1	02	01	H9065_003_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9065	008	0	1	01	01	H9065_008_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	3	2	0.00	
H9065	008	0	1	01	01	H9065_008_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9065	008	0	1	01	01	H9065_008_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9065	008	0	1	01	01	H9065_008_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9065	008	0	1	01	01	H9065_008_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9065	008	0	1	01	01	H9065_008_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9096	001	0	1	02	01	H9096_001_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	01	1	2	0.00	
H9096	001	0	1	02	01	H9096_001_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H9096	001	0	1	02	01	H9096_001_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H9096	001	0	1	02	01	H9096_001_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H9096	001	0	1	02	01	H9096_001_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H9096	001	0	1	02	01	H9096_001_0	4			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	11	1	2	0.00	
H9096	002	0	1	02	01	H9096_002_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	01	1	2	0.00	
H9096	002	0	1	02	01	H9096_002_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H9096	002	0	1	02	01	H9096_002_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H9096	002	0	1	02	01	H9096_002_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H9096	002	0	1	02	01	H9096_002_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H9096	002	0	1	02	01	H9096_002_0	4			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	11	1	2	0.00	
H9096	004	0	1	01	01	H9096_004_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	01	1	2	0.00	
H9096	004	0	1	01	01	H9096_004_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H9096	004	0	1	01	01	H9096_004_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H9096	004	0	1	01	01	H9096_004_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H9096	004	0	1	01	01	H9096_004_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H9096	004	0	1	01	01	H9096_004_0	5			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	11	1	2	0.00	
H9096	005	0	1	01	01	H9096_005_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	01	1	2	0.00	
H9096	005	0	1	01	01	H9096_005_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	11	1	2	0.00	
H9096	005	0	1	01	01	H9096_005_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H9096	005	0	1	01	01	H9096_005_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H9096	005	0	1	01	01	H9096_005_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H9096	005	0	1	01	01	H9096_005_0	4			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	11	1	2	0.00	
H9147	001	0	1	02	01	H9147_001_0	11		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H9147	001	0	1	02	01	H9147_001_0	11		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9147	001	0	1	02	01	H9147_001_0	11		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9147	001	0	1	02	01	H9147_001_0	11		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9147	001	0	1	02	01	H9147_001_0	11		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9147	001	0	1	02	01	H9147_001_0	11		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9179	001	0	1	01	01	H9179_001_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H9179	001	0	1	01	01	H9179_001_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H9179	001	0	1	01	01	H9179_001_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9179	001	0	1	01	01	H9179_001_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9179	001	0	1	01	01	H9179_001_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9179	002	0	1	01	01	H9179_002_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H9179	002	0	1	01	01	H9179_002_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	5.00	
H9179	002	0	1	01	01	H9179_002_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9179	002	0	1	01	01	H9179_002_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9179	002	0	1	01	01	H9179_002_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9207	002	0	1	01	01	H9207_002_0	16			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H9207	002	0	1	01	01	H9207_002_0	16			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H9207	002	0	1	01	01	H9207_002_0	16			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9207	002	0	1	01	01	H9207_002_0	16			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9207	002	0	1	01	01	H9207_002_0	16			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9207	004	0	1	01	01	H9207_004_0	18		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H9207	004	0	1	01	01	H9207_004_0	18		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9207	004	0	1	01	01	H9207_004_0	18		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9207	004	0	1	01	01	H9207_004_0	18		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9207	004	0	1	01	01	H9207_004_0	18		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9207	004	0	1	01	01	H9207_004_0	18		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H9207	012	0	1	01	01	H9207_012_0	16			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H9207	012	0	1	01	01	H9207_012_0	16			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H9207	012	0	1	01	01	H9207_012_0	16			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9207	012	0	1	01	01	H9207_012_0	16			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9207	012	0	1	01	01	H9207_012_0	16			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9207	013	0	1	01	01	H9207_013_0	19			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H9207	013	0	1	01	01	H9207_013_0	19			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H9207	013	0	1	01	01	H9207_013_0	19			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9207	013	0	1	01	01	H9207_013_0	19			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9207	013	0	1	01	01	H9207_013_0	19			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9207	015	0	1	01	01	H9207_015_0	16			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H9207	015	0	1	01	01	H9207_015_0	16			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H9207	015	0	1	01	01	H9207_015_0	16			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9207	015	0	1	01	01	H9207_015_0	16			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9207	015	0	1	01	01	H9207_015_0	16			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9207	016	0	1	01	01	H9207_016_0	16		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H9207	016	0	1	01	01	H9207_016_0	16		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9207	016	0	1	01	01	H9207_016_0	16		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9207	016	0	1	01	01	H9207_016_0	16		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9207	016	0	1	01	01	H9207_016_0	16		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9207	016	0	1	01	01	H9207_016_0	16		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H9207	017	0	1	01	01	H9207_017_0	16		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H9207	017	0	1	01	01	H9207_017_0	16		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9207	017	0	1	01	01	H9207_017_0	16		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9207	017	0	1	01	01	H9207_017_0	16		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9207	017	0	1	01	01	H9207_017_0	16		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9207	017	0	1	01	01	H9207_017_0	16		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H9207	018	0	1	01	01	H9207_018_0	22			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H9207	018	0	1	01	01	H9207_018_0	22			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H9207	018	0	1	01	01	H9207_018_0	22			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9207	018	0	1	01	01	H9207_018_0	22			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9207	018	0	1	01	01	H9207_018_0	22			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9231	002	0	1	04	01	H9231_002_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H9231	002	0	1	04	01	H9231_002_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H9231	002	0	1	04	01	H9231_002_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9231	002	0	1	04	01	H9231_002_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9231	002	0	1	04	01	H9231_002_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9231	005	0	1	04	01	H9231_005_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H9231	005	0	1	04	01	H9231_005_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H9231	005	0	1	04	01	H9231_005_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9231	005	0	1	04	01	H9231_005_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9231	005	0	1	04	01	H9231_005_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9231	006	0	1	04	01	H9231_006_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H9231	006	0	1	04	01	H9231_006_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H9231	006	0	1	04	01	H9231_006_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9231	006	0	1	04	01	H9231_006_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9231	006	0	1	04	01	H9231_006_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9231	007	0	1	04	01	H9231_007_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H9231	007	0	1	04	01	H9231_007_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	5.00	
H9231	007	0	1	04	01	H9231_007_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9231	007	0	1	04	01	H9231_007_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9231	007	0	1	04	01	H9231_007_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9231	010	0	1	04	01	H9231_010_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H9231	010	0	1	04	01	H9231_010_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	5.00	
H9231	010	0	1	04	01	H9231_010_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9231	010	0	1	04	01	H9231_010_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9231	010	0	1	04	01	H9231_010_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9231	011	0	1	04	01	H9231_011_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H9231	011	0	1	04	01	H9231_011_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H9231	011	0	1	04	01	H9231_011_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9231	011	0	1	04	01	H9231_011_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9231	011	0	1	04	01	H9231_011_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9231	012	0	1	04	01	H9231_012_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H9231	012	0	1	04	01	H9231_012_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H9231	012	0	1	04	01	H9231_012_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9231	012	0	1	04	01	H9231_012_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9231	012	0	1	04	01	H9231_012_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9231	015	0	1	04	01	H9231_015_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H9231	015	0	1	04	01	H9231_015_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	5.00	
H9231	015	0	1	04	01	H9231_015_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9231	015	0	1	04	01	H9231_015_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9231	015	0	1	04	01	H9231_015_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9231	016	0	1	04	01	H9231_016_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H9231	016	0	1	04	01	H9231_016_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9231	016	0	1	04	01	H9231_016_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9231	016	0	1	04	01	H9231_016_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9231	016	0	1	04	01	H9231_016_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9231	016	0	1	04	01	H9231_016_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9231	017	0	1	04	01	H9231_017_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H9231	017	0	1	04	01	H9231_017_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9231	017	0	1	04	01	H9231_017_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9231	017	0	1	04	01	H9231_017_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9231	017	0	1	04	01	H9231_017_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9231	017	0	1	04	01	H9231_017_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9231	018	0	1	04	01	H9231_018_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H9231	018	0	1	04	01	H9231_018_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9231	018	0	1	04	01	H9231_018_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9231	018	0	1	04	01	H9231_018_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9231	018	0	1	04	01	H9231_018_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9231	018	0	1	04	01	H9231_018_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9231	019	0	1	04	01	H9231_019_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H9231	019	0	1	04	01	H9231_019_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9231	019	0	1	04	01	H9231_019_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9231	019	0	1	04	01	H9231_019_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9231	019	0	1	04	01	H9231_019_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9231	019	0	1	04	01	H9231_019_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9231	020	0	1	04	01	H9231_020_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H9231	020	0	1	04	01	H9231_020_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9231	020	0	1	04	01	H9231_020_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9231	020	0	1	04	01	H9231_020_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9231	020	0	1	04	01	H9231_020_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9231	020	0	1	04	01	H9231_020_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9306	002	0	1	01	01	H9306_002_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	1	2	11	1	2	0.00	
H9306	002	0	1	01	01	H9306_002_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	2	2	11	1	2	0.00	
H9306	002	0	1	01	01	H9306_002_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	3	2	11	1	2	0.00	
H9306	002	0	1	01	01	H9306_002_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	4	2	11	1	2	0.00	
H9306	002	0	1	01	01	H9306_002_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	5	2	11	1	2	0.00	
H9306	002	0	1	01	01	H9306_002_0	9			Supplemental Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Supplemental Drugs	6	2	01	2	2	0.00	
H9306	008	1	1	01	01	H9306_008_1	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H9306	008	1	1	01	01	H9306_008_1	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H9306	008	1	1	01	01	H9306_008_1	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9306	008	1	1	01	01	H9306_008_1	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9306	008	1	1	01	01	H9306_008_1	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9306	008	2	1	01	01	H9306_008_2	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H9306	008	2	1	01	01	H9306_008_2	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H9306	008	2	1	01	01	H9306_008_2	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9306	008	2	1	01	01	H9306_008_2	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9306	008	2	1	01	01	H9306_008_2	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9306	009	1	1	01	01	H9306_009_1	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H9306	009	1	1	01	01	H9306_009_1	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H9306	009	1	1	01	01	H9306_009_1	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9306	009	1	1	01	01	H9306_009_1	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9306	009	1	1	01	01	H9306_009_1	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9306	009	2	1	01	01	H9306_009_2	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H9306	009	2	1	01	01	H9306_009_2	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H9306	009	2	1	01	01	H9306_009_2	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9306	009	2	1	01	01	H9306_009_2	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9306	009	2	1	01	01	H9306_009_2	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9314	001	0	1	01	01	H9314_001_0	2		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H9314	001	0	1	01	01	H9314_001_0	2		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H9314	001	0	1	01	01	H9314_001_0	2		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9314	001	0	1	01	01	H9314_001_0	2		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9314	001	0	1	01	01	H9314_001_0	2		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9326	001	0	1	04	01	H9326_001_0	8			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H9326	001	0	1	04	01	H9326_001_0	8			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H9326	001	0	1	04	01	H9326_001_0	8			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H9326	001	0	1	04	01	H9326_001_0	8			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9326	001	0	1	04	01	H9326_001_0	8			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9326	002	0	1	04	01	H9326_002_0	8			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H9326	002	0	1	04	01	H9326_002_0	8			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H9326	002	0	1	04	01	H9326_002_0	8			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H9326	002	0	1	04	01	H9326_002_0	8			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9326	002	0	1	04	01	H9326_002_0	8			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9364	001	0	1	02	01	H9364_001_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H9364	001	0	1	02	01	H9364_001_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9364	001	0	1	02	01	H9364_001_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9364	001	0	1	02	01	H9364_001_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9364	001	0	1	02	01	H9364_001_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9364	001	0	1	02	01	H9364_001_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9364	002	0	1	02	01	H9364_002_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H9364	002	0	1	02	01	H9364_002_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9364	002	0	1	02	01	H9364_002_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9364	002	0	1	02	01	H9364_002_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9364	002	0	1	02	01	H9364_002_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9364	002	0	1	02	01	H9364_002_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9364	003	0	1	02	01	H9364_003_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H9364	003	0	1	02	01	H9364_003_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9364	003	0	1	02	01	H9364_003_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9364	003	0	1	02	01	H9364_003_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9364	003	0	1	02	01	H9364_003_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9364	003	0	1	02	01	H9364_003_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9364	004	0	1	02	01	H9364_004_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H9364	004	0	1	02	01	H9364_004_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9364	004	0	1	02	01	H9364_004_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9364	004	0	1	02	01	H9364_004_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9364	004	0	1	02	01	H9364_004_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9364	004	0	1	02	01	H9364_004_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9387	001	0	1	04	01	H9387_001_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H9387	001	0	1	04	01	H9387_001_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9387	001	0	1	04	01	H9387_001_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9387	001	0	1	04	01	H9387_001_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9387	001	0	1	04	01	H9387_001_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9387	001	0	1	04	01	H9387_001_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9387	004	0	1	04	01	H9387_004_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H9387	004	0	1	04	01	H9387_004_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9387	004	0	1	04	01	H9387_004_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9387	004	0	1	04	01	H9387_004_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9387	004	0	1	04	01	H9387_004_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9387	004	0	1	04	01	H9387_004_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9431	014	0	1	04	01	H9431_014_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H9431	014	0	1	04	01	H9431_014_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H9431	014	0	1	04	01	H9431_014_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9431	014	0	1	04	01	H9431_014_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9431	014	0	1	04	01	H9431_014_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9460	001	0	1	01	01	H9460_001_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H9460	001	0	1	01	01	H9460_001_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H9460	001	0	1	01	01	H9460_001_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9460	001	0	1	01	01	H9460_001_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9460	001	0	1	01	01	H9460_001_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9460	003	0	1	01	01	H9460_003_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H9460	003	0	1	01	01	H9460_003_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H9460	003	0	1	01	01	H9460_003_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9460	003	0	1	01	01	H9460_003_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9460	003	0	1	01	01	H9460_003_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9485	001	0	1	04	01	H9485_001_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H9485	001	0	1	04	01	H9485_001_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	5.00	
H9485	001	0	1	04	01	H9485_001_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	3	2	47.00	
H9485	001	0	1	04	01	H9485_001_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	3	1		25
H9485	001	0	1	04	01	H9485_001_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9485	002	0	1	04	01	H9485_002_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H9485	002	0	1	04	01	H9485_002_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	5.00	
H9485	002	0	1	04	01	H9485_002_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	3	2	47.00	
H9485	002	0	1	04	01	H9485_002_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	3	1		25
H9485	002	0	1	04	01	H9485_002_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9485	003	0	1	04	01	H9485_003_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H9485	003	0	1	04	01	H9485_003_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	5.00	
H9485	003	0	1	04	01	H9485_003_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	3	2	47.00	
H9485	003	0	1	04	01	H9485_003_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	3	1		25
H9485	003	0	1	04	01	H9485_003_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9525	003	0	1	01	01	H9525_003_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H9525	003	0	1	01	01	H9525_003_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9525	003	0	1	01	01	H9525_003_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9525	003	0	1	01	01	H9525_003_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9525	003	0	1	01	01	H9525_003_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9525	003	0	1	01	01	H9525_003_0	5		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9525	004	0	1	02	01	H9525_004_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H9525	004	0	1	02	01	H9525_004_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9525	004	0	1	02	01	H9525_004_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9525	004	0	1	02	01	H9525_004_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9525	004	0	1	02	01	H9525_004_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9525	004	0	1	02	01	H9525_004_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9525	006	0	1	02	01	H9525_006_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H9525	006	0	1	02	01	H9525_006_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9525	006	0	1	02	01	H9525_006_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9525	006	0	1	02	01	H9525_006_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9525	006	0	1	02	01	H9525_006_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9525	006	0	1	02	01	H9525_006_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9525	011	0	1	02	01	H9525_011_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H9525	011	0	1	02	01	H9525_011_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9525	011	0	1	02	01	H9525_011_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9525	011	0	1	02	01	H9525_011_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9525	011	0	1	02	01	H9525_011_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9525	011	0	1	02	01	H9525_011_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9525	013	1	1	02	01	H9525_013_1	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H9525	013	1	1	02	01	H9525_013_1	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9525	013	1	1	02	01	H9525_013_1	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9525	013	1	1	02	01	H9525_013_1	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9525	013	1	1	02	01	H9525_013_1	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9525	013	1	1	02	01	H9525_013_1	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9525	013	2	1	02	01	H9525_013_2	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H9525	013	2	1	02	01	H9525_013_2	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9525	013	2	1	02	01	H9525_013_2	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9525	013	2	1	02	01	H9525_013_2	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9525	013	2	1	02	01	H9525_013_2	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9525	013	2	1	02	01	H9525_013_2	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9525	013	3	1	02	01	H9525_013_3	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H9525	013	3	1	02	01	H9525_013_3	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9525	013	3	1	02	01	H9525_013_3	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9525	013	3	1	02	01	H9525_013_3	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9525	013	3	1	02	01	H9525_013_3	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9525	013	3	1	02	01	H9525_013_3	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9525	013	4	1	02	01	H9525_013_4	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H9525	013	4	1	02	01	H9525_013_4	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9525	013	4	1	02	01	H9525_013_4	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9525	013	4	1	02	01	H9525_013_4	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9525	013	4	1	02	01	H9525_013_4	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9525	013	4	1	02	01	H9525_013_4	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9525	013	5	1	02	01	H9525_013_5	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H9525	013	5	1	02	01	H9525_013_5	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9525	013	5	1	02	01	H9525_013_5	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9525	013	5	1	02	01	H9525_013_5	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9525	013	5	1	02	01	H9525_013_5	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9525	013	5	1	02	01	H9525_013_5	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9525	018	0	1	01	01	H9525_018_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H9525	018	0	1	01	01	H9525_018_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9525	018	0	1	01	01	H9525_018_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9525	018	0	1	01	01	H9525_018_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9525	018	0	1	01	01	H9525_018_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9525	018	0	1	01	01	H9525_018_0	5		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9572	001	1	1	04	01	H9572_001_1	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H9572	001	1	1	04	01	H9572_001_1	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H9572	001	1	1	04	01	H9572_001_1	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9572	001	1	1	04	01	H9572_001_1	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9572	001	1	1	04	01	H9572_001_1	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9572	001	2	1	04	01	H9572_001_2	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H9572	001	2	1	04	01	H9572_001_2	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H9572	001	2	1	04	01	H9572_001_2	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9572	001	2	1	04	01	H9572_001_2	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9572	001	2	1	04	01	H9572_001_2	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9572	001	3	1	04	01	H9572_001_3	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H9572	001	3	1	04	01	H9572_001_3	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H9572	001	3	1	04	01	H9572_001_3	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9572	001	3	1	04	01	H9572_001_3	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9572	001	3	1	04	01	H9572_001_3	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9572	001	4	1	04	01	H9572_001_4	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H9572	001	4	1	04	01	H9572_001_4	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H9572	001	4	1	04	01	H9572_001_4	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9572	001	4	1	04	01	H9572_001_4	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9572	001	4	1	04	01	H9572_001_4	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9572	001	6	1	04	01	H9572_001_6	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H9572	001	6	1	04	01	H9572_001_6	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H9572	001	6	1	04	01	H9572_001_6	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9572	001	6	1	04	01	H9572_001_6	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9572	001	6	1	04	01	H9572_001_6	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9572	002	1	1	04	01	H9572_002_1	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H9572	002	1	1	04	01	H9572_002_1	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H9572	002	1	1	04	01	H9572_002_1	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9572	002	1	1	04	01	H9572_002_1	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9572	002	1	1	04	01	H9572_002_1	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9572	002	2	1	04	01	H9572_002_2	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H9572	002	2	1	04	01	H9572_002_2	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H9572	002	2	1	04	01	H9572_002_2	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9572	002	2	1	04	01	H9572_002_2	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9572	002	2	1	04	01	H9572_002_2	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9572	002	3	1	04	01	H9572_002_3	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H9572	002	3	1	04	01	H9572_002_3	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H9572	002	3	1	04	01	H9572_002_3	