pbp_a_hnumber	pbp_a_plan_identifier	segment_id	pbp_a_ben_cov	pbp_a_plan_type	orgtype	bid_id	version	pbp_c_pos_outpt_group_num_id	pbp_c_pos_outpt_bendesc_cats	pbp_c_pos_group_lbl	pbp_c_pos_outpt_coins_yn	pbp_c_pos_outpt_coins_min_pct	pbp_c_pos_outpt_coins_max_pct	pbp_c_pos_outpt_coins_cov	pbp_c_pos_outpt_copay_yn	pbp_c_pos_outpt_copay_min_amt	pbp_c_pos_outpt_copay_max_amt
H0401	002	0	1	02	01	H0401_002_0	9	3	00000000000000110000000000000000000000000000	Three	1	0	40	6	1	0.00	20.00
H0401	002	0	1	02	01	H0401_002_0	9	2	01000000000000000000000000000000000000000000		2				1	185.00	185.00
H0401	002	0	1	02	01	H0401_002_0	9	10	00000000000000000000000001000000000000000010		2				2		
H0401	002	0	1	02	01	H0401_002_0	9	1	00101001000001001101000000000001011111100000		1	40	40	6	2		
H0401	002	0	1	02	01	H0401_002_0	9	4	00010000000000000000000000000000000000000000		2				1	75.00	75.00
H0401	002	0	1	02	01	H0401_002_0	9	6	00000010101100000000000000000000000000001101		2				1	38.00	38.00
H0401	002	0	1	02	01	H0401_002_0	9	7	00000100000000000000000000000000100000000000		2				1	28.00	28.00
H0401	002	0	1	02	01	H0401_002_0	9	8	00000000000000000000100000000000000000000000		2				1	175.00	175.00
H0401	002	0	1	02	01	H0401_002_0	9	9	00000000000000000000001110000000000000000000		1	30	30	6	2		
H0401	002	0	1	02	01	H0401_002_0	9	5	00000000010010000010000000000000000000000000		2				1	35.00	45.00
H0401	003	0	1	02	01	H0401_003_0	8	1	00101001000001001101000000000001011111100010		1	40	40	6	2		
H0401	003	0	1	02	01	H0401_003_0	8	10	00000000000000000000001110000000000000000000		1	30	30	2	2		
H0401	003	0	1	02	01	H0401_003_0	8	2	01000000000000000000000000000000000000000000		2				1	185.00	185.00
H0401	003	0	1	02	01	H0401_003_0	8	3	00000000000000110000000000000000000000000000		1	0	40	6	1	0.00	20.00
H0401	003	0	1	02	01	H0401_003_0	8	4	00010000000000000000000000000000000000000000		2				1	75.00	75.00
H0401	003	0	1	02	01	H0401_003_0	8	5	00000000010110000010000000000000000000000000		2				1	35.00	45.00
H0401	003	0	1	02	01	H0401_003_0	8	6	00000010101000000000000000000000000000001101		2				1	38.00	38.00
H0401	003	0	1	02	01	H0401_003_0	8	7	00000100000000000000000000000000100000000000		2				1	28.00	28.00
H0401	003	0	1	02	01	H0401_003_0	8	9	00000000000000000000100000000000000000000000		2				1	175.00	175.00
H0401	003	0	1	02	01	H0401_003_0	8	8	00000000000000000000000001000000000000000000		2				2		
H0401	004	0	1	02	01	H0401_004_0	4	1	01111111111111111111111111000001111111101101	Group 1	1	30	30	6	2		
H0401	004	0	1	02	01	H0401_004_0	4	2	10000000000000000000000000000000000000000010	Group 2	2				2		
H0408	001	0	1	02	01	H0408_001_0	4	2	10000000000000000000000000000000000000000010	Group 2	2				2		
H0408	001	0	1	02	01	H0408_001_0	4	1	01111111111111111111111111000001111111101101	Group 1	1	30	30	6	2		
H0408	002	0	1	02	01	H0408_002_0	4	1	01111111111111111111111111000001111111101101	Group 1	1	30	30	6	2		
H0408	002	0	1	02	01	H0408_002_0	4	2	10000000000000000000000000000000000000000010	Group 2	2				2		
H0410	001	0	1	37	05	H0410_001_0	3	1	01111011111111111111101111000001111111101101	Group 1	1	30	30	6	2		
H0410	001	0	1	37	05	H0410_001_0	3	2	10000000000000000000000000000000000000000010	Group 2	2				2		
H0410	002	0	1	37	05	H0410_002_0	2	1	01111011111111111111101111000001111111101101	Group 1	1	30	30	6	2		
H0410	002	0	1	37	05	H0410_002_0	2	2	10000000000000000000000000000000000000000010	Group 2	2				2		
H0410	003	0	1	37	05	H0410_003_0	4	1	01111011111111111111101111000001111111101101	Group 1	1	30	30	6	2		
H0410	003	0	1	37	05	H0410_003_0	4	2	10000000000000000000000000000000000000000010	Group 2	2				2		
H0410	004	0	1	37	05	H0410_004_0	4	1	01111011111111111111101111000001111111101101	Group 1	1	30	30	6	2		
H0410	004	0	1	37	05	H0410_004_0	4	2	10000000000000000000000000000000000000000010	Group 2	2				2		
H0755	020	0	1	02	01	H0755_020_0	6	1	00100001000001111101001100000000000000000000	20% Coinsurance	1	20	20	2	2		
H0755	020	0	1	02	01	H0755_020_0	6	2	00000110101100000000000000000000100000000101	$35 Copayment	2				1	35.00	35.00