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9572	002	3	1	04	01	H9572_002_3	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9572	002	3	1	04	01	H9572_002_3	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9572	002	4	1	04	01	H9572_002_4	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H9572	002	4	1	04	01	H9572_002_4	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H9572	002	4	1	04	01	H9572_002_4	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9572	002	4	1	04	01	H9572_002_4	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9572	002	4	1	04	01	H9572_002_4	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9572	002	6	1	04	01	H9572_002_6	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H9572	002	6	1	04	01	H9572_002_6	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H9572	002	6	1	04	01	H9572_002_6	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9572	002	6	1	04	01	H9572_002_6	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9572	002	6	1	04	01	H9572_002_6	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9572	003	1	1	04	01	H9572_003_1	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H9572	003	1	1	04	01	H9572_003_1	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H9572	003	1	1	04	01	H9572_003_1	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9572	003	1	1	04	01	H9572_003_1	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9572	003	1	1	04	01	H9572_003_1	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9572	003	2	1	04	01	H9572_003_2	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H9572	003	2	1	04	01	H9572_003_2	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H9572	003	2	1	04	01	H9572_003_2	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9572	003	2	1	04	01	H9572_003_2	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9572	003	2	1	04	01	H9572_003_2	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9572	003	3	1	04	01	H9572_003_3	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H9572	003	3	1	04	01	H9572_003_3	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H9572	003	3	1	04	01	H9572_003_3	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9572	003	3	1	04	01	H9572_003_3	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9572	003	3	1	04	01	H9572_003_3	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9572	003	4	1	04	01	H9572_003_4	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H9572	003	4	1	04	01	H9572_003_4	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H9572	003	4	1	04	01	H9572_003_4	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9572	003	4	1	04	01	H9572_003_4	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9572	003	4	1	04	01	H9572_003_4	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9572	003	6	1	04	01	H9572_003_6	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H9572	003	6	1	04	01	H9572_003_6	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H9572	003	6	1	04	01	H9572_003_6	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9572	003	6	1	04	01	H9572_003_6	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9572	003	6	1	04	01	H9572_003_6	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9572	004	1	1	04	01	H9572_004_1	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H9572	004	1	1	04	01	H9572_004_1	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H9572	004	1	1	04	01	H9572_004_1	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9572	004	1	1	04	01	H9572_004_1	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9572	004	1	1	04	01	H9572_004_1	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9572	004	2	1	04	01	H9572_004_2	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H9572	004	2	1	04	01	H9572_004_2	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H9572	004	2	1	04	01	H9572_004_2	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9572	004	2	1	04	01	H9572_004_2	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9572	004	2	1	04	01	H9572_004_2	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9572	004	4	1	04	01	H9572_004_4	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H9572	004	4	1	04	01	H9572_004_4	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H9572	004	4	1	04	01	H9572_004_4	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9572	004	4	1	04	01	H9572_004_4	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9572	004	4	1	04	01	H9572_004_4	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9572	004	6	1	04	01	H9572_004_6	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H9572	004	6	1	04	01	H9572_004_6	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H9572	004	6	1	04	01	H9572_004_6	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9572	004	6	1	04	01	H9572_004_6	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9572	004	6	1	04	01	H9572_004_6	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9572	007	1	1	04	01	H9572_007_1	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H9572	007	1	1	04	01	H9572_007_1	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H9572	007	1	1	04	01	H9572_007_1	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9572	007	1	1	04	01	H9572_007_1	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9572	007	1	1	04	01	H9572_007_1	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9572	007	2	1	04	01	H9572_007_2	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H9572	007	2	1	04	01	H9572_007_2	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H9572	007	2	1	04	01	H9572_007_2	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9572	007	2	1	04	01	H9572_007_2	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9572	007	2	1	04	01	H9572_007_2	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9572	007	3	1	04	01	H9572_007_3	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H9572	007	3	1	04	01	H9572_007_3	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H9572	007	3	1	04	01	H9572_007_3	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9572	007	3	1	04	01	H9572_007_3	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9572	007	3	1	04	01	H9572_007_3	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9572	007	4	1	04	01	H9572_007_4	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H9572	007	4	1	04	01	H9572_007_4	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H9572	007	4	1	04	01	H9572_007_4	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9572	007	4	1	04	01	H9572_007_4	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9572	007	4	1	04	01	H9572_007_4	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9572	007	6	1	04	01	H9572_007_6	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H9572	007	6	1	04	01	H9572_007_6	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H9572	007	6	1	04	01	H9572_007_6	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9572	007	6	1	04	01	H9572_007_6	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9572	007	6	1	04	01	H9572_007_6	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9572	008	0	1	04	01	H9572_008_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H9572	008	0	1	04	01	H9572_008_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H9572	008	0	1	04	01	H9572_008_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H9572	008	0	1	04	01	H9572_008_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9572	008	0	1	04	01	H9572_008_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9572	009	0	1	04	01	H9572_009_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H9572	009	0	1	04	01	H9572_009_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H9572	009	0	1	04	01	H9572_009_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9572	009	0	1	04	01	H9572_009_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9572	009	0	1	04	01	H9572_009_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9572	010	0	1	04	01	H9572_010_0	7			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H9572	010	0	1	04	01	H9572_010_0	7			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H9572	010	0	1	04	01	H9572_010_0	7			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H9572	010	0	1	04	01	H9572_010_0	7			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9572	010	0	1	04	01	H9572_010_0	7			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9589	003	0	1	04	01	H9589_003_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H9589	003	0	1	04	01	H9589_003_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H9589	003	0	1	04	01	H9589_003_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9589	003	0	1	04	01	H9589_003_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9589	003	0	1	04	01	H9589_003_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9589	003	0	1	04	01	H9589_003_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H9615	021	0	1	04	01	H9615_021_0	16			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H9615	021	0	1	04	01	H9615_021_0	16			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H9615	021	0	1	04	01	H9615_021_0	16			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9615	021	0	1	04	01	H9615_021_0	16			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9615	021	0	1	04	01	H9615_021_0	16			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9615	022	0	1	04	01	H9615_022_0	16			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H9615	022	0	1	04	01	H9615_022_0	16			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H9615	022	0	1	04	01	H9615_022_0	16			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9615	022	0	1	04	01	H9615_022_0	16			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9615	022	0	1	04	01	H9615_022_0	16			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9615	023	0	1	04	01	H9615_023_0	16			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H9615	023	0	1	04	01	H9615_023_0	16			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H9615	023	0	1	04	01	H9615_023_0	16			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9615	023	0	1	04	01	H9615_023_0	16			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9615	023	0	1	04	01	H9615_023_0	16			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9615	024	0	1	04	01	H9615_024_0	16			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H9615	024	0	1	04	01	H9615_024_0	16			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H9615	024	0	1	04	01	H9615_024_0	16			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9615	024	0	1	04	01	H9615_024_0	16			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9615	024	0	1	04	01	H9615_024_0	16			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9630	002	0	1	02	01	H9630_002_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H9630	002	0	1	02	01	H9630_002_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9630	002	0	1	02	01	H9630_002_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9630	002	0	1	02	01	H9630_002_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9630	002	0	1	02	01	H9630_002_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9630	002	0	1	02	01	H9630_002_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9630	008	0	1	02	01	H9630_008_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H9630	008	0	1	02	01	H9630_008_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9630	008	0	1	02	01	H9630_008_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9630	008	0	1	02	01	H9630_008_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9630	008	0	1	02	01	H9630_008_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9630	008	0	1	02	01	H9630_008_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9630	010	0	1	02	01	H9630_010_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H9630	010	0	1	02	01	H9630_010_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9630	010	0	1	02	01	H9630_010_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9630	010	0	1	02	01	H9630_010_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9630	010	0	1	02	01	H9630_010_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9630	010	0	1	02	01	H9630_010_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9630	011	0	1	02	01	H9630_011_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H9630	011	0	1	02	01	H9630_011_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9630	011	0	1	02	01	H9630_011_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9630	011	0	1	02	01	H9630_011_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9630	011	0	1	02	01	H9630_011_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9630	011	0	1	02	01	H9630_011_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9630	014	0	1	02	01	H9630_014_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H9630	014	0	1	02	01	H9630_014_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9630	014	0	1	02	01	H9630_014_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9630	014	0	1	02	01	H9630_014_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9630	014	0	1	02	01	H9630_014_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9630	014	0	1	02	01	H9630_014_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9678	002	0	1	04	01	H9678_002_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H9678	002	0	1	04	01	H9678_002_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	3	2	2.00	
H9678	002	0	1	04	01	H9678_002_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9678	002	0	1	04	01	H9678_002_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9678	002	0	1	04	01	H9678_002_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9678	002	0	1	04	01	H9678_002_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H9686	004	0	1	01	01	H9686_004_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H9686	004	0	1	01	01	H9686_004_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9686	004	0	1	01	01	H9686_004_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	3	2	40.00	
H9686	004	0	1	01	01	H9686_004_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	3	2	100.00	
H9686	004	0	1	01	01	H9686_004_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9686	004	0	1	01	01	H9686_004_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H9686	005	0	1	01	01	H9686_005_0	8		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H9686	005	0	1	01	01	H9686_005_0	8		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9686	005	0	1	01	01	H9686_005_0	8		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9686	005	0	1	01	01	H9686_005_0	8		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9686	005	0	1	01	01	H9686_005_0	8		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9686	005	0	1	01	01	H9686_005_0	8		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H9686	006	0	1	01	01	H9686_006_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H9686	006	0	1	01	01	H9686_006_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9686	006	0	1	01	01	H9686_006_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9686	006	0	1	01	01	H9686_006_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9686	006	0	1	01	01	H9686_006_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9686	006	0	1	01	01	H9686_006_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H9686	007	0	1	01	01	H9686_007_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H9686	007	0	1	01	01	H9686_007_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9686	007	0	1	01	01	H9686_007_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	3	2	40.00	
H9686	007	0	1	01	01	H9686_007_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	3	1		32
H9686	007	0	1	01	01	H9686_007_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9686	007	0	1	01	01	H9686_007_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H9686	008	0	1	01	01	H9686_008_0	10			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H9686	008	0	1	01	01	H9686_008_0	10			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9686	008	0	1	01	01	H9686_008_0	10			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	3	2	45.00	
H9686	008	0	1	01	01	H9686_008_0	10			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	3	1		32
H9686	008	0	1	01	01	H9686_008_0	10			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9686	008	0	1	01	01	H9686_008_0	10			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H9686	009	0	1	01	01	H9686_009_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H9686	009	0	1	01	01	H9686_009_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9686	009	0	1	01	01	H9686_009_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	3	2	30.00	
H9686	009	0	1	01	01	H9686_009_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	3	1		32
H9686	009	0	1	01	01	H9686_009_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9686	009	0	1	01	01	H9686_009_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H9699	007	0	1	01	01	H9699_007_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H9699	007	0	1	01	01	H9699_007_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H9699	007	0	1	01	01	H9699_007_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9699	007	0	1	01	01	H9699_007_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9699	007	0	1	01	01	H9699_007_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9700	001	0	1	04	01	H9700_001_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H9700	001	0	1	04	01	H9700_001_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H9700	001	0	1	04	01	H9700_001_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9700	001	0	1	04	01	H9700_001_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9700	001	0	1	04	01	H9700_001_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9700	002	0	1	04	01	H9700_002_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H9700	002	0	1	04	01	H9700_002_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H9700	002	0	1	04	01	H9700_002_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9700	002	0	1	04	01	H9700_002_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9700	002	0	1	04	01	H9700_002_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9700	003	0	1	04	01	H9700_003_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H9700	003	0	1	04	01	H9700_003_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H9700	003	0	1	04	01	H9700_003_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9700	003	0	1	04	01	H9700_003_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9700	003	0	1	04	01	H9700_003_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9700	004	0	1	04	01	H9700_004_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H9700	004	0	1	04	01	H9700_004_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H9700	004	0	1	04	01	H9700_004_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9700	004	0	1	04	01	H9700_004_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9700	004	0	1	04	01	H9700_004_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9700	005	0	1	04	01	H9700_005_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H9700	005	0	1	04	01	H9700_005_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H9700	005	0	1	04	01	H9700_005_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9700	005	0	1	04	01	H9700_005_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9700	005	0	1	04	01	H9700_005_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9700	006	0	1	04	01	H9700_006_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H9700	006	0	1	04	01	H9700_006_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H9700	006	0	1	04	01	H9700_006_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9700	006	0	1	04	01	H9700_006_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9700	006	0	1	04	01	H9700_006_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9700	008	0	1	04	01	H9700_008_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H9700	008	0	1	04	01	H9700_008_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H9700	008	0	1	04	01	H9700_008_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9700	008	0	1	04	01	H9700_008_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9700	008	0	1	04	01	H9700_008_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9700	009	0	1	04	01	H9700_009_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H9700	009	0	1	04	01	H9700_009_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H9700	009	0	1	04	01	H9700_009_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9700	009	0	1	04	01	H9700_009_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9700	009	0	1	04	01	H9700_009_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9706	001	0	1	01	01	H9706_001_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H9706	001	0	1	01	01	H9706_001_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H9706	001	0	1	01	01	H9706_001_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9706	001	0	1	01	01	H9706_001_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9706	001	0	1	01	01	H9706_001_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9706	005	0	1	01	01	H9706_005_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H9706	005	0	1	01	01	H9706_005_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H9706	005	0	1	01	01	H9706_005_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9706	005	0	1	01	01	H9706_005_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9706	005	0	1	01	01	H9706_005_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9706	007	0	1	01	01	H9706_007_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H9706	007	0	1	01	01	H9706_007_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H9706	007	0	1	01	01	H9706_007_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9706	007	0	1	01	01	H9706_007_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9706	007	0	1	01	01	H9706_007_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9706	008	0	1	01	01	H9706_008_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H9706	008	0	1	01	01	H9706_008_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H9706	008	0	1	01	01	H9706_008_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9706	008	0	1	01	01	H9706_008_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9706	008	0	1	01	01	H9706_008_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9706	009	0	1	01	01	H9706_009_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H9706	009	0	1	01	01	H9706_009_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H9706	009	0	1	01	01	H9706_009_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9706	009	0	1	01	01	H9706_009_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9706	009	0	1	01	01	H9706_009_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9725	003	0	1	01	01	H9725_003_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H9725	003	0	1	01	01	H9725_003_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H9725	003	0	1	01	01	H9725_003_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9725	003	0	1	01	01	H9725_003_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9725	003	0	1	01	01	H9725_003_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9725	009	1	1	01	01	H9725_009_1	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H9725	009	1	1	01	01	H9725_009_1	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H9725	009	1	1	01	01	H9725_009_1	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9725	009	1	1	01	01	H9725_009_1	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9725	009	1	1	01	01	H9725_009_1	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9725	009	2	1	01	01	H9725_009_2	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H9725	009	2	1	01	01	H9725_009_2	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H9725	009	2	1	01	01	H9725_009_2	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9725	009	2	1	01	01	H9725_009_2	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9725	009	2	1	01	01	H9725_009_2	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9725	009	3	1	01	01	H9725_009_3	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H9725	009	3	1	01	01	H9725_009_3	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H9725	009	3	1	01	01	H9725_009_3	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9725	009	3	1	01	01	H9725_009_3	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9725	009	3	1	01	01	H9725_009_3	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9725	009	4	1	01	01	H9725_009_4	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H9725	009	4	1	01	01	H9725_009_4	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H9725	009	4	1	01	01	H9725_009_4	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9725	009	4	1	01	01	H9725_009_4	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9725	009	4	1	01	01	H9725_009_4	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9725	013	0	1	01	01	H9725_013_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H9725	013	0	1	01	01	H9725_013_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H9725	013	0	1	01	01	H9725_013_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9725	013	0	1	01	01	H9725_013_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9725	013	0	1	01	01	H9725_013_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9725	014	0	1	01	01	H9725_014_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H9725	014	0	1	01	01	H9725_014_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H9725	014	0	1	01	01	H9725_014_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9725	014	0	1	01	01	H9725_014_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9725	014	0	1	01	01	H9725_014_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9725	015	1	1	01	01	H9725_015_1	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H9725	015	1	1	01	01	H9725_015_1	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H9725	015	1	1	01	01	H9725_015_1	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9725	015	1	1	01	01	H9725_015_1	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9725	015	1	1	01	01	H9725_015_1	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9725	015	2	1	01	01	H9725_015_2	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H9725	015	2	1	01	01	H9725_015_2	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H9725	015	2	1	01	01	H9725_015_2	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9725	015	2	1	01	01	H9725_015_2	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9725	015	2	1	01	01	H9725_015_2	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9725	015	3	1	01	01	H9725_015_3	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H9725	015	3	1	01	01	H9725_015_3	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H9725	015	3	1	01	01	H9725_015_3	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9725	015	3	1	01	01	H9725_015_3	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9725	015	3	1	01	01	H9725_015_3	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9725	015	4	1	01	01	H9725_015_4	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H9725	015	4	1	01	01	H9725_015_4	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H9725	015	4	1	01	01	H9725_015_4	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9725	015	4	1	01	01	H9725_015_4	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9725	015	4	1	01	01	H9725_015_4	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9725	016	0	1	01	01	H9725_016_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	9.00	
H9725	016	0	1	01	01	H9725_016_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H9725	016	0	1	01	01	H9725_016_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9725	016	0	1	01	01	H9725_016_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9725	016	0	1	01	01	H9725_016_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9725	017	1	1	01	01	H9725_017_1	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H9725	017	1	1	01	01	H9725_017_1	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H9725	017	1	1	01	01	H9725_017_1	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9725	017	1	1	01	01	H9725_017_1	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9725	017	1	1	01	01	H9725_017_1	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9725	017	2	1	01	01	H9725_017_2	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H9725	017	2	1	01	01	H9725_017_2	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H9725	017	2	1	01	01	H9725_017_2	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9725	017	2	1	01	01	H9725_017_2	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9725	017	2	1	01	01	H9725_017_2	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9725	017	3	1	01	01	H9725_017_3	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H9725	017	3	1	01	01	H9725_017_3	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H9725	017	3	1	01	01	H9725_017_3	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9725	017	3	1	01	01	H9725_017_3	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9725	017	3	1	01	01	H9725_017_3	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9725	017	4	1	01	01	H9725_017_4	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H9725	017	4	1	01	01	H9725_017_4	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H9725	017	4	1	01	01	H9725_017_4	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9725	017	4	1	01	01	H9725_017_4	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9725	017	4	1	01	01	H9725_017_4	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9725	018	0	1	02	01	H9725_018_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	10.00	
H9725	018	0	1	02	01	H9725_018_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H9725	018	0	1	02	01	H9725_018_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9725	018	0	1	02	01	H9725_018_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9725	018	0	1	02	01	H9725_018_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9730	003	0	1	02	01	H9730_003_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H9730	003	0	1	02	01	H9730_003_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9730	003	0	1	02	01	H9730_003_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9730	003	0	1	02	01	H9730_003_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9730	003	0	1	02	01	H9730_003_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9730	003	0	1	02	01	H9730_003_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9730	004	0	1	02	01	H9730_004_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H9730	004	0	1	02	01	H9730_004_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9730	004	0	1	02	01	H9730_004_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9730	004	0	1	02	01	H9730_004_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9730	004	0	1	02	01	H9730_004_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9730	004	0	1	02	01	H9730_004_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9730	007	0	1	02	01	H9730_007_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H9730	007	0	1	02	01	H9730_007_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9730	007	0	1	02	01	H9730_007_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9730	007	0	1	02	01	H9730_007_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9730	007	0	1	02	01	H9730_007_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9730	007	0	1	02	01	H9730_007_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9730	009	0	1	02	01	H9730_009_0	8			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	3	2	0.00	
H9730	009	0	1	02	01	H9730_009_0	8			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9730	009	0	1	02	01	H9730_009_0	8			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9730	009	0	1	02	01	H9730_009_0	8			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9730	009	0	1	02	01	H9730_009_0	8			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9730	009	0	1	02	01	H9730_009_0	8			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9730	010	0	1	02	01	H9730_010_0	8			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H9730	010	0	1	02	01	H9730_010_0	8			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9730	010	0	1	02	01	H9730_010_0	8			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9730	010	0	1	02	01	H9730_010_0	8			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9730	010	0	1	02	01	H9730_010_0	8			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9730	010	0	1	02	01	H9730_010_0	8			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9730	011	0	1	02	01	H9730_011_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H9730	011	0	1	02	01	H9730_011_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9730	011	0	1	02	01	H9730_011_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9730	011	0	1	02	01	H9730_011_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9730	011	0	1	02	01	H9730_011_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9730	011	0	1	02	01	H9730_011_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9771	001	0	1	01	01	H9771_001_0	2		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H9771	001	0	1	01	01	H9771_001_0	2		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H9771	001	0	1	01	01	H9771_001_0	2		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9771	001	0	1	01	01	H9771_001_0	2		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9771	001	0	1	01	01	H9771_001_0	2		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9802	001	0	1	04	01	H9802_001_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H9802	001	0	1	04	01	H9802_001_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H9802	001	0	1	04	01	H9802_001_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9802	001	0	1	04	01	H9802_001_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9802	001	0	1	04	01	H9802_001_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9802	002	0	1	04	01	H9802_002_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H9802	002	0	1	04	01	H9802_002_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H9802	002	0	1	04	01	H9802_002_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9802	002	0	1	04	01	H9802_002_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9802	002	0	1	04	01	H9802_002_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9802	004	0	1	04	01	H9802_004_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H9802	004	0	1	04	01	H9802_004_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9802	004	0	1	04	01	H9802_004_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9802	004	0	1	04	01	H9802_004_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9802	004	0	1	04	01	H9802_004_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9802	004	0	1	04	01	H9802_004_0	5		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H9802	006	0	1	04	01	H9802_006_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H9802	006	0	1	04	01	H9802_006_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9802	006	0	1	04	01	H9802_006_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9802	006	0	1	04	01	H9802_006_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9802	006	0	1	04	01	H9802_006_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9802	006	0	1	04	01	H9802_006_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9802	008	0	1	04	01	H9802_008_0	6		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H9802	008	0	1	04	01	H9802_008_0	6		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9802	008	0	1	04	01	H9802_008_0	6		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9802	008	0	1	04	01	H9802_008_0	6		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9802	008	0	1	04	01	H9802_008_0	6		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9802	008	0	1	04	01	H9802_008_0	6		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H9802	009	0	1	04	01	H9802_009_0	7			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H9802	009	0	1	04	01	H9802_009_0	7			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9802	009	0	1	04	01	H9802_009_0	7			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9802	009	0	1	04	01	H9802_009_0	7			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9802	009	0	1	04	01	H9802_009_0	7			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9802	009	0	1	04	01	H9802_009_0	7			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9808	004	0	1	04	01	H9808_004_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	0.00	
H9808	004	0	1	04	01	H9808_004_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H9808	004	0	1	04	01	H9808_004_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9808	004	0	1	04	01	H9808_004_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9808	004	0	1	04	01	H9808_004_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9808	005	0	1	04	01	H9808_005_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	0.00	
H9808	005	0	1	04	01	H9808_005_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H9808	005	0	1	04	01	H9808_005_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9808	005	0	1	04	01	H9808_005_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9808	005	0	1	04	01	H9808_005_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9808	010	0	1	04	01	H9808_010_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	3	2	0.00	
H9808	010	0	1	04	01	H9808_010_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H9808	010	0	1	04	01	H9808_010_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9808	010	0	1	04	01	H9808_010_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9808	010	0	1	04	01	H9808_010_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9826	003	0	1	01	01	H9826_003_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H9826	003	0	1	01	01	H9826_003_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H9826	003	0	1	01	01	H9826_003_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H9826	003	0	1	01	01	H9826_003_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9826	003	0	1	01	01	H9826_003_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9826	003	0	1	01	01	H9826_003_0	5		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9826	004	0	1	01	01	H9826_004_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H9826	004	0	1	01	01	H9826_004_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H9826	004	0	1	01	01	H9826_004_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
H9826	004	0	1	01	01	H9826_004_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9826	004	0	1	01	01	H9826_004_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9826	004	0	1	01	01	H9826_004_0	5		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9827	001	0	1	01	01	H9827_001_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H9827	001	0	1	01	01	H9827_001_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	5.00	
H9827	001	0	1	01	01	H9827_001_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9827	001	0	1	01	01	H9827_001_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9827	001	0	1	01	01	H9827_001_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9827	004	0	1	01	01	H9827_004_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H9827	004	0	1	01	01	H9827_004_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	5.00	
H9827	004	0	1	01	01	H9827_004_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9827	004	0	1	01	01	H9827_004_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9827	004	0	1	01	01	H9827_004_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9834	001	0	1	01	01	H9834_001_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H9834	001	0	1	01	01	H9834_001_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H9834	001	0	1	01	01	H9834_001_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9834	001	0	1	01	01	H9834_001_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9834	001	0	1	01	01	H9834_001_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9834	001	0	1	01	01	H9834_001_0	5			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9834	003	0	1	01	01	H9834_003_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H9834	003	0	1	01	01	H9834_003_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H9834	003	0	1	01	01	H9834_003_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9834	003	0	1	01	01	H9834_003_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9834	003	0	1	01	01	H9834_003_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9834	003	0	1	01	01	H9834_003_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9834	006	0	1	01	01	H9834_006_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H9834	006	0	1	01	01	H9834_006_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H9834	006	0	1	01	01	H9834_006_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9834	006	0	1	01	01	H9834_006_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9834	006	0	1	01	01	H9834_006_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9834	006	0	1	01	01	H9834_006_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9834	007	0	1	01	01	H9834_007_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
H9834	007	0	1	01	01	H9834_007_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
H9834	007	0	1	01	01	H9834_007_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9834	007	0	1	01	01	H9834_007_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9834	007	0	1	01	01	H9834_007_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9834	007	0	1	01	01	H9834_007_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9884	008	0	1	04	01	H9884_008_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H9884	008	0	1	04	01	H9884_008_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H9884	008	0	1	04	01	H9884_008_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9884	008	0	1	04	01	H9884_008_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9884	008	0	1	04	01	H9884_008_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9884	013	0	1	04	01	H9884_013_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H9884	013	0	1	04	01	H9884_013_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H9884	013	0	1	04	01	H9884_013_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9884	013	0	1	04	01	H9884_013_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9884	013	0	1	04	01	H9884_013_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9884	015	0	1	04	01	H9884_015_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H9884	015	0	1	04	01	H9884_015_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H9884	015	0	1	04	01	H9884_015_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9884	015	0	1	04	01	H9884_015_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9884	015	0	1	04	01	H9884_015_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9888	001	0	1	04	01	H9888_001_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H9888	001	0	1	04	01	H9888_001_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H9888	001	0	1	04	01	H9888_001_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9888	001	0	1	04	01	H9888_001_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9888	001	0	1	04	01	H9888_001_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9888	002	0	1	04	01	H9888_002_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H9888	002	0	1	04	01	H9888_002_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H9888	002	0	1	04	01	H9888_002_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9888	002	0	1	04	01	H9888_002_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9888	002	0	1	04	01	H9888_002_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9888	005	0	1	04	01	H9888_005_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H9888	005	0	1	04	01	H9888_005_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H9888	005	0	1	04	01	H9888_005_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9888	005	0	1	04	01	H9888_005_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9888	005	0	1	04	01	H9888_005_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9888	006	0	1	04	01	H9888_006_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H9888	006	0	1	04	01	H9888_006_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H9888	006	0	1	04	01	H9888_006_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9888	006	0	1	04	01	H9888_006_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9888	006	0	1	04	01	H9888_006_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9888	008	0	1	04	01	H9888_008_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H9888	008	0	1	04	01	H9888_008_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H9888	008	0	1	04	01	H9888_008_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9888	008	0	1	04	01	H9888_008_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9888	008	0	1	04	01	H9888_008_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9888	009	0	1	04	01	H9888_009_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H9888	009	0	1	04	01	H9888_009_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9888	009	0	1	04	01	H9888_009_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9888	009	0	1	04	01	H9888_009_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9888	009	0	1	04	01	H9888_009_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9888	009	0	1	04	01	H9888_009_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9888	010	0	1	04	01	H9888_010_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H9888	010	0	1	04	01	H9888_010_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H9888	010	0	1	04	01	H9888_010_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9888	010	0	1	04	01	H9888_010_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9888	010	0	1	04	01	H9888_010_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9888	011	0	1	04	01	H9888_011_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H9888	011	0	1	04	01	H9888_011_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9888	011	0	1	04	01	H9888_011_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9888	011	0	1	04	01	H9888_011_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9888	011	0	1	04	01	H9888_011_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9888	011	0	1	04	01	H9888_011_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9888	012	0	1	04	01	H9888_012_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H9888	012	0	1	04	01	H9888_012_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9888	012	0	1	04	01	H9888_012_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9888	012	0	1	04	01	H9888_012_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9888	012	0	1	04	01	H9888_012_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9888	012	0	1	04	01	H9888_012_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9888	013	0	1	04	01	H9888_013_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H9888	013	0	1	04	01	H9888_013_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9888	013	0	1	04	01	H9888_013_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9888	013	0	1	04	01	H9888_013_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9888	013	0	1	04	01	H9888_013_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9888	013	0	1	04	01	H9888_013_0	5		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H9888	014	0	1	04	01	H9888_014_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H9888	014	0	1	04	01	H9888_014_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9888	014	0	1	04	01	H9888_014_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9888	014	0	1	04	01	H9888_014_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9888	014	0	1	04	01	H9888_014_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9888	014	0	1	04	01	H9888_014_0	5		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	3	2	0.00	
H9888	015	0	1	04	01	H9888_015_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H9888	015	0	1	04	01	H9888_015_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9888	015	0	1	04	01	H9888_015_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9888	015	0	1	04	01	H9888_015_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9888	015	0	1	04	01	H9888_015_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9888	015	0	1	04	01	H9888_015_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9904	001	0	1	04	01	H9904_001_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H9904	001	0	1	04	01	H9904_001_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H9904	001	0	1	04	01	H9904_001_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9904	001	0	1	04	01	H9904_001_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9904	001	0	1	04	01	H9904_001_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9904	002	0	1	04	01	H9904_002_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
H9904	002	0	1	04	01	H9904_002_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
H9904	002	0	1	04	01	H9904_002_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9904	002	0	1	04	01	H9904_002_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9904	002	0	1	04	01	H9904_002_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9907	002	1	1	04	01	H9907_002_1	10			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	01	3	2	0.00	
H9907	002	1	1	04	01	H9907_002_1	10			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	01	3	2	0.00	
H9907	002	1	1	04	01	H9907_002_1	10			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H9907	002	1	1	04	01	H9907_002_1	10			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H9907	002	1	1	04	01	H9907_002_1	10			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H9907	002	1	1	04	01	H9907_002_1	10			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	11	1	2	0.00	
H9907	002	2	1	04	01	H9907_002_2	10			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	01	3	2	0.00	
H9907	002	2	1	04	01	H9907_002_2	10			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	01	3	2	0.00	
H9907	002	2	1	04	01	H9907_002_2	10			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H9907	002	2	1	04	01	H9907_002_2	10			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H9907	002	2	1	04	01	H9907_002_2	10			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H9907	002	2	1	04	01	H9907_002_2	10			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	11	1	2	0.00	
H9907	002	3	1	04	01	H9907_002_3	10			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	1	2	01	3	2	0.00	
H9907	002	3	1	04	01	H9907_002_3	10			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	2	2	01	3	2	0.00	
H9907	002	3	1	04	01	H9907_002_3	10			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	3	2	11	1	2	0.00	
H9907	002	3	1	04	01	H9907_002_3	10			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	4	2	11	1	2	0.00	
H9907	002	3	1	04	01	H9907_002_3	10			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	5	2	11	1	2	0.00	
H9907	002	3	1	04	01	H9907_002_3	10			Vaccines	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Vaccines	6	2	11	1	2	0.00	
H9916	001	0	1	02	01	H9916_001_0	8		N	Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H9916	001	0	1	02	01	H9916_001_0	8		N	Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9916	001	0	1	02	01	H9916_001_0	8		N	Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9916	001	0	1	02	01	H9916_001_0	8		N	Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9916	001	0	1	02	01	H9916_001_0	8		N	Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9916	001	0	1	02	01	H9916_001_0	8		N	Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9917	004	0	1	01	01	H9917_004_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
H9917	004	0	1	01	01	H9917_004_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
H9917	004	0	1	01	01	H9917_004_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
H9917	004	0	1	01	01	H9917_004_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	10	1	2	0.00	
H9917	004	0	1	01	01	H9917_004_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9955	007	0	1	01	01	H9955_007_0	8		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H9955	007	0	1	01	01	H9955_007_0	8		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9955	007	0	1	01	01	H9955_007_0	8		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9955	007	0	1	01	01	H9955_007_0	8		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9955	007	0	1	01	01	H9955_007_0	8		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9955	007	0	1	01	01	H9955_007_0	8		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H9955	008	0	1	01	01	H9955_008_0	9		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H9955	008	0	1	01	01	H9955_008_0	9		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9955	008	0	1	01	01	H9955_008_0	9		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9955	008	0	1	01	01	H9955_008_0	9		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9955	008	0	1	01	01	H9955_008_0	9		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9955	008	0	1	01	01	H9955_008_0	9		N	Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	01	1	2	0.00	
H9977	001	0	1	01	01	H9977_001_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H9977	001	0	1	01	01	H9977_001_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H9977	001	0	1	01	01	H9977_001_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9977	001	0	1	01	01	H9977_001_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9977	001	0	1	01	01	H9977_001_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9977	002	0	1	01	01	H9977_002_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H9977	002	0	1	01	01	H9977_002_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H9977	002	0	1	01	01	H9977_002_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9977	002	0	1	01	01	H9977_002_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9977	002	0	1	01	01	H9977_002_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9977	003	0	1	01	01	H9977_003_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H9977	003	0	1	01	01	H9977_003_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9977	003	0	1	01	01	H9977_003_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9977	003	0	1	01	01	H9977_003_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9977	003	0	1	01	01	H9977_003_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9977	003	0	1	01	01	H9977_003_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9977	004	0	1	01	01	H9977_004_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H9977	004	0	1	01	01	H9977_004_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9977	004	0	1	01	01	H9977_004_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9977	004	0	1	01	01	H9977_004_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9977	004	0	1	01	01	H9977_004_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9977	004	0	1	01	01	H9977_004_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
H9977	005	0	1	01	01	H9977_005_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H9977	005	0	1	01	01	H9977_005_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
H9977	005	0	1	01	01	H9977_005_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9977	005	0	1	01	01	H9977_005_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9977	005	0	1	01	01	H9977_005_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9977	006	0	1	01	01	H9977_006_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
H9977	006	0	1	01	01	H9977_006_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	3.00	
H9977	006	0	1	01	01	H9977_006_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
H9977	006	0	1	01	01	H9977_006_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
H9977	006	0	1	01	01	H9977_006_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
H9977	007	0	1	01	01	H9977_007_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
H9977	007	0	1	01	01	H9977_007_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
H9977	007	0	1	01	01	H9977_007_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
H9977	007	0	1	01	01	H9977_007_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
H9977	007	0	1	01	01	H9977_007_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
H9977	007	0	1	01	01	H9977_007_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
R0110	003	0	1	31	11	R0110_003_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
R0110	003	0	1	31	11	R0110_003_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
R0110	003	0	1	31	11	R0110_003_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
R0110	003	0	1	31	11	R0110_003_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
R0110	003	0	1	31	11	R0110_003_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
R0110	005	0	1	31	11	R0110_005_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
R0110	005	0	1	31	11	R0110_005_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
R0110	005	0	1	31	11	R0110_005_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
R0110	005	0	1	31	11	R0110_005_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
R0110	005	0	1	31	11	R0110_005_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
R0110	008	0	1	31	11	R0110_008_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
R0110	008	0	1	31	11	R0110_008_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
R0110	008	0	1	31	11	R0110_008_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
R0110	008	0	1	31	11	R0110_008_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
R0110	008	0	1	31	11	R0110_008_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
R0110	012	0	1	31	11	R0110_012_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
R0110	012	0	1	31	11	R0110_012_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
R0110	012	0	1	31	11	R0110_012_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
R0110	012	0	1	31	11	R0110_012_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
R0110	012	0	1	31	11	R0110_012_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
R0110	018	0	1	31	11	R0110_018_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
R0110	018	0	1	31	11	R0110_018_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
R0110	018	0	1	31	11	R0110_018_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
R0110	018	0	1	31	11	R0110_018_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
R0110	018	0	1	31	11	R0110_018_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
R0110	020	0	1	31	11	R0110_020_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
R0110	020	0	1	31	11	R0110_020_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
R0110	020	0	1	31	11	R0110_020_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
R0110	020	0	1	31	11	R0110_020_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
R0110	020	0	1	31	11	R0110_020_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
R0759	001	0	1	31	11	R0759_001_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
R0759	001	0	1	31	11	R0759_001_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	8.00	
R0759	001	0	1	31	11	R0759_001_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
R0759	001	0	1	31	11	R0759_001_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
R0759	001	0	1	31	11	R0759_001_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
R0759	003	0	1	31	11	R0759_003_0	5		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
R0759	003	0	1	31	11	R0759_003_0	5		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
R0759	003	0	1	31	11	R0759_003_0	5		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
R0759	003	0	1	31	11	R0759_003_0	5		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
R0759	003	0	1	31	11	R0759_003_0	5		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
R1532	002	0	1	31	11	R1532_002_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
R1532	002	0	1	31	11	R1532_002_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
R1532	002	0	1	31	11	R1532_002_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
R1532	002	0	1	31	11	R1532_002_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
R1532	002	0	1	31	11	R1532_002_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
R3444	009	0	1	31	11	R3444_009_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
R3444	009	0	1	31	11	R3444_009_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	15.00	
R3444	009	0	1	31	11	R3444_009_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
R3444	009	0	1	31	11	R3444_009_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
R3444	009	0	1	31	11	R3444_009_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
R3444	012	0	1	31	11	R3444_012_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
R3444	012	0	1	31	11	R3444_012_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
R3444	012	0	1	31	11	R3444_012_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
R3444	012	0	1	31	11	R3444_012_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
R3444	012	0	1	31	11	R3444_012_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
R4182	003	0	1	31	11	R4182_003_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
R4182	003	0	1	31	11	R4182_003_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
R4182	003	0	1	31	11	R4182_003_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
R4182	003	0	1	31	11	R4182_003_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
R4182	003	0	1	31	11	R4182_003_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
R4182	004	0	1	31	11	R4182_004_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
R4182	004	0	1	31	11	R4182_004_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
R4182	004	0	1	31	11	R4182_004_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
R4182	004	0	1	31	11	R4182_004_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
R4182	004	0	1	31	11	R4182_004_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
R5361	002	0	1	31	11	R5361_002_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
R5361	002	0	1	31	11	R5361_002_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
R5361	002	0	1	31	11	R5361_002_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
R5361	002	0	1	31	11	R5361_002_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
R5361	002	0	1	31	11	R5361_002_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
R5826	005	0	1	31	11	R5826_005_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	3	2	0.00	
R5826	005	0	1	31	11	R5826_005_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
R5826	005	0	1	31	11	R5826_005_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
R5826	005	0	1	31	11	R5826_005_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
R5826	005	0	1	31	11	R5826_005_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
R5941	014	0	1	31	11	R5941_014_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
R5941	014	0	1	31	11	R5941_014_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
R5941	014	0	1	31	11	R5941_014_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
R5941	014	0	1	31	11	R5941_014_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
R5941	014	0	1	31	11	R5941_014_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
R5941	014	0	1	31	11	R5941_014_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
R5941	016	0	1	31	11	R5941_016_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
R5941	016	0	1	31	11	R5941_016_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
R5941	016	0	1	31	11	R5941_016_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
R5941	016	0	1	31	11	R5941_016_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
R5941	016	0	1	31	11	R5941_016_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
R5941	016	0	1	31	11	R5941_016_0	6			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
R6694	006	0	1	31	11	R6694_006_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
R6694	006	0	1	31	11	R6694_006_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
R6694	006	0	1	31	11	R6694_006_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
R6694	006	0	1	31	11	R6694_006_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
R6694	006	0	1	31	11	R6694_006_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
R6801	008	0	1	31	11	R6801_008_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
R6801	008	0	1	31	11	R6801_008_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
R6801	008	0	1	31	11	R6801_008_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
R6801	008	0	1	31	11	R6801_008_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
R6801	008	0	1	31	11	R6801_008_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
R6801	009	0	1	31	11	R6801_009_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
R6801	009	0	1	31	11	R6801_009_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
R6801	009	0	1	31	11	R6801_009_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
R6801	009	0	1	31	11	R6801_009_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
R6801	009	0	1	31	11	R6801_009_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
R6801	011	0	1	31	11	R6801_011_0	4		N	Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
R6801	011	0	1	31	11	R6801_011_0	4		N	Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
R6801	011	0	1	31	11	R6801_011_0	4		N	Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
R6801	011	0	1	31	11	R6801_011_0	4		N	Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
R6801	011	0	1	31	11	R6801_011_0	4		N	Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
R6801	012	0	1	31	11	R6801_012_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
R6801	012	0	1	31	11	R6801_012_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	14.00	
R6801	012	0	1	31	11	R6801_012_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
R6801	012	0	1	31	11	R6801_012_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
R6801	012	0	1	31	11	R6801_012_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
R7220	002	0	1	31	11	R7220_002_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
R7220	002	0	1	31	11	R7220_002_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
R7220	002	0	1	31	11	R7220_002_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
R7220	002	0	1	31	11	R7220_002_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
R7220	002	0	1	31	11	R7220_002_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S1030	001	0		29	10	S1030_001_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S1030	001	0		29	10	S1030_001_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S1030	001	0		29	10	S1030_001_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
S1030	001	0		29	10	S1030_001_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S1030	001	0		29	10	S1030_001_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S1030	006	0		29	10	S1030_006_0	3			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S1030	006	0		29	10	S1030_006_0	3			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S1030	006	0		29	10	S1030_006_0	3			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S1030	006	0		29	10	S1030_006_0	3			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S1030	006	0		29	10	S1030_006_0	3			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S2468	003	0		29	10	S2468_003_0	4			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S2468	003	0		29	10	S2468_003_0	4			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S2468	003	0		29	10	S2468_003_0	4			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S2468	003	0		29	10	S2468_003_0	4			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S2468	003	0		29	10	S2468_003_0	4			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S2468	004	0		29	10	S2468_004_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S2468	004	0		29	10	S2468_004_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S2468	004	0		29	10	S2468_004_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S2468	004	0		29	10	S2468_004_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S2468	004	0		29	10	S2468_004_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S2893	001	0		29	10	S2893_001_0	2			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S2893	001	0		29	10	S2893_001_0	2			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S2893	001	0		29	10	S2893_001_0	2			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S2893	001	0		29	10	S2893_001_0	2			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S2893	001	0		29	10	S2893_001_0	2			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S2893	003	0		29	10	S2893_003_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S2893	003	0		29	10	S2893_003_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S2893	003	0		29	10	S2893_003_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S2893	003	0		29	10	S2893_003_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S2893	003	0		29	10	S2893_003_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S4802	012	0		29	10	S4802_012_0	3			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S4802	012	0		29	10	S4802_012_0	3			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S4802	012	0		29	10	S4802_012_0	3			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S4802	012	0		29	10	S4802_012_0	3			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S4802	012	0		29	10	S4802_012_0	3			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S4802	013	0		29	10	S4802_013_0	3			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S4802	013	0		29	10	S4802_013_0	3			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S4802	013	0		29	10	S4802_013_0	3			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S4802	013	0		29	10	S4802_013_0	3			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S4802	013	0		29	10	S4802_013_0	3			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S4802	014	0		29	10	S4802_014_0	3			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S4802	014	0		29	10	S4802_014_0	3			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S4802	014	0		29	10	S4802_014_0	3			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S4802	014	0		29	10	S4802_014_0	3			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S4802	014	0		29	10	S4802_014_0	3			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S4802	020	0		29	10	S4802_020_0	3			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S4802	020	0		29	10	S4802_020_0	3			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S4802	020	0		29	10	S4802_020_0	3			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S4802	020	0		29	10	S4802_020_0	3			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S4802	020	0		29	10	S4802_020_0	3			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S4802	021	0		29	10	S4802_021_0	3			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S4802	021	0		29	10	S4802_021_0	3			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S4802	021	0		29	10	S4802_021_0	3			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S4802	021	0		29	10	S4802_021_0	3			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S4802	021	0		29	10	S4802_021_0	3			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S4802	069	0		29	10	S4802_069_0	3			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S4802	069	0		29	10	S4802_069_0	3			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S4802	069	0		29	10	S4802_069_0	3			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S4802	069	0		29	10	S4802_069_0	3			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S4802	069	0		29	10	S4802_069_0	3			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S4802	070	0		29	10	S4802_070_0	3			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S4802	070	0		29	10	S4802_070_0	3			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S4802	070	0		29	10	S4802_070_0	3			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S4802	070	0		29	10	S4802_070_0	3			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S4802	070	0		29	10	S4802_070_0	3			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S4802	071	0		29	10	S4802_071_0	3			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S4802	071	0		29	10	S4802_071_0	3			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S4802	071	0		29	10	S4802_071_0	3			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S4802	071	0		29	10	S4802_071_0	3			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S4802	071	0		29	10	S4802_071_0	3			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S4802	072	0		29	10	S4802_072_0	3			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S4802	072	0		29	10	S4802_072_0	3			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S4802	072	0		29	10	S4802_072_0	3			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S4802	072	0		29	10	S4802_072_0	3			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S4802	072	0		29	10	S4802_072_0	3			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S4802	073	0		29	10	S4802_073_0	3			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S4802	073	0		29	10	S4802_073_0	3			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S4802	073	0		29	10	S4802_073_0	3			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S4802	073	0		29	10	S4802_073_0	3			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S4802	073	0		29	10	S4802_073_0	3			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S4802	074	0		29	10	S4802_074_0	3			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S4802	074	0		29	10	S4802_074_0	3			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S4802	074	0		29	10	S4802_074_0	3			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S4802	074	0		29	10	S4802_074_0	3			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S4802	074	0		29	10	S4802_074_0	3			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S4802	075	0		29	10	S4802_075_0	3			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S4802	075	0		29	10	S4802_075_0	3			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S4802	075	0		29	10	S4802_075_0	3			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S4802	075	0		29	10	S4802_075_0	3			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S4802	075	0		29	10	S4802_075_0	3			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S4802	076	0		29	10	S4802_076_0	3			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S4802	076	0		29	10	S4802_076_0	3			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S4802	076	0		29	10	S4802_076_0	3			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S4802	076	0		29	10	S4802_076_0	3			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S4802	076	0		29	10	S4802_076_0	3			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S4802	077	0		29	10	S4802_077_0	3			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S4802	077	0		29	10	S4802_077_0	3			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S4802	077	0		29	10	S4802_077_0	3			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S4802	077	0		29	10	S4802_077_0	3			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S4802	077	0		29	10	S4802_077_0	3			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S4802	078	0		29	10	S4802_078_0	3			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S4802	078	0		29	10	S4802_078_0	3			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S4802	078	0		29	10	S4802_078_0	3			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S4802	078	0		29	10	S4802_078_0	3			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S4802	078	0		29	10	S4802_078_0	3			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S4802	079	0		29	10	S4802_079_0	3			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S4802	079	0		29	10	S4802_079_0	3			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S4802	079	0		29	10	S4802_079_0	3			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S4802	079	0		29	10	S4802_079_0	3			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S4802	079	0		29	10	S4802_079_0	3			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S4802	080	0		29	10	S4802_080_0	3			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S4802	080	0		29	10	S4802_080_0	3			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S4802	080	0		29	10	S4802_080_0	3			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S4802	080	0		29	10	S4802_080_0	3			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S4802	080	0		29	10	S4802_080_0	3			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S4802	081	0		29	10	S4802_081_0	3			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S4802	081	0		29	10	S4802_081_0	3			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S4802	081	0		29	10	S4802_081_0	3			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S4802	081	0		29	10	S4802_081_0	3			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S4802	081	0		29	10	S4802_081_0	3			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S4802	082	0		29	10	S4802_082_0	3			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S4802	082	0		29	10	S4802_082_0	3			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S4802	082	0		29	10	S4802_082_0	3			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S4802	082	0		29	10	S4802_082_0	3			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S4802	082	0		29	10	S4802_082_0	3			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S4802	083	0		29	10	S4802_083_0	3			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S4802	083	0		29	10	S4802_083_0	3			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S4802	083	0		29	10	S4802_083_0	3			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S4802	083	0		29	10	S4802_083_0	3			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S4802	083	0		29	10	S4802_083_0	3			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S4802	084	0		29	10	S4802_084_0	3			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S4802	084	0		29	10	S4802_084_0	3			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S4802	084	0		29	10	S4802_084_0	3			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S4802	084	0		29	10	S4802_084_0	3			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S4802	084	0		29	10	S4802_084_0	3			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S4802	085	0		29	10	S4802_085_0	3			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S4802	085	0		29	10	S4802_085_0	3			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S4802	085	0		29	10	S4802_085_0	3			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S4802	085	0		29	10	S4802_085_0	3			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S4802	085	0		29	10	S4802_085_0	3			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S4802	086	0		29	10	S4802_086_0	3			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S4802	086	0		29	10	S4802_086_0	3			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S4802	086	0		29	10	S4802_086_0	3			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S4802	086	0		29	10	S4802_086_0	3			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S4802	086	0		29	10	S4802_086_0	3			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S4802	087	0		29	10	S4802_087_0	3			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S4802	087	0		29	10	S4802_087_0	3			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S4802	087	0		29	10	S4802_087_0	3			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S4802	087	0		29	10	S4802_087_0	3			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S4802	087	0		29	10	S4802_087_0	3			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S4802	088	0		29	10	S4802_088_0	3			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S4802	088	0		29	10	S4802_088_0	3			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S4802	088	0		29	10	S4802_088_0	3			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S4802	088	0		29	10	S4802_088_0	3			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S4802	088	0		29	10	S4802_088_0	3			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S4802	089	0		29	10	S4802_089_0	3			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S4802	089	0		29	10	S4802_089_0	3			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S4802	089	0		29	10	S4802_089_0	3			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S4802	089	0		29	10	S4802_089_0	3			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S4802	089	0		29	10	S4802_089_0	3			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S4802	090	0		29	10	S4802_090_0	3			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S4802	090	0		29	10	S4802_090_0	3			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S4802	090	0		29	10	S4802_090_0	3			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S4802	090	0		29	10	S4802_090_0	3			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S4802	090	0		29	10	S4802_090_0	3			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S4802	091	0		29	10	S4802_091_0	3			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S4802	091	0		29	10	S4802_091_0	3			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S4802	091	0		29	10	S4802_091_0	3			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S4802	091	0		29	10	S4802_091_0	3			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S4802	091	0		29	10	S4802_091_0	3			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S4802	092	0		29	10	S4802_092_0	3			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S4802	092	0		29	10	S4802_092_0	3			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S4802	092	0		29	10	S4802_092_0	3			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S4802	092	0		29	10	S4802_092_0	3			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S4802	092	0		29	10	S4802_092_0	3			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S4802	093	0		29	10	S4802_093_0	3			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S4802	093	0		29	10	S4802_093_0	3			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S4802	093	0		29	10	S4802_093_0	3			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S4802	093	0		29	10	S4802_093_0	3			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S4802	093	0		29	10	S4802_093_0	3			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S4802	094	0		29	10	S4802_094_0	3			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S4802	094	0		29	10	S4802_094_0	3			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S4802	094	0		29	10	S4802_094_0	3			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S4802	094	0		29	10	S4802_094_0	3			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S4802	094	0		29	10	S4802_094_0	3			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S4802	095	0		29	10	S4802_095_0	3			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S4802	095	0		29	10	S4802_095_0	3			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S4802	095	0		29	10	S4802_095_0	3			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S4802	095	0		29	10	S4802_095_0	3			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S4802	095	0		29	10	S4802_095_0	3			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S4802	096	0		29	10	S4802_096_0	3			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S4802	096	0		29	10	S4802_096_0	3			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S4802	096	0		29	10	S4802_096_0	3			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S4802	096	0		29	10	S4802_096_0	3			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S4802	096	0		29	10	S4802_096_0	3			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S4802	097	0		29	10	S4802_097_0	3			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S4802	097	0		29	10	S4802_097_0	3			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S4802	097	0		29	10	S4802_097_0	3			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S4802	097	0		29	10	S4802_097_0	3			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S4802	097	0		29	10	S4802_097_0	3			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S4802	132	0		29	10	S4802_132_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
S4802	132	0		29	10	S4802_132_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
S4802	132	0		29	10	S4802_132_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
S4802	132	0		29	10	S4802_132_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
S4802	132	0		29	10	S4802_132_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
S4802	132	0		29	10	S4802_132_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
S4802	133	0		29	10	S4802_133_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
S4802	133	0		29	10	S4802_133_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
S4802	133	0		29	10	S4802_133_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
S4802	133	0		29	10	S4802_133_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
S4802	133	0		29	10	S4802_133_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
S4802	133	0		29	10	S4802_133_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
S4802	134	0		29	10	S4802_134_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
S4802	134	0		29	10	S4802_134_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
S4802	134	0		29	10	S4802_134_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
S4802	134	0		29	10	S4802_134_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
S4802	134	0		29	10	S4802_134_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
S4802	134	0		29	10	S4802_134_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
S4802	135	0		29	10	S4802_135_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
S4802	135	0		29	10	S4802_135_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
S4802	135	0		29	10	S4802_135_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
S4802	135	0		29	10	S4802_135_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
S4802	135	0		29	10	S4802_135_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
S4802	135	0		29	10	S4802_135_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
S4802	136	0		29	10	S4802_136_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
S4802	136	0		29	10	S4802_136_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
S4802	136	0		29	10	S4802_136_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
S4802	136	0		29	10	S4802_136_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
S4802	136	0		29	10	S4802_136_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
S4802	136	0		29	10	S4802_136_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
S4802	137	0		29	10	S4802_137_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
S4802	137	0		29	10	S4802_137_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
S4802	137	0		29	10	S4802_137_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
S4802	137	0		29	10	S4802_137_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
S4802	137	0		29	10	S4802_137_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
S4802	137	0		29	10	S4802_137_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
S4802	138	0		29	10	S4802_138_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
S4802	138	0		29	10	S4802_138_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
S4802	138	0		29	10	S4802_138_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
S4802	138	0		29	10	S4802_138_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
S4802	138	0		29	10	S4802_138_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
S4802	138	0		29	10	S4802_138_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
S4802	139	0		29	10	S4802_139_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
S4802	139	0		29	10	S4802_139_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
S4802	139	0		29	10	S4802_139_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
S4802	139	0		29	10	S4802_139_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
S4802	139	0		29	10	S4802_139_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
S4802	139	0		29	10	S4802_139_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
S4802	140	0		29	10	S4802_140_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
S4802	140	0		29	10	S4802_140_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
S4802	140	0		29	10	S4802_140_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
S4802	140	0		29	10	S4802_140_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
S4802	140	0		29	10	S4802_140_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
S4802	140	0		29	10	S4802_140_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
S4802	141	0		29	10	S4802_141_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
S4802	141	0		29	10	S4802_141_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
S4802	141	0		29	10	S4802_141_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
S4802	141	0		29	10	S4802_141_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
S4802	141	0		29	10	S4802_141_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
S4802	141	0		29	10	S4802_141_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
S4802	142	0		29	10	S4802_142_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
S4802	142	0		29	10	S4802_142_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
S4802	142	0		29	10	S4802_142_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
S4802	142	0		29	10	S4802_142_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
S4802	142	0		29	10	S4802_142_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
S4802	142	0		29	10	S4802_142_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
S4802	143	0		29	10	S4802_143_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
S4802	143	0		29	10	S4802_143_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
S4802	143	0		29	10	S4802_143_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
S4802	143	0		29	10	S4802_143_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
S4802	143	0		29	10	S4802_143_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
S4802	143	0		29	10	S4802_143_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
S4802	144	0		29	10	S4802_144_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
S4802	144	0		29	10	S4802_144_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
S4802	144	0		29	10	S4802_144_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
S4802	144	0		29	10	S4802_144_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
S4802	144	0		29	10	S4802_144_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
S4802	144	0		29	10	S4802_144_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
S4802	145	0		29	10	S4802_145_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
S4802	145	0		29	10	S4802_145_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
S4802	145	0		29	10	S4802_145_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
S4802	145	0		29	10	S4802_145_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
S4802	145	0		29	10	S4802_145_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
S4802	145	0		29	10	S4802_145_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
S4802	146	0		29	10	S4802_146_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
S4802	146	0		29	10	S4802_146_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
S4802	146	0		29	10	S4802_146_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
S4802	146	0		29	10	S4802_146_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
S4802	146	0		29	10	S4802_146_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
S4802	146	0		29	10	S4802_146_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
S4802	147	0		29	10	S4802_147_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
S4802	147	0		29	10	S4802_147_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
S4802	147	0		29	10	S4802_147_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
S4802	147	0		29	10	S4802_147_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
S4802	147	0		29	10	S4802_147_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
S4802	147	0		29	10	S4802_147_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
S4802	148	0		29	10	S4802_148_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
S4802	148	0		29	10	S4802_148_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
S4802	148	0		29	10	S4802_148_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
S4802	148	0		29	10	S4802_148_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
S4802	148	0		29	10	S4802_148_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
S4802	148	0		29	10	S4802_148_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
S4802	149	0		29	10	S4802_149_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
S4802	149	0		29	10	S4802_149_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
S4802	149	0		29	10	S4802_149_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
S4802	149	0		29	10	S4802_149_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
S4802	149	0		29	10	S4802_149_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
S4802	149	0		29	10	S4802_149_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
S4802	150	0		29	10	S4802_150_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
S4802	150	0		29	10	S4802_150_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
S4802	150	0		29	10	S4802_150_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
S4802	150	0		29	10	S4802_150_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
S4802	150	0		29	10	S4802_150_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
S4802	150	0		29	10	S4802_150_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
S4802	151	0		29	10	S4802_151_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
S4802	151	0		29	10	S4802_151_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
S4802	151	0		29	10	S4802_151_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
S4802	151	0		29	10	S4802_151_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
S4802	151	0		29	10	S4802_151_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
S4802	151	0		29	10	S4802_151_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
S4802	152	0		29	10	S4802_152_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
S4802	152	0		29	10	S4802_152_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
S4802	152	0		29	10	S4802_152_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
S4802	152	0		29	10	S4802_152_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
S4802	152	0		29	10	S4802_152_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
S4802	152	0		29	10	S4802_152_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
S4802	153	0		29	10	S4802_153_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
S4802	153	0		29	10	S4802_153_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
S4802	153	0		29	10	S4802_153_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
S4802	153	0		29	10	S4802_153_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
S4802	153	0		29	10	S4802_153_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
S4802	153	0		29	10	S4802_153_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
S4802	154	0		29	10	S4802_154_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
S4802	154	0		29	10	S4802_154_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
S4802	154	0		29	10	S4802_154_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
S4802	154	0		29	10	S4802_154_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
S4802	154	0		29	10	S4802_154_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
S4802	154	0		29	10	S4802_154_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
S4802	155	0		29	10	S4802_155_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
S4802	155	0		29	10	S4802_155_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
S4802	155	0		29	10	S4802_155_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
S4802	155	0		29	10	S4802_155_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
S4802	155	0		29	10	S4802_155_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
S4802	155	0		29	10	S4802_155_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
S4802	156	0		29	10	S4802_156_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
S4802	156	0		29	10	S4802_156_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
S4802	156	0		29	10	S4802_156_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
S4802	156	0		29	10	S4802_156_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
S4802	156	0		29	10	S4802_156_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
S4802	156	0		29	10	S4802_156_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
S4802	157	0		29	10	S4802_157_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
S4802	157	0		29	10	S4802_157_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
S4802	157	0		29	10	S4802_157_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
S4802	157	0		29	10	S4802_157_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
S4802	157	0		29	10	S4802_157_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
S4802	157	0		29	10	S4802_157_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
S4802	158	0		29	10	S4802_158_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
S4802	158	0		29	10	S4802_158_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
S4802	158	0		29	10	S4802_158_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
S4802	158	0		29	10	S4802_158_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
S4802	158	0		29	10	S4802_158_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
S4802	158	0		29	10	S4802_158_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
S4802	159	0		29	10	S4802_159_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
S4802	159	0		29	10	S4802_159_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
S4802	159	0		29	10	S4802_159_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
S4802	159	0		29	10	S4802_159_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
S4802	159	0		29	10	S4802_159_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
S4802	159	0		29	10	S4802_159_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
S4802	160	0		29	10	S4802_160_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
S4802	160	0		29	10	S4802_160_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
S4802	160	0		29	10	S4802_160_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
S4802	160	0		29	10	S4802_160_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
S4802	160	0		29	10	S4802_160_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
S4802	160	0		29	10	S4802_160_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
S4802	161	0		29	10	S4802_161_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
S4802	161	0		29	10	S4802_161_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
S4802	161	0		29	10	S4802_161_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
S4802	161	0		29	10	S4802_161_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
S4802	161	0		29	10	S4802_161_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
S4802	161	0		29	10	S4802_161_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
S4802	162	0		29	10	S4802_162_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
S4802	162	0		29	10	S4802_162_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
S4802	162	0		29	10	S4802_162_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
S4802	162	0		29	10	S4802_162_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
S4802	162	0		29	10	S4802_162_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
S4802	162	0		29	10	S4802_162_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
S4802	163	0		29	10	S4802_163_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
S4802	163	0		29	10	S4802_163_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
S4802	163	0		29	10	S4802_163_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
S4802	163	0		29	10	S4802_163_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
S4802	163	0		29	10	S4802_163_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
S4802	163	0		29	10	S4802_163_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
S4802	164	0		29	10	S4802_164_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
S4802	164	0		29	10	S4802_164_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
S4802	164	0		29	10	S4802_164_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
S4802	164	0		29	10	S4802_164_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
S4802	164	0		29	10	S4802_164_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
S4802	164	0		29	10	S4802_164_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
S4802	165	0		29	10	S4802_165_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	11	1	2	0.00	
S4802	165	0		29	10	S4802_165_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	11	1	2	0.00	
S4802	165	0		29	10	S4802_165_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
S4802	165	0		29	10	S4802_165_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
S4802	165	0		29	10	S4802_165_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
S4802	165	0		29	10	S4802_165_0	4			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
S5540	002	0		29	10	S5540_002_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5540	002	0		29	10	S5540_002_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5540	002	0		29	10	S5540_002_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5540	002	0		29	10	S5540_002_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5540	002	0		29	10	S5540_002_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5540	004	0		29	10	S5540_004_0	9			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5540	004	0		29	10	S5540_004_0	9			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5540	004	0		29	10	S5540_004_0	9			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5540	004	0		29	10	S5540_004_0	9			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5540	004	0		29	10	S5540_004_0	9			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5584	001	0		29	10	S5584_001_0	4			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5584	001	0		29	10	S5584_001_0	4			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5584	001	0		29	10	S5584_001_0	4			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5584	001	0		29	10	S5584_001_0	4			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5584	001	0		29	10	S5584_001_0	4			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5584	002	0		29	10	S5584_002_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5584	002	0		29	10	S5584_002_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5584	002	0		29	10	S5584_002_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5584	002	0		29	10	S5584_002_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5584	002	0		29	10	S5584_002_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5593	003	0		29	10	S5593_003_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5593	003	0		29	10	S5593_003_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5593	003	0		29	10	S5593_003_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5593	003	0		29	10	S5593_003_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5593	003	0		29	10	S5593_003_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5601	002	0		29	10	S5601_002_0	2			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5601	002	0		29	10	S5601_002_0	2			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5601	002	0		29	10	S5601_002_0	2			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5601	002	0		29	10	S5601_002_0	2			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5601	002	0		29	10	S5601_002_0	2			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5601	004	0		29	10	S5601_004_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5601	004	0		29	10	S5601_004_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5601	004	0		29	10	S5601_004_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5601	004	0		29	10	S5601_004_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5601	004	0		29	10	S5601_004_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5601	006	0		29	10	S5601_006_0	2			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5601	006	0		29	10	S5601_006_0	2			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5601	006	0		29	10	S5601_006_0	2			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5601	006	0		29	10	S5601_006_0	2			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5601	006	0		29	10	S5601_006_0	2			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5601	008	0		29	10	S5601_008_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5601	008	0		29	10	S5601_008_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5601	008	0		29	10	S5601_008_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5601	008	0		29	10	S5601_008_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5601	008	0		29	10	S5601_008_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5601	010	0		29	10	S5601_010_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5601	010	0		29	10	S5601_010_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5601	010	0		29	10	S5601_010_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5601	010	0		29	10	S5601_010_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5601	010	0		29	10	S5601_010_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5601	012	0		29	10	S5601_012_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5601	012	0		29	10	S5601_012_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5601	012	0		29	10	S5601_012_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5601	012	0		29	10	S5601_012_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5601	012	0		29	10	S5601_012_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5601	014	0		29	10	S5601_014_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5601	014	0		29	10	S5601_014_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5601	014	0		29	10	S5601_014_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5601	014	0		29	10	S5601_014_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5601	014	0		29	10	S5601_014_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5601	016	0		29	10	S5601_016_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5601	016	0		29	10	S5601_016_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5601	016	0		29	10	S5601_016_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5601	016	0		29	10	S5601_016_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5601	016	0		29	10	S5601_016_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5601	018	0		29	10	S5601_018_0	2			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5601	018	0		29	10	S5601_018_0	2			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5601	018	0		29	10	S5601_018_0	2			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5601	018	0		29	10	S5601_018_0	2			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5601	018	0		29	10	S5601_018_0	2			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5601	020	0		29	10	S5601_020_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5601	020	0		29	10	S5601_020_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5601	020	0		29	10	S5601_020_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5601	020	0		29	10	S5601_020_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5601	020	0		29	10	S5601_020_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5601	022	0		29	10	S5601_022_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5601	022	0		29	10	S5601_022_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5601	022	0		29	10	S5601_022_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5601	022	0		29	10	S5601_022_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5601	022	0		29	10	S5601_022_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5601	024	0		29	10	S5601_024_0	2			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5601	024	0		29	10	S5601_024_0	2			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5601	024	0		29	10	S5601_024_0	2			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5601	024	0		29	10	S5601_024_0	2			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5601	024	0		29	10	S5601_024_0	2			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5601	026	0		29	10	S5601_026_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5601	026	0		29	10	S5601_026_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5601	026	0		29	10	S5601_026_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5601	026	0		29	10	S5601_026_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5601	026	0		29	10	S5601_026_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5601	028	0		29	10	S5601_028_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5601	028	0		29	10	S5601_028_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5601	028	0		29	10	S5601_028_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5601	028	0		29	10	S5601_028_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5601	028	0		29	10	S5601_028_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5601	030	0		29	10	S5601_030_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5601	030	0		29	10	S5601_030_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5601	030	0		29	10	S5601_030_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5601	030	0		29	10	S5601_030_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5601	030	0		29	10	S5601_030_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5601	032	0		29	10	S5601_032_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5601	032	0		29	10	S5601_032_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5601	032	0		29	10	S5601_032_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5601	032	0		29	10	S5601_032_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5601	032	0		29	10	S5601_032_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5601	034	0		29	10	S5601_034_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5601	034	0		29	10	S5601_034_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5601	034	0		29	10	S5601_034_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5601	034	0		29	10	S5601_034_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5601	034	0		29	10	S5601_034_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5601	036	0		29	10	S5601_036_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5601	036	0		29	10	S5601_036_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5601	036	0		29	10	S5601_036_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5601	036	0		29	10	S5601_036_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5601	036	0		29	10	S5601_036_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5601	038	0		29	10	S5601_038_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5601	038	0		29	10	S5601_038_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5601	038	0		29	10	S5601_038_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5601	038	0		29	10	S5601_038_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5601	038	0		29	10	S5601_038_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5601	040	0		29	10	S5601_040_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5601	040	0		29	10	S5601_040_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5601	040	0		29	10	S5601_040_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5601	040	0		29	10	S5601_040_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5601	040	0		29	10	S5601_040_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5601	042	0		29	10	S5601_042_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5601	042	0		29	10	S5601_042_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5601	042	0		29	10	S5601_042_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5601	042	0		29	10	S5601_042_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5601	042	0		29	10	S5601_042_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5601	044	0		29	10	S5601_044_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5601	044	0		29	10	S5601_044_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5601	044	0		29	10	S5601_044_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5601	044	0		29	10	S5601_044_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5601	044	0		29	10	S5601_044_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5601	048	0		29	10	S5601_048_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5601	048	0		29	10	S5601_048_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5601	048	0		29	10	S5601_048_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5601	048	0		29	10	S5601_048_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5601	048	0		29	10	S5601_048_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5601	050	0		29	10	S5601_050_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5601	050	0		29	10	S5601_050_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5601	050	0		29	10	S5601_050_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5601	050	0		29	10	S5601_050_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5601	050	0		29	10	S5601_050_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5601	052	0		29	10	S5601_052_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5601	052	0		29	10	S5601_052_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5601	052	0		29	10	S5601_052_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5601	052	0		29	10	S5601_052_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5601	052	0		29	10	S5601_052_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5601	054	0		29	10	S5601_054_0	2			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5601	054	0		29	10	S5601_054_0	2			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5601	054	0		29	10	S5601_054_0	2			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5601	054	0		29	10	S5601_054_0	2			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5601	054	0		29	10	S5601_054_0	2			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5601	056	0		29	10	S5601_056_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5601	056	0		29	10	S5601_056_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5601	056	0		29	10	S5601_056_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5601	056	0		29	10	S5601_056_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5601	056	0		29	10	S5601_056_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5601	058	0		29	10	S5601_058_0	2			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5601	058	0		29	10	S5601_058_0	2			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5601	058	0		29	10	S5601_058_0	2			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5601	058	0		29	10	S5601_058_0	2			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5601	058	0		29	10	S5601_058_0	2			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5601	060	0		29	10	S5601_060_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5601	060	0		29	10	S5601_060_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5601	060	0		29	10	S5601_060_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5601	060	0		29	10	S5601_060_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5601	060	0		29	10	S5601_060_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5601	062	0		29	10	S5601_062_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5601	062	0		29	10	S5601_062_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5601	062	0		29	10	S5601_062_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5601	062	0		29	10	S5601_062_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5601	062	0		29	10	S5601_062_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5601	064	0		29	10	S5601_064_0	2			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5601	064	0		29	10	S5601_064_0	2			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5601	064	0		29	10	S5601_064_0	2			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5601	064	0		29	10	S5601_064_0	2			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5601	064	0		29	10	S5601_064_0	2			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5601	066	0		29	10	S5601_066_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5601	066	0		29	10	S5601_066_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5601	066	0		29	10	S5601_066_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5601	066	0		29	10	S5601_066_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5601	066	0		29	10	S5601_066_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5601	068	0		29	10	S5601_068_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5601	068	0		29	10	S5601_068_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5601	068	0		29	10	S5601_068_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5601	068	0		29	10	S5601_068_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5601	068	0		29	10	S5601_068_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5617	003	0		29	10	S5617_003_0	4			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5617	003	0		29	10	S5617_003_0	4			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5617	003	0		29	10	S5617_003_0	4			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5617	003	0		29	10	S5617_003_0	4			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5617	003	0		29	10	S5617_003_0	4			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5617	008	0		29	10	S5617_008_0	5			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5617	008	0		29	10	S5617_008_0	5			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5617	008	0		29	10	S5617_008_0	5			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5617	008	0		29	10	S5617_008_0	5			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5617	008	0		29	10	S5617_008_0	5			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5617	013	0		29	10	S5617_013_0	4			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5617	013	0		29	10	S5617_013_0	4			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5617	013	0		29	10	S5617_013_0	4			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5617	013	0		29	10	S5617_013_0	4			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5617	013	0		29	10	S5617_013_0	4			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5617	018	0		29	10	S5617_018_0	4			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5617	018	0		29	10	S5617_018_0	4			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5617	018	0		29	10	S5617_018_0	4			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5617	018	0		29	10	S5617_018_0	4			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5617	018	0		29	10	S5617_018_0	4			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5617	068	0		29	10	S5617_068_0	4			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5617	068	0		29	10	S5617_068_0	4			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5617	068	0		29	10	S5617_068_0	4			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5617	068	0		29	10	S5617_068_0	4			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5617	068	0		29	10	S5617_068_0	4			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5617	088	0		29	10	S5617_088_0	4			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5617	088	0		29	10	S5617_088_0	4			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5617	088	0		29	10	S5617_088_0	4			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5617	088	0		29	10	S5617_088_0	4			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5617	088	0		29	10	S5617_088_0	4			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5617	103	0		29	10	S5617_103_0	4			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5617	103	0		29	10	S5617_103_0	4			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5617	103	0		29	10	S5617_103_0	4			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5617	103	0		29	10	S5617_103_0	4			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5617	103	0		29	10	S5617_103_0	4			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5617	108	0		29	10	S5617_108_0	4			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5617	108	0		29	10	S5617_108_0	4			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5617	108	0		29	10	S5617_108_0	4			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5617	108	0		29	10	S5617_108_0	4			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5617	108	0		29	10	S5617_108_0	4			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5617	113	0		29	10	S5617_113_0	4			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5617	113	0		29	10	S5617_113_0	4			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5617	113	0		29	10	S5617_113_0	4			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5617	113	0		29	10	S5617_113_0	4			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5617	113	0		29	10	S5617_113_0	4			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5617	118	0		29	10	S5617_118_0	4			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5617	118	0		29	10	S5617_118_0	4			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5617	118	0		29	10	S5617_118_0	4			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5617	118	0		29	10	S5617_118_0	4			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5617	118	0		29	10	S5617_118_0	4			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5617	123	0		29	10	S5617_123_0	4			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5617	123	0		29	10	S5617_123_0	4			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5617	123	0		29	10	S5617_123_0	4			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5617	123	0		29	10	S5617_123_0	4			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5617	123	0		29	10	S5617_123_0	4			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5617	128	0		29	10	S5617_128_0	5			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5617	128	0		29	10	S5617_128_0	5			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5617	128	0		29	10	S5617_128_0	5			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5617	128	0		29	10	S5617_128_0	5			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5617	128	0		29	10	S5617_128_0	5			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5617	133	0		29	10	S5617_133_0	5			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5617	133	0		29	10	S5617_133_0	5			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5617	133	0		29	10	S5617_133_0	5			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5617	133	0		29	10	S5617_133_0	5			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5617	133	0		29	10	S5617_133_0	5			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5617	138	0		29	10	S5617_138_0	4			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5617	138	0		29	10	S5617_138_0	4			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5617	138	0		29	10	S5617_138_0	4			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5617	138	0		29	10	S5617_138_0	4			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5617	138	0		29	10	S5617_138_0	4			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5617	143	0		29	10	S5617_143_0	4			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5617	143	0		29	10	S5617_143_0	4			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5617	143	0		29	10	S5617_143_0	4			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5617	143	0		29	10	S5617_143_0	4			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5617	143	0		29	10	S5617_143_0	4			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5617	148	0		29	10	S5617_148_0	5			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5617	148	0		29	10	S5617_148_0	5			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5617	148	0		29	10	S5617_148_0	5			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5617	148	0		29	10	S5617_148_0	5			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5617	148	0		29	10	S5617_148_0	5			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5617	153	0		29	10	S5617_153_0	4			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5617	153	0		29	10	S5617_153_0	4			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5617	153	0		29	10	S5617_153_0	4			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5617	153	0		29	10	S5617_153_0	4			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5617	153	0		29	10	S5617_153_0	4			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5617	158	0		29	10	S5617_158_0	4			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5617	158	0		29	10	S5617_158_0	4			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5617	158	0		29	10	S5617_158_0	4			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5617	158	0		29	10	S5617_158_0	4			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5617	158	0		29	10	S5617_158_0	4			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5617	214	0		29	10	S5617_214_0	4			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5617	214	0		29	10	S5617_214_0	4			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5617	214	0		29	10	S5617_214_0	4			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5617	214	0		29	10	S5617_214_0	4			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5617	214	0		29	10	S5617_214_0	4			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5617	215	0		29	10	S5617_215_0	4			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5617	215	0		29	10	S5617_215_0	4			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5617	215	0		29	10	S5617_215_0	4			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5617	215	0		29	10	S5617_215_0	4			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5617	215	0		29	10	S5617_215_0	4			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5617	216	0		29	10	S5617_216_0	4			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5617	216	0		29	10	S5617_216_0	4			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5617	216	0		29	10	S5617_216_0	4			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5617	216	0		29	10	S5617_216_0	4			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5617	216	0		29	10	S5617_216_0	4			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5617	217	0		29	10	S5617_217_0	4			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5617	217	0		29	10	S5617_217_0	4			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5617	217	0		29	10	S5617_217_0	4			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5617	217	0		29	10	S5617_217_0	4			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5617	217	0		29	10	S5617_217_0	4			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5617	218	0		29	10	S5617_218_0	5			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5617	218	0		29	10	S5617_218_0	5			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5617	218	0		29	10	S5617_218_0	5			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5617	218	0		29	10	S5617_218_0	5			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5617	218	0		29	10	S5617_218_0	5			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5617	219	0		29	10	S5617_219_0	5			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5617	219	0		29	10	S5617_219_0	5			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5617	219	0		29	10	S5617_219_0	5			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5617	219	0		29	10	S5617_219_0	5			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5617	219	0		29	10	S5617_219_0	5			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5617	220	0		29	10	S5617_220_0	4			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5617	220	0		29	10	S5617_220_0	4			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5617	220	0		29	10	S5617_220_0	4			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5617	220	0		29	10	S5617_220_0	4			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5617	220	0		29	10	S5617_220_0	4			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5617	221	0		29	10	S5617_221_0	4			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5617	221	0		29	10	S5617_221_0	4			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5617	221	0		29	10	S5617_221_0	4			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5617	221	0		29	10	S5617_221_0	4			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5617	221	0		29	10	S5617_221_0	4			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5617	222	0		29	10	S5617_222_0	4			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5617	222	0		29	10	S5617_222_0	4			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5617	222	0		29	10	S5617_222_0	4			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5617	222	0		29	10	S5617_222_0	4			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5617	222	0		29	10	S5617_222_0	4			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5617	223	0		29	10	S5617_223_0	4			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5617	223	0		29	10	S5617_223_0	4			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5617	223	0		29	10	S5617_223_0	4			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5617	223	0		29	10	S5617_223_0	4			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5617	223	0		29	10	S5617_223_0	4			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5617	224	0		29	10	S5617_224_0	4			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5617	224	0		29	10	S5617_224_0	4			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5617	224	0		29	10	S5617_224_0	4			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5617	224	0		29	10	S5617_224_0	4			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5617	224	0		29	10	S5617_224_0	4			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5617	225	0		29	10	S5617_225_0	5			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5617	225	0		29	10	S5617_225_0	5			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5617	225	0		29	10	S5617_225_0	5			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5617	225	0		29	10	S5617_225_0	5			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5617	225	0		29	10	S5617_225_0	5			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5617	226	0		29	10	S5617_226_0	4			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5617	226	0		29	10	S5617_226_0	4			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5617	226	0		29	10	S5617_226_0	4			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5617	226	0		29	10	S5617_226_0	4			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5617	226	0		29	10	S5617_226_0	4			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5617	227	0		29	10	S5617_227_0	5			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5617	227	0		29	10	S5617_227_0	5			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5617	227	0		29	10	S5617_227_0	5			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5617	227	0		29	10	S5617_227_0	5			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5617	227	0		29	10	S5617_227_0	5			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5617	348	0		29	10	S5617_348_0	5			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5617	348	0		29	10	S5617_348_0	5			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5617	348	0		29	10	S5617_348_0	5			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5617	348	0		29	10	S5617_348_0	5			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5617	348	0		29	10	S5617_348_0	5			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5617	353	0		29	10	S5617_353_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5617	353	0		29	10	S5617_353_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	11.00	
S5617	353	0		29	10	S5617_353_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5617	353	0		29	10	S5617_353_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	3	1		30
S5617	353	0		29	10	S5617_353_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5617	354	0		29	10	S5617_354_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5617	354	0		29	10	S5617_354_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	11.00	
S5617	354	0		29	10	S5617_354_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5617	354	0		29	10	S5617_354_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	3	1		30
S5617	354	0		29	10	S5617_354_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5617	355	0		29	10	S5617_355_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5617	355	0		29	10	S5617_355_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
S5617	355	0		29	10	S5617_355_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5617	355	0		29	10	S5617_355_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	3	1		34
S5617	355	0		29	10	S5617_355_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5617	356	0		29	10	S5617_356_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5617	356	0		29	10	S5617_356_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	11.00	
S5617	356	0		29	10	S5617_356_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5617	356	0		29	10	S5617_356_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	3	1		32
S5617	356	0		29	10	S5617_356_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5617	358	0		29	10	S5617_358_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5617	358	0		29	10	S5617_358_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
S5617	358	0		29	10	S5617_358_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5617	358	0		29	10	S5617_358_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	3	1		32
S5617	358	0		29	10	S5617_358_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5617	359	0		29	10	S5617_359_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5617	359	0		29	10	S5617_359_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
S5617	359	0		29	10	S5617_359_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5617	359	0		29	10	S5617_359_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	3	1		30
S5617	359	0		29	10	S5617_359_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5617	360	0		29	10	S5617_360_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5617	360	0		29	10	S5617_360_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	11.00	
S5617	360	0		29	10	S5617_360_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5617	360	0		29	10	S5617_360_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	3	1		32
S5617	360	0		29	10	S5617_360_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5617	362	0		29	10	S5617_362_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5617	362	0		29	10	S5617_362_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
S5617	362	0		29	10	S5617_362_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5617	362	0		29	10	S5617_362_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	3	1		33
S5617	362	0		29	10	S5617_362_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5617	363	0		29	10	S5617_363_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5617	363	0		29	10	S5617_363_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
S5617	363	0		29	10	S5617_363_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5617	363	0		29	10	S5617_363_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	3	1		33
S5617	363	0		29	10	S5617_363_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5617	364	0		29	10	S5617_364_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5617	364	0		29	10	S5617_364_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
S5617	364	0		29	10	S5617_364_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5617	364	0		29	10	S5617_364_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	3	1		32
S5617	364	0		29	10	S5617_364_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5617	365	0		29	10	S5617_365_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5617	365	0		29	10	S5617_365_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	11.00	
S5617	365	0		29	10	S5617_365_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5617	365	0		29	10	S5617_365_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	3	1		30
S5617	365	0		29	10	S5617_365_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5617	366	0		29	10	S5617_366_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5617	366	0		29	10	S5617_366_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	13.00	
S5617	366	0		29	10	S5617_366_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5617	366	0		29	10	S5617_366_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	3	1		34
S5617	366	0		29	10	S5617_366_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5617	367	0		29	10	S5617_367_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5617	367	0		29	10	S5617_367_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
S5617	367	0		29	10	S5617_367_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5617	367	0		29	10	S5617_367_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	3	1		32
S5617	367	0		29	10	S5617_367_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5617	368	0		29	10	S5617_368_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5617	368	0		29	10	S5617_368_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
S5617	368	0		29	10	S5617_368_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5617	368	0		29	10	S5617_368_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	3	1		32
S5617	368	0		29	10	S5617_368_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5617	369	0		29	10	S5617_369_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5617	369	0		29	10	S5617_369_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
S5617	369	0		29	10	S5617_369_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5617	369	0		29	10	S5617_369_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	3	1		35
S5617	369	0		29	10	S5617_369_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5617	370	0		29	10	S5617_370_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5617	370	0		29	10	S5617_370_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	11.00	
S5617	370	0		29	10	S5617_370_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5617	370	0		29	10	S5617_370_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	3	1		30
S5617	370	0		29	10	S5617_370_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5617	371	0		29	10	S5617_371_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5617	371	0		29	10	S5617_371_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
S5617	371	0		29	10	S5617_371_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5617	371	0		29	10	S5617_371_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	3	1		31
S5617	371	0		29	10	S5617_371_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5617	372	0		29	10	S5617_372_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5617	372	0		29	10	S5617_372_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
S5617	372	0		29	10	S5617_372_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5617	372	0		29	10	S5617_372_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	3	1		32
S5617	372	0		29	10	S5617_372_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5617	373	0		29	10	S5617_373_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5617	373	0		29	10	S5617_373_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
S5617	373	0		29	10	S5617_373_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5617	373	0		29	10	S5617_373_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	3	1		33
S5617	373	0		29	10	S5617_373_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5617	375	0		29	10	S5617_375_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5617	375	0		29	10	S5617_375_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
S5617	375	0		29	10	S5617_375_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5617	375	0		29	10	S5617_375_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	3	1		32
S5617	375	0		29	10	S5617_375_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5617	377	0		29	10	S5617_377_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5617	377	0		29	10	S5617_377_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
S5617	377	0		29	10	S5617_377_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5617	377	0		29	10	S5617_377_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	3	1		32
S5617	377	0		29	10	S5617_377_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5617	378	0		29	10	S5617_378_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5617	378	0		29	10	S5617_378_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
S5617	378	0		29	10	S5617_378_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5617	378	0		29	10	S5617_378_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	3	1		32
S5617	378	0		29	10	S5617_378_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5617	379	0		29	10	S5617_379_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5617	379	0		29	10	S5617_379_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
S5617	379	0		29	10	S5617_379_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5617	379	0		29	10	S5617_379_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	3	1		33
S5617	379	0		29	10	S5617_379_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5617	380	0		29	10	S5617_380_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5617	380	0		29	10	S5617_380_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	11.00	
S5617	380	0		29	10	S5617_380_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5617	380	0		29	10	S5617_380_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	3	1		31
S5617	380	0		29	10	S5617_380_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5617	381	0		29	10	S5617_381_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5617	381	0		29	10	S5617_381_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	11.00	
S5617	381	0		29	10	S5617_381_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5617	381	0		29	10	S5617_381_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	3	1		32
S5617	381	0		29	10	S5617_381_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5617	382	0		29	10	S5617_382_0	5			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5617	382	0		29	10	S5617_382_0	5			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	11.00	
S5617	382	0		29	10	S5617_382_0	5			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5617	382	0		29	10	S5617_382_0	5			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	3	1		30
S5617	382	0		29	10	S5617_382_0	5			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5617	385	0		29	10	S5617_385_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5617	385	0		29	10	S5617_385_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	12.00	
S5617	385	0		29	10	S5617_385_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5617	385	0		29	10	S5617_385_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	3	1		33
S5617	385	0		29	10	S5617_385_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5715	001	0		29	10	S5715_001_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5715	001	0		29	10	S5715_001_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5715	001	0		29	10	S5715_001_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5715	001	0		29	10	S5715_001_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5715	001	0		29	10	S5715_001_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5715	005	0		29	10	S5715_005_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5715	005	0		29	10	S5715_005_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5715	005	0		29	10	S5715_005_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5715	005	0		29	10	S5715_005_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5715	005	0		29	10	S5715_005_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5715	010	0		29	10	S5715_010_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5715	010	0		29	10	S5715_010_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5715	010	0		29	10	S5715_010_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5715	010	0		29	10	S5715_010_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5715	010	0		29	10	S5715_010_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5715	012	0		29	10	S5715_012_0	4			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5715	012	0		29	10	S5715_012_0	4			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5715	012	0		29	10	S5715_012_0	4			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5715	012	0		29	10	S5715_012_0	4			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5715	012	0		29	10	S5715_012_0	4			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5715	013	0		29	10	S5715_013_0	5			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5715	013	0		29	10	S5715_013_0	5			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5715	013	0		29	10	S5715_013_0	5			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5715	013	0		29	10	S5715_013_0	5			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5715	013	0		29	10	S5715_013_0	5			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5715	014	0		29	10	S5715_014_0	4			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5715	014	0		29	10	S5715_014_0	4			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5715	014	0		29	10	S5715_014_0	4			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5715	014	0		29	10	S5715_014_0	4			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5715	014	0		29	10	S5715_014_0	4			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5715	015	0		29	10	S5715_015_0	4			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5715	015	0		29	10	S5715_015_0	4			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5715	015	0		29	10	S5715_015_0	4			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5715	015	0		29	10	S5715_015_0	4			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5715	015	0		29	10	S5715_015_0	4			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5715	020	0		29	10	S5715_020_0	4			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5715	020	0		29	10	S5715_020_0	4			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5715	020	0		29	10	S5715_020_0	4			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5715	020	0		29	10	S5715_020_0	4			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5715	020	0		29	10	S5715_020_0	4			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5726	013	0		29	10	S5726_013_0	1			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5726	013	0		29	10	S5726_013_0	1			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5726	013	0		29	10	S5726_013_0	1			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5726	013	0		29	10	S5726_013_0	1			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5726	013	0		29	10	S5726_013_0	1			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5726	014	0		29	10	S5726_014_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5726	014	0		29	10	S5726_014_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
S5726	014	0		29	10	S5726_014_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5726	014	0		29	10	S5726_014_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5726	014	0		29	10	S5726_014_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5726	020	0		29	10	S5726_020_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5726	020	0		29	10	S5726_020_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	0.00	
S5726	020	0		29	10	S5726_020_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	10	1	2	0.00	
S5726	020	0		29	10	S5726_020_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5726	020	0		29	10	S5726_020_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	10	1	2	0.00	
S5743	001	0		29	10	S5743_001_0	3			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5743	001	0		29	10	S5743_001_0	3			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5743	001	0		29	10	S5743_001_0	3			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5743	001	0		29	10	S5743_001_0	3			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5743	001	0		29	10	S5743_001_0	3			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5795	002	0		29	10	S5795_002_0	3			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5795	002	0		29	10	S5795_002_0	3			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5795	002	0		29	10	S5795_002_0	3			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5795	002	0		29	10	S5795_002_0	3			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5795	002	0		29	10	S5795_002_0	3			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5795	003	0		29	10	S5795_003_0	3			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5795	003	0		29	10	S5795_003_0	3			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5795	003	0		29	10	S5795_003_0	3			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5795	003	0		29	10	S5795_003_0	3			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5795	003	0		29	10	S5795_003_0	3			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	101	0		29	10	S5884_101_0	4			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	101	0		29	10	S5884_101_0	4			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	101	0		29	10	S5884_101_0	4			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	101	0		29	10	S5884_101_0	4			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	101	0		29	10	S5884_101_0	4			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	102	0		29	10	S5884_102_0	2			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	102	0		29	10	S5884_102_0	2			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	102	0		29	10	S5884_102_0	2			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	102	0		29	10	S5884_102_0	2			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	102	0		29	10	S5884_102_0	2			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	103	0		29	10	S5884_103_0	2			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	103	0		29	10	S5884_103_0	2			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	103	0		29	10	S5884_103_0	2			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	103	0		29	10	S5884_103_0	2			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	103	0		29	10	S5884_103_0	2			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	104	0		29	10	S5884_104_0	2			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	104	0		29	10	S5884_104_0	2			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	104	0		29	10	S5884_104_0	2			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	104	0		29	10	S5884_104_0	2			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	104	0		29	10	S5884_104_0	2			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	105	0		29	10	S5884_105_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	105	0		29	10	S5884_105_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	105	0		29	10	S5884_105_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	105	0		29	10	S5884_105_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	105	0		29	10	S5884_105_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	106	0		29	10	S5884_106_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	106	0		29	10	S5884_106_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	106	0		29	10	S5884_106_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	106	0		29	10	S5884_106_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	106	0		29	10	S5884_106_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	107	0		29	10	S5884_107_0	2			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	107	0		29	10	S5884_107_0	2			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	107	0		29	10	S5884_107_0	2			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	107	0		29	10	S5884_107_0	2			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	107	0		29	10	S5884_107_0	2			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	108	0		29	10	S5884_108_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	108	0		29	10	S5884_108_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	108	0		29	10	S5884_108_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	108	0		29	10	S5884_108_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	108	0		29	10	S5884_108_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	109	0		29	10	S5884_109_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	109	0		29	10	S5884_109_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	109	0		29	10	S5884_109_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	109	0		29	10	S5884_109_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	109	0		29	10	S5884_109_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	110	0		29	10	S5884_110_0	3			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	110	0		29	10	S5884_110_0	3			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	110	0		29	10	S5884_110_0	3			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	110	0		29	10	S5884_110_0	3			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	110	0		29	10	S5884_110_0	3			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	111	0		29	10	S5884_111_0	3			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	111	0		29	10	S5884_111_0	3			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	111	0		29	10	S5884_111_0	3			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	111	0		29	10	S5884_111_0	3			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	111	0		29	10	S5884_111_0	3			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	112	0		29	10	S5884_112_0	2			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	112	0		29	10	S5884_112_0	2			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	112	0		29	10	S5884_112_0	2			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	112	0		29	10	S5884_112_0	2			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	112	0		29	10	S5884_112_0	2			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	113	0		29	10	S5884_113_0	2			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	113	0		29	10	S5884_113_0	2			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	113	0		29	10	S5884_113_0	2			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	113	0		29	10	S5884_113_0	2			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	113	0		29	10	S5884_113_0	2			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	114	0		29	10	S5884_114_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	114	0		29	10	S5884_114_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	114	0		29	10	S5884_114_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	114	0		29	10	S5884_114_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	114	0		29	10	S5884_114_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	115	0		29	10	S5884_115_0	2			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	115	0		29	10	S5884_115_0	2			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	115	0		29	10	S5884_115_0	2			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	115	0		29	10	S5884_115_0	2			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	115	0		29	10	S5884_115_0	2			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	116	0		29	10	S5884_116_0	3			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	116	0		29	10	S5884_116_0	3			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	116	0		29	10	S5884_116_0	3			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	116	0		29	10	S5884_116_0	3			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	116	0		29	10	S5884_116_0	3			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	131	0		29	10	S5884_131_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	131	0		29	10	S5884_131_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	131	0		29	10	S5884_131_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	131	0		29	10	S5884_131_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	131	0		29	10	S5884_131_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	132	0		29	10	S5884_132_0	3			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	132	0		29	10	S5884_132_0	3			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	132	0		29	10	S5884_132_0	3			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	132	0		29	10	S5884_132_0	3			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	132	0		29	10	S5884_132_0	3			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	133	0		29	10	S5884_133_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	133	0		29	10	S5884_133_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	133	0		29	10	S5884_133_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	133	0		29	10	S5884_133_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	133	0		29	10	S5884_133_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	134	0		29	10	S5884_134_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	134	0		29	10	S5884_134_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	134	0		29	10	S5884_134_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	134	0		29	10	S5884_134_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	134	0		29	10	S5884_134_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	135	0		29	10	S5884_135_0	2			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	135	0		29	10	S5884_135_0	2			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	135	0		29	10	S5884_135_0	2			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	135	0		29	10	S5884_135_0	2			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	135	0		29	10	S5884_135_0	2			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	136	0		29	10	S5884_136_0	2			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	136	0		29	10	S5884_136_0	2			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	136	0		29	10	S5884_136_0	2			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	136	0		29	10	S5884_136_0	2			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	136	0		29	10	S5884_136_0	2			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	137	0		29	10	S5884_137_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	137	0		29	10	S5884_137_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	137	0		29	10	S5884_137_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	137	0		29	10	S5884_137_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	137	0		29	10	S5884_137_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	138	0		29	10	S5884_138_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	138	0		29	10	S5884_138_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	138	0		29	10	S5884_138_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	138	0		29	10	S5884_138_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	138	0		29	10	S5884_138_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	139	0		29	10	S5884_139_0	2			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	139	0		29	10	S5884_139_0	2			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	139	0		29	10	S5884_139_0	2			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	139	0		29	10	S5884_139_0	2			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	139	0		29	10	S5884_139_0	2			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	140	0		29	10	S5884_140_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	140	0		29	10	S5884_140_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	140	0		29	10	S5884_140_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	140	0		29	10	S5884_140_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	140	0		29	10	S5884_140_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	141	0		29	10	S5884_141_0	2			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	141	0		29	10	S5884_141_0	2			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	141	0		29	10	S5884_141_0	2			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	141	0		29	10	S5884_141_0	2			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	141	0		29	10	S5884_141_0	2			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	142	0		29	10	S5884_142_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	142	0		29	10	S5884_142_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	142	0		29	10	S5884_142_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	142	0		29	10	S5884_142_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	142	0		29	10	S5884_142_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	143	0		29	10	S5884_143_0	2			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	143	0		29	10	S5884_143_0	2			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	143	0		29	10	S5884_143_0	2			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	143	0		29	10	S5884_143_0	2			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	143	0		29	10	S5884_143_0	2			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	144	0		29	10	S5884_144_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	144	0		29	10	S5884_144_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	144	0		29	10	S5884_144_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	144	0		29	10	S5884_144_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	144	0		29	10	S5884_144_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	145	0		29	10	S5884_145_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	145	0		29	10	S5884_145_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	145	0		29	10	S5884_145_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	145	0		29	10	S5884_145_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	145	0		29	10	S5884_145_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	146	0		29	10	S5884_146_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	146	0		29	10	S5884_146_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	146	0		29	10	S5884_146_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	146	0		29	10	S5884_146_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	146	0		29	10	S5884_146_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	147	0		29	10	S5884_147_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	147	0		29	10	S5884_147_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	147	0		29	10	S5884_147_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	147	0		29	10	S5884_147_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	147	0		29	10	S5884_147_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	148	0		29	10	S5884_148_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	148	0		29	10	S5884_148_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
S5884	148	0		29	10	S5884_148_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	148	0		29	10	S5884_148_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	148	0		29	10	S5884_148_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	149	0		29	10	S5884_149_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	149	0		29	10	S5884_149_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
S5884	149	0		29	10	S5884_149_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	149	0		29	10	S5884_149_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	149	0		29	10	S5884_149_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	150	0		29	10	S5884_150_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	150	0		29	10	S5884_150_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
S5884	150	0		29	10	S5884_150_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	150	0		29	10	S5884_150_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	150	0		29	10	S5884_150_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	151	0		29	10	S5884_151_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	151	0		29	10	S5884_151_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
S5884	151	0		29	10	S5884_151_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	151	0		29	10	S5884_151_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	151	0		29	10	S5884_151_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	152	0		29	10	S5884_152_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	152	0		29	10	S5884_152_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
S5884	152	0		29	10	S5884_152_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	152	0		29	10	S5884_152_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	152	0		29	10	S5884_152_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	153	0		29	10	S5884_153_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	153	0		29	10	S5884_153_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
S5884	153	0		29	10	S5884_153_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	153	0		29	10	S5884_153_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	153	0		29	10	S5884_153_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	154	0		29	10	S5884_154_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	154	0		29	10	S5884_154_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
S5884	154	0		29	10	S5884_154_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	154	0		29	10	S5884_154_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	154	0		29	10	S5884_154_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	155	0		29	10	S5884_155_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	155	0		29	10	S5884_155_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
S5884	155	0		29	10	S5884_155_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	155	0		29	10	S5884_155_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	155	0		29	10	S5884_155_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	156	0		29	10	S5884_156_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	156	0		29	10	S5884_156_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
S5884	156	0		29	10	S5884_156_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	156	0		29	10	S5884_156_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	156	0		29	10	S5884_156_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	157	0		29	10	S5884_157_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	157	0		29	10	S5884_157_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
S5884	157	0		29	10	S5884_157_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	157	0		29	10	S5884_157_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	157	0		29	10	S5884_157_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	158	0		29	10	S5884_158_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	158	0		29	10	S5884_158_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
S5884	158	0		29	10	S5884_158_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	158	0		29	10	S5884_158_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	158	0		29	10	S5884_158_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	159	0		29	10	S5884_159_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	159	0		29	10	S5884_159_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
S5884	159	0		29	10	S5884_159_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	159	0		29	10	S5884_159_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	159	0		29	10	S5884_159_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	160	0		29	10	S5884_160_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	160	0		29	10	S5884_160_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
S5884	160	0		29	10	S5884_160_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	160	0		29	10	S5884_160_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	160	0		29	10	S5884_160_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	161	0		29	10	S5884_161_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	161	0		29	10	S5884_161_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
S5884	161	0		29	10	S5884_161_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	161	0		29	10	S5884_161_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	161	0		29	10	S5884_161_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	162	0		29	10	S5884_162_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	162	0		29	10	S5884_162_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
S5884	162	0		29	10	S5884_162_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	162	0		29	10	S5884_162_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	162	0		29	10	S5884_162_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	163	0		29	10	S5884_163_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	163	0		29	10	S5884_163_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
S5884	163	0		29	10	S5884_163_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	163	0		29	10	S5884_163_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	163	0		29	10	S5884_163_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	164	0		29	10	S5884_164_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	164	0		29	10	S5884_164_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
S5884	164	0		29	10	S5884_164_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	164	0		29	10	S5884_164_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	164	0		29	10	S5884_164_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	165	0		29	10	S5884_165_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	165	0		29	10	S5884_165_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
S5884	165	0		29	10	S5884_165_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	165	0		29	10	S5884_165_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	165	0		29	10	S5884_165_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	166	0		29	10	S5884_166_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	166	0		29	10	S5884_166_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
S5884	166	0		29	10	S5884_166_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	166	0		29	10	S5884_166_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	166	0		29	10	S5884_166_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	167	0		29	10	S5884_167_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	167	0		29	10	S5884_167_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
S5884	167	0		29	10	S5884_167_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	167	0		29	10	S5884_167_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	167	0		29	10	S5884_167_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	168	0		29	10	S5884_168_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	168	0		29	10	S5884_168_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
S5884	168	0		29	10	S5884_168_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	168	0		29	10	S5884_168_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	168	0		29	10	S5884_168_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	169	0		29	10	S5884_169_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	169	0		29	10	S5884_169_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
S5884	169	0		29	10	S5884_169_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	169	0		29	10	S5884_169_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	169	0		29	10	S5884_169_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	170	0		29	10	S5884_170_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	170	0		29	10	S5884_170_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
S5884	170	0		29	10	S5884_170_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	170	0		29	10	S5884_170_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	170	0		29	10	S5884_170_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	171	0		29	10	S5884_171_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	171	0		29	10	S5884_171_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
S5884	171	0		29	10	S5884_171_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	171	0		29	10	S5884_171_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	171	0		29	10	S5884_171_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	172	0		29	10	S5884_172_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	172	0		29	10	S5884_172_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
S5884	172	0		29	10	S5884_172_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	172	0		29	10	S5884_172_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	172	0		29	10	S5884_172_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	173	0		29	10	S5884_173_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	173	0		29	10	S5884_173_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
S5884	173	0		29	10	S5884_173_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	173	0		29	10	S5884_173_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	173	0		29	10	S5884_173_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	174	0		29	10	S5884_174_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	174	0		29	10	S5884_174_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
S5884	174	0		29	10	S5884_174_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	174	0		29	10	S5884_174_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	174	0		29	10	S5884_174_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	175	0		29	10	S5884_175_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	175	0		29	10	S5884_175_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
S5884	175	0		29	10	S5884_175_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	175	0		29	10	S5884_175_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	175	0		29	10	S5884_175_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	176	0		29	10	S5884_176_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	176	0		29	10	S5884_176_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
S5884	176	0		29	10	S5884_176_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	176	0		29	10	S5884_176_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	176	0		29	10	S5884_176_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	177	0		29	10	S5884_177_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	177	0		29	10	S5884_177_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
S5884	177	0		29	10	S5884_177_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	177	0		29	10	S5884_177_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	177	0		29	10	S5884_177_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	178	0		29	10	S5884_178_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	178	0		29	10	S5884_178_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
S5884	178	0		29	10	S5884_178_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	178	0		29	10	S5884_178_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	178	0		29	10	S5884_178_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	179	0		29	10	S5884_179_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	179	0		29	10	S5884_179_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
S5884	179	0		29	10	S5884_179_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	179	0		29	10	S5884_179_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	179	0		29	10	S5884_179_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	180	0		29	10	S5884_180_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	180	0		29	10	S5884_180_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
S5884	180	0		29	10	S5884_180_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	180	0		29	10	S5884_180_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	180	0		29	10	S5884_180_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	181	0		29	10	S5884_181_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	181	0		29	10	S5884_181_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	181	0		29	10	S5884_181_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	181	0		29	10	S5884_181_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	181	0		29	10	S5884_181_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	182	0		29	10	S5884_182_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	182	0		29	10	S5884_182_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	182	0		29	10	S5884_182_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	182	0		29	10	S5884_182_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	182	0		29	10	S5884_182_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	183	0		29	10	S5884_183_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	183	0		29	10	S5884_183_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	183	0		29	10	S5884_183_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	183	0		29	10	S5884_183_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	183	0		29	10	S5884_183_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	184	0		29	10	S5884_184_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	184	0		29	10	S5884_184_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	184	0		29	10	S5884_184_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	184	0		29	10	S5884_184_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	184	0		29	10	S5884_184_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	185	0		29	10	S5884_185_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	185	0		29	10	S5884_185_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	185	0		29	10	S5884_185_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	185	0		29	10	S5884_185_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	185	0		29	10	S5884_185_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	186	0		29	10	S5884_186_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	186	0		29	10	S5884_186_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	186	0		29	10	S5884_186_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	186	0		29	10	S5884_186_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	186	0		29	10	S5884_186_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	187	0		29	10	S5884_187_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	187	0		29	10	S5884_187_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	187	0		29	10	S5884_187_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	187	0		29	10	S5884_187_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	187	0		29	10	S5884_187_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	188	0		29	10	S5884_188_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	188	0		29	10	S5884_188_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	188	0		29	10	S5884_188_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	188	0		29	10	S5884_188_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	188	0		29	10	S5884_188_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	189	0		29	10	S5884_189_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	189	0		29	10	S5884_189_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	189	0		29	10	S5884_189_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	189	0		29	10	S5884_189_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	189	0		29	10	S5884_189_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	190	0		29	10	S5884_190_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	190	0		29	10	S5884_190_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	190	0		29	10	S5884_190_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	190	0		29	10	S5884_190_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	190	0		29	10	S5884_190_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	191	0		29	10	S5884_191_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	191	0		29	10	S5884_191_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	191	0		29	10	S5884_191_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	191	0		29	10	S5884_191_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	191	0		29	10	S5884_191_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	192	0		29	10	S5884_192_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	192	0		29	10	S5884_192_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	192	0		29	10	S5884_192_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	192	0		29	10	S5884_192_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	192	0		29	10	S5884_192_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	193	0		29	10	S5884_193_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	193	0		29	10	S5884_193_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	193	0		29	10	S5884_193_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	193	0		29	10	S5884_193_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	193	0		29	10	S5884_193_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	194	0		29	10	S5884_194_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	194	0		29	10	S5884_194_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	194	0		29	10	S5884_194_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	194	0		29	10	S5884_194_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	194	0		29	10	S5884_194_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	195	0		29	10	S5884_195_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	195	0		29	10	S5884_195_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	195	0		29	10	S5884_195_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	195	0		29	10	S5884_195_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	195	0		29	10	S5884_195_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	196	0		29	10	S5884_196_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	196	0		29	10	S5884_196_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	196	0		29	10	S5884_196_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	196	0		29	10	S5884_196_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	196	0		29	10	S5884_196_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	197	0		29	10	S5884_197_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	197	0		29	10	S5884_197_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	197	0		29	10	S5884_197_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	197	0		29	10	S5884_197_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	197	0		29	10	S5884_197_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	198	0		29	10	S5884_198_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	198	0		29	10	S5884_198_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	198	0		29	10	S5884_198_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	198	0		29	10	S5884_198_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	198	0		29	10	S5884_198_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	199	0		29	10	S5884_199_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	199	0		29	10	S5884_199_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	199	0		29	10	S5884_199_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	199	0		29	10	S5884_199_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	199	0		29	10	S5884_199_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	200	0		29	10	S5884_200_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	200	0		29	10	S5884_200_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	200	0		29	10	S5884_200_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	200	0		29	10	S5884_200_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	200	0		29	10	S5884_200_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	201	0		29	10	S5884_201_0	2			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	201	0		29	10	S5884_201_0	2			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	201	0		29	10	S5884_201_0	2			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	201	0		29	10	S5884_201_0	2			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	201	0		29	10	S5884_201_0	2			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	202	0		29	10	S5884_202_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	202	0		29	10	S5884_202_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	202	0		29	10	S5884_202_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	202	0		29	10	S5884_202_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	202	0		29	10	S5884_202_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	203	0		29	10	S5884_203_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	203	0		29	10	S5884_203_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	203	0		29	10	S5884_203_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	203	0		29	10	S5884_203_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	203	0		29	10	S5884_203_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	204	0		29	10	S5884_204_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	204	0		29	10	S5884_204_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	204	0		29	10	S5884_204_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	204	0		29	10	S5884_204_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	204	0		29	10	S5884_204_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	205	0		29	10	S5884_205_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	205	0		29	10	S5884_205_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	205	0		29	10	S5884_205_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	205	0		29	10	S5884_205_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	205	0		29	10	S5884_205_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	206	0		29	10	S5884_206_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	206	0		29	10	S5884_206_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	206	0		29	10	S5884_206_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	206	0		29	10	S5884_206_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	206	0		29	10	S5884_206_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	207	0		29	10	S5884_207_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	207	0		29	10	S5884_207_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	207	0		29	10	S5884_207_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	207	0		29	10	S5884_207_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	207	0		29	10	S5884_207_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	208	0		29	10	S5884_208_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	208	0		29	10	S5884_208_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	208	0		29	10	S5884_208_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	208	0		29	10	S5884_208_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	208	0		29	10	S5884_208_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	209	0		29	10	S5884_209_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	209	0		29	10	S5884_209_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	209	0		29	10	S5884_209_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	209	0		29	10	S5884_209_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	209	0		29	10	S5884_209_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	210	0		29	10	S5884_210_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	210	0		29	10	S5884_210_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	210	0		29	10	S5884_210_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	210	0		29	10	S5884_210_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	210	0		29	10	S5884_210_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	211	0		29	10	S5884_211_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	211	0		29	10	S5884_211_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	211	0		29	10	S5884_211_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	211	0		29	10	S5884_211_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	211	0		29	10	S5884_211_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	212	0		29	10	S5884_212_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	212	0		29	10	S5884_212_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	212	0		29	10	S5884_212_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	212	0		29	10	S5884_212_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	212	0		29	10	S5884_212_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	213	0		29	10	S5884_213_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	213	0		29	10	S5884_213_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	213	0		29	10	S5884_213_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	213	0		29	10	S5884_213_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	213	0		29	10	S5884_213_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	216	0		29	10	S5884_216_0	2			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	216	0		29	10	S5884_216_0	2			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	216	0		29	10	S5884_216_0	2			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	216	0		29	10	S5884_216_0	2			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	216	0		29	10	S5884_216_0	2			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	217	0		29	10	S5884_217_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	217	0		29	10	S5884_217_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	3	2	0.00	
S5884	217	0		29	10	S5884_217_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	217	0		29	10	S5884_217_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	217	0		29	10	S5884_217_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5884	218	0		29	10	S5884_218_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	11	1	2	0.00	
S5884	218	0		29	10	S5884_218_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	11	1	2	0.00	
S5884	218	0		29	10	S5884_218_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5884	218	0		29	10	S5884_218_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5884	218	0		29	10	S5884_218_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5904	001	0		29	10	S5904_001_0	6			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
S5904	001	0		29	10	S5904_001_0	6			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
S5904	001	0		29	10	S5904_001_0	6			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
S5904	001	0		29	10	S5904_001_0	6			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
S5904	001	0		29	10	S5904_001_0	6			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
S5904	001	0		29	10	S5904_001_0	6			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
S5904	002	0		29	10	S5904_002_0	7			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
S5904	002	0		29	10	S5904_002_0	7			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
S5904	002	0		29	10	S5904_002_0	7			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	11	1	2	0.00	
S5904	002	0		29	10	S5904_002_0	7			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
S5904	002	0		29	10	S5904_002_0	7			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
S5904	002	0		29	10	S5904_002_0	7			Select Care Drugs	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
S5921	348	0		29	10	S5921_348_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	348	0		29	10	S5921_348_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5921	348	0		29	10	S5921_348_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	348	0		29	10	S5921_348_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	348	0		29	10	S5921_348_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	349	0		29	10	S5921_349_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	349	0		29	10	S5921_349_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5921	349	0		29	10	S5921_349_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	349	0		29	10	S5921_349_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	349	0		29	10	S5921_349_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	350	0		29	10	S5921_350_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	350	0		29	10	S5921_350_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5921	350	0		29	10	S5921_350_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	350	0		29	10	S5921_350_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	350	0		29	10	S5921_350_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	351	0		29	10	S5921_351_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	351	0		29	10	S5921_351_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5921	351	0		29	10	S5921_351_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	351	0		29	10	S5921_351_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	351	0		29	10	S5921_351_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	352	0		29	10	S5921_352_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	352	0		29	10	S5921_352_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5921	352	0		29	10	S5921_352_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	352	0		29	10	S5921_352_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	352	0		29	10	S5921_352_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	353	0		29	10	S5921_353_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	353	0		29	10	S5921_353_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5921	353	0		29	10	S5921_353_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	353	0		29	10	S5921_353_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	353	0		29	10	S5921_353_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	354	0		29	10	S5921_354_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	354	0		29	10	S5921_354_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5921	354	0		29	10	S5921_354_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	354	0		29	10	S5921_354_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	354	0		29	10	S5921_354_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	355	0		29	10	S5921_355_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	355	0		29	10	S5921_355_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5921	355	0		29	10	S5921_355_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	355	0		29	10	S5921_355_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	355	0		29	10	S5921_355_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	356	0		29	10	S5921_356_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	356	0		29	10	S5921_356_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5921	356	0		29	10	S5921_356_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	356	0		29	10	S5921_356_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	356	0		29	10	S5921_356_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	357	0		29	10	S5921_357_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	357	0		29	10	S5921_357_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5921	357	0		29	10	S5921_357_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	357	0		29	10	S5921_357_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	357	0		29	10	S5921_357_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	358	0		29	10	S5921_358_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	358	0		29	10	S5921_358_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5921	358	0		29	10	S5921_358_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	358	0		29	10	S5921_358_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	358	0		29	10	S5921_358_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	359	0		29	10	S5921_359_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	359	0		29	10	S5921_359_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5921	359	0		29	10	S5921_359_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	359	0		29	10	S5921_359_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	359	0		29	10	S5921_359_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	360	0		29	10	S5921_360_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	360	0		29	10	S5921_360_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5921	360	0		29	10	S5921_360_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	360	0		29	10	S5921_360_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	360	0		29	10	S5921_360_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	361	0		29	10	S5921_361_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	361	0		29	10	S5921_361_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5921	361	0		29	10	S5921_361_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	361	0		29	10	S5921_361_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	361	0		29	10	S5921_361_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	362	0		29	10	S5921_362_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	362	0		29	10	S5921_362_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5921	362	0		29	10	S5921_362_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	362	0		29	10	S5921_362_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	362	0		29	10	S5921_362_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	363	0		29	10	S5921_363_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	363	0		29	10	S5921_363_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5921	363	0		29	10	S5921_363_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	363	0		29	10	S5921_363_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	363	0		29	10	S5921_363_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	364	0		29	10	S5921_364_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	364	0		29	10	S5921_364_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5921	364	0		29	10	S5921_364_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	364	0		29	10	S5921_364_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	364	0		29	10	S5921_364_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	365	0		29	10	S5921_365_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	365	0		29	10	S5921_365_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5921	365	0		29	10	S5921_365_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	365	0		29	10	S5921_365_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	365	0		29	10	S5921_365_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	366	0		29	10	S5921_366_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	366	0		29	10	S5921_366_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5921	366	0		29	10	S5921_366_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	366	0		29	10	S5921_366_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	366	0		29	10	S5921_366_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	367	0		29	10	S5921_367_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	367	0		29	10	S5921_367_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5921	367	0		29	10	S5921_367_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	367	0		29	10	S5921_367_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	367	0		29	10	S5921_367_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	368	0		29	10	S5921_368_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	368	0		29	10	S5921_368_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5921	368	0		29	10	S5921_368_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	368	0		29	10	S5921_368_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	368	0		29	10	S5921_368_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	369	0		29	10	S5921_369_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	369	0		29	10	S5921_369_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5921	369	0		29	10	S5921_369_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	369	0		29	10	S5921_369_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	369	0		29	10	S5921_369_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	370	0		29	10	S5921_370_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	370	0		29	10	S5921_370_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5921	370	0		29	10	S5921_370_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	370	0		29	10	S5921_370_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	370	0		29	10	S5921_370_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	371	0		29	10	S5921_371_0	2			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	371	0		29	10	S5921_371_0	2			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5921	371	0		29	10	S5921_371_0	2			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	371	0		29	10	S5921_371_0	2			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	371	0		29	10	S5921_371_0	2			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	372	0		29	10	S5921_372_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	372	0		29	10	S5921_372_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5921	372	0		29	10	S5921_372_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	372	0		29	10	S5921_372_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	372	0		29	10	S5921_372_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	373	0		29	10	S5921_373_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	373	0		29	10	S5921_373_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5921	373	0		29	10	S5921_373_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	373	0		29	10	S5921_373_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	373	0		29	10	S5921_373_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	374	0		29	10	S5921_374_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	374	0		29	10	S5921_374_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5921	374	0		29	10	S5921_374_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	374	0		29	10	S5921_374_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	374	0		29	10	S5921_374_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	375	0		29	10	S5921_375_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	375	0		29	10	S5921_375_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5921	375	0		29	10	S5921_375_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	375	0		29	10	S5921_375_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	375	0		29	10	S5921_375_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	376	0		29	10	S5921_376_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	376	0		29	10	S5921_376_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5921	376	0		29	10	S5921_376_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	376	0		29	10	S5921_376_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	376	0		29	10	S5921_376_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	377	0		29	10	S5921_377_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	377	0		29	10	S5921_377_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5921	377	0		29	10	S5921_377_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	377	0		29	10	S5921_377_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	377	0		29	10	S5921_377_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	378	0		29	10	S5921_378_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	378	0		29	10	S5921_378_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5921	378	0		29	10	S5921_378_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	378	0		29	10	S5921_378_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	378	0		29	10	S5921_378_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	379	0		29	10	S5921_379_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	379	0		29	10	S5921_379_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5921	379	0		29	10	S5921_379_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	379	0		29	10	S5921_379_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	379	0		29	10	S5921_379_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	380	0		29	10	S5921_380_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	380	0		29	10	S5921_380_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5921	380	0		29	10	S5921_380_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	380	0		29	10	S5921_380_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	380	0		29	10	S5921_380_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	381	0		29	10	S5921_381_0	1			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	381	0		29	10	S5921_381_0	1			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5921	381	0		29	10	S5921_381_0	1			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	381	0		29	10	S5921_381_0	1			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	381	0		29	10	S5921_381_0	1			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	382	0		29	10	S5921_382_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	382	0		29	10	S5921_382_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	18.00	
S5921	382	0		29	10	S5921_382_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	382	0		29	10	S5921_382_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	382	0		29	10	S5921_382_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	383	0		29	10	S5921_383_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	383	0		29	10	S5921_383_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	18.00	
S5921	383	0		29	10	S5921_383_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	383	0		29	10	S5921_383_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	383	0		29	10	S5921_383_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	384	0		29	10	S5921_384_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	384	0		29	10	S5921_384_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	18.00	
S5921	384	0		29	10	S5921_384_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	384	0		29	10	S5921_384_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	384	0		29	10	S5921_384_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	385	0		29	10	S5921_385_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	385	0		29	10	S5921_385_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	18.00	
S5921	385	0		29	10	S5921_385_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	385	0		29	10	S5921_385_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	385	0		29	10	S5921_385_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	386	0		29	10	S5921_386_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	386	0		29	10	S5921_386_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	18.00	
S5921	386	0		29	10	S5921_386_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	386	0		29	10	S5921_386_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	386	0		29	10	S5921_386_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	387	0		29	10	S5921_387_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	387	0		29	10	S5921_387_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	18.00	
S5921	387	0		29	10	S5921_387_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	387	0		29	10	S5921_387_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	387	0		29	10	S5921_387_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	388	0		29	10	S5921_388_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	388	0		29	10	S5921_388_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	18.00	
S5921	388	0		29	10	S5921_388_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	388	0		29	10	S5921_388_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	388	0		29	10	S5921_388_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	389	0		29	10	S5921_389_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	389	0		29	10	S5921_389_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	18.00	
S5921	389	0		29	10	S5921_389_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	389	0		29	10	S5921_389_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	389	0		29	10	S5921_389_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	390	0		29	10	S5921_390_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	390	0		29	10	S5921_390_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	18.00	
S5921	390	0		29	10	S5921_390_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	390	0		29	10	S5921_390_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	390	0		29	10	S5921_390_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	391	0		29	10	S5921_391_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	391	0		29	10	S5921_391_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	18.00	
S5921	391	0		29	10	S5921_391_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	391	0		29	10	S5921_391_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	391	0		29	10	S5921_391_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	392	0		29	10	S5921_392_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	392	0		29	10	S5921_392_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	18.00	
S5921	392	0		29	10	S5921_392_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	392	0		29	10	S5921_392_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	392	0		29	10	S5921_392_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	393	0		29	10	S5921_393_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	393	0		29	10	S5921_393_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	18.00	
S5921	393	0		29	10	S5921_393_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	393	0		29	10	S5921_393_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	393	0		29	10	S5921_393_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	394	0		29	10	S5921_394_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	394	0		29	10	S5921_394_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	18.00	
S5921	394	0		29	10	S5921_394_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	394	0		29	10	S5921_394_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	394	0		29	10	S5921_394_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	395	0		29	10	S5921_395_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	395	0		29	10	S5921_395_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	18.00	
S5921	395	0		29	10	S5921_395_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	395	0		29	10	S5921_395_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	395	0		29	10	S5921_395_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	396	0		29	10	S5921_396_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	396	0		29	10	S5921_396_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	18.00	
S5921	396	0		29	10	S5921_396_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	396	0		29	10	S5921_396_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	396	0		29	10	S5921_396_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	397	0		29	10	S5921_397_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	397	0		29	10	S5921_397_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	18.00	
S5921	397	0		29	10	S5921_397_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	397	0		29	10	S5921_397_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	397	0		29	10	S5921_397_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	398	0		29	10	S5921_398_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	398	0		29	10	S5921_398_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	18.00	
S5921	398	0		29	10	S5921_398_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	398	0		29	10	S5921_398_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	398	0		29	10	S5921_398_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	399	0		29	10	S5921_399_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	399	0		29	10	S5921_399_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	18.00	
S5921	399	0		29	10	S5921_399_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	399	0		29	10	S5921_399_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	399	0		29	10	S5921_399_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	400	0		29	10	S5921_400_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	400	0		29	10	S5921_400_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	18.00	
S5921	400	0		29	10	S5921_400_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	400	0		29	10	S5921_400_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	400	0		29	10	S5921_400_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	401	0		29	10	S5921_401_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	401	0		29	10	S5921_401_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	18.00	
S5921	401	0		29	10	S5921_401_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	401	0		29	10	S5921_401_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	401	0		29	10	S5921_401_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	402	0		29	10	S5921_402_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	402	0		29	10	S5921_402_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	18.00	
S5921	402	0		29	10	S5921_402_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	402	0		29	10	S5921_402_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	402	0		29	10	S5921_402_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	403	0		29	10	S5921_403_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	403	0		29	10	S5921_403_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	18.00	
S5921	403	0		29	10	S5921_403_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	403	0		29	10	S5921_403_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	403	0		29	10	S5921_403_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	404	0		29	10	S5921_404_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	404	0		29	10	S5921_404_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	18.00	
S5921	404	0		29	10	S5921_404_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	404	0		29	10	S5921_404_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	404	0		29	10	S5921_404_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	405	0		29	10	S5921_405_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	405	0		29	10	S5921_405_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	18.00	
S5921	405	0		29	10	S5921_405_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	405	0		29	10	S5921_405_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	405	0		29	10	S5921_405_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	406	0		29	10	S5921_406_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	406	0		29	10	S5921_406_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	18.00	
S5921	406	0		29	10	S5921_406_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	406	0		29	10	S5921_406_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	406	0		29	10	S5921_406_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	407	0		29	10	S5921_407_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	407	0		29	10	S5921_407_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	18.00	
S5921	407	0		29	10	S5921_407_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	407	0		29	10	S5921_407_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	407	0		29	10	S5921_407_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	408	0		29	10	S5921_408_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	408	0		29	10	S5921_408_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	18.00	
S5921	408	0		29	10	S5921_408_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	408	0		29	10	S5921_408_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	408	0		29	10	S5921_408_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	409	0		29	10	S5921_409_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	409	0		29	10	S5921_409_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	18.00	
S5921	409	0		29	10	S5921_409_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	409	0		29	10	S5921_409_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	409	0		29	10	S5921_409_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	410	0		29	10	S5921_410_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	410	0		29	10	S5921_410_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	18.00	
S5921	410	0		29	10	S5921_410_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	410	0		29	10	S5921_410_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	410	0		29	10	S5921_410_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	411	0		29	10	S5921_411_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	411	0		29	10	S5921_411_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	18.00	
S5921	411	0		29	10	S5921_411_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	411	0		29	10	S5921_411_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	411	0		29	10	S5921_411_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	412	0		29	10	S5921_412_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	412	0		29	10	S5921_412_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	18.00	
S5921	412	0		29	10	S5921_412_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	412	0		29	10	S5921_412_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	412	0		29	10	S5921_412_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	413	0		29	10	S5921_413_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	413	0		29	10	S5921_413_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	18.00	
S5921	413	0		29	10	S5921_413_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	413	0		29	10	S5921_413_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	413	0		29	10	S5921_413_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	414	0		29	10	S5921_414_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	414	0		29	10	S5921_414_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	18.00	
S5921	414	0		29	10	S5921_414_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	414	0		29	10	S5921_414_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	414	0		29	10	S5921_414_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5921	415	0		29	10	S5921_415_0	1			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5921	415	0		29	10	S5921_415_0	1			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	3	2	18.00	
S5921	415	0		29	10	S5921_415_0	1			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5921	415	0		29	10	S5921_415_0	1			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5921	415	0		29	10	S5921_415_0	1			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5953	001	0		29	10	S5953_001_0	3			Preferred Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	1	2	01	1	2	0.00	
S5953	001	0		29	10	S5953_001_0	3			Generic	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	2	2	01	1	2	0.00	
S5953	001	0		29	10	S5953_001_0	3			Preferred Brand	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	3	2	10	1	2	0.00	
S5953	001	0		29	10	S5953_001_0	3			Non-Preferred Drug	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	4	2	11	1	2	0.00	
S5953	001	0		29	10	S5953_001_0	3			Specialty Tier	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	5	2	11	1	2	0.00	
S5953	001	0		29	10	S5953_001_0	3			Select Care Drugs	3	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier, Select Care Drugs	6	2	11	1	2	0.00	
S5993	001	0		29	10	S5993_001_0	5			Preferred Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5993	001	0		29	10	S5993_001_0	5			Generic	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5993	001	0		29	10	S5993_001_0	5			Preferred Brand	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5993	001	0		29	10	S5993_001_0	5			Non-Preferred Drug	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5993	001	0		29	10	S5993_001_0	5			Specialty Tier	2	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
S5993	003	0		29	10	S5993_003_0	6			Preferred Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	1	2	01	1	2	0.00	
S5993	003	0		29	10	S5993_003_0	6			Generic	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	2	2	01	1	2	0.00	
S5993	003	0		29	10	S5993_003_0	6			Preferred Brand	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	3	2	11	1	2	0.00	
S5993	003	0		29	10	S5993_003_0	6			Non-Preferred Drug	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	4	2	11	1	2	0.00	
S5993	003	0		29	10	S5993_003_0	6			Specialty Tier	4	Preferred Generic, Generic, Preferred Brand, Non-Preferred Drug, Specialty Tier	5	2	11	1	2	0.00	