H0755	020	0	1	02	01	H0755_020_0	6	3	00000000000000000000000011000001011111100010	No Copayment	2				1	0.00	0.00
H1013	026	0	1	02	01	H1013_026_0	6	1	01101111101101111101001101000001111111100000	Preferred Options POS Benefit	1	35	35	1	2		
H1035	002	0	1	02	01	H1035_002_0	7	1	01111111111111111111001111011101111111100000	Medicare Covered Benefits	1	20	20	6	2		
H1035	006	0	1	02	01	H1035_006_0	6	1	01111111111111111111001111011101111111100000	Medicare Covered Benefits	1	20	20	6	2		
H1035	007	0	1	02	01	H1035_007_0	2	1	01111111111111111111001111111101111111100000	Medicare Covered Benefits	1	20	20	6	2		
H1076	020	0	1	02	01	H1076_020_0	6	1	01101111101101111101001101000001111111100000	Preferred Options POS Benefit	1	30	30	1	2		
H1076	022	0	1	02	01	H1076_022_0	6	1	01101111101101111101001101000001111111100000	Preferred Options POS Benefit	1	30	30	1	2		
H1080	011	0	1	02	01	H1080_011_0	12	4	00000000000000110000000000000000000000000000		1	0	30	6	1	0.00	20.00
H1080	011	0	1	02	01	H1080_011_0	12	3	00000000010010000010000000000000000000000000		2				1	35.00	45.00
H1080	011	0	1	02	01	H1080_011_0	12	2	00000110101110000000000000000000100000001101		2				1	40.00	40.00
H1080	011	0	1	02	01	H1080_011_0	12	5	00000000000000000000000001000000000000000000		2				2		
H1080	011	0	1	02	01	H1080_011_0	12	1	00101000000000001101001110000001011111100010		1	30	30	6	2		
H1080	038	0	1	02	01	H1080_038_0	7	1	00101001000001001101001110000001011111000010		1	30	30	6	2		
H1080	038	0	1	02	01	H1080_038_0	7	2	00000000000000110000000000000000000000000000		1	0	30	6	1	0.00	20.00
H1080	038	0	1	02	01	H1080_038_0	7	5	00000000000000000000000001000000000000000000		2				2		
H1080	038	0	1	02	01	H1080_038_0	7	4	00000000010010000010000000000000000000000000		2				1	35.00	45.00
H1080	038	0	1	02	01	H1080_038_0	7	3	00000110101100000000000000000000100000001100		2				1	40.00	40.00
H1111	002	0	1	02	01	H1111_002_0	8	1	01000000000000000000000000000000000000000000		2				1	185.00	185.00
H1111	002	0	1	02	01	H1111_002_0	8	2	00101001000001001101001101000001011111100010		1	30	30	6	2		
H1111	002	0	1	02	01	H1111_002_0	8	3	00000000000000000000100000000000000000000000		2				1	175.00	175.00
H1111	002	0	1	02	01	H1111_002_0	8	4	00000000000000110000000000000000000000000000		1	0	30	6	1	0.00	20.00
H1111	002	0	1	02	01	H1111_002_0	8	9	00000000000000000000000001000000000000000000		2				2		
H1111	002	0	1	02	01	H1111_002_0	8	8	00000010101100000000000000000000000000000101		2				1	35.00	35.00
H1111	002	0	1	02	01	H1111_002_0	8	7	00000100000000000000000000000000100000000000		2				1	20.00	20.00
H1111	002	0	1	02	01	H1111_002_0	8	6	00000000010010000010000000000000000000000000		2				1	35.00	45.00
H1111	002	0	1	02	01	H1111_002_0	8	5	00010000000000000000000000000000000000000000		2				1	75.00	75.00
H1111	003	0	1	02	01	H1111_003_0	8	6	00000000010010000010000000000000000000000000		2				1	35.00	45.00
H1111	003	0	1	02	01	H1111_003_0	8	5	00010000000000000000000000000000000000000000		2				1	75.00	75.00
H1111	003	0	1	02	01	H1111_003_0	8	4	00000000000000110000000000000000000000000000		1	0	30	6	1	0.00	20.00
H1111	003	0	1	02	01	H1111_003_0	8	3	00000000000000000000100000000000000000000000		2				1	175.00	175.00
H1111	003	0	1	02	01	H1111_003_0	8	2	00101001000001001101001110000001011111100010		1	30	30	6	2		
H1111	003	0	1	02	01	H1111_003_0	8	1	01000000000000000000000000000000000000000000		2				1	185.00	185.00
H1111	003	0	1	02	01	H1111_003_0	8	7	00000100000000000000000000000000100000000000		2				1	20.00	20.00
H1111	003	0	1	02	01	H1111_003_0	8	9	00000000000000000000000001000000000000000000		2				2		
H1111	003	0	1	02	01	H1111_003_0	8	8	00000010101100000000000000000000000000001101		2				1	35.00	35.00
H1286	001	0	1	02	01	H1286_001_0	4	2	10000000000000000000000000000000000000000010	Group 2	2				2		
H1286	001	0	1	02	01	H1286_001_0	4	1	01111111111111111111111111000001111111101101	Group 1	1	30	30	6	2		
H1286	002	0	1	02	01	H1286_002_0	6	3	01000000000000000000100000000000000000000000	Group 3	2				1	175.00	175.00
H1286	002	0	1	02	01	H1286_002_0	6	9	00000010101100000000000000000000000000001101		2				1	35.00	35.00
H1286	002	0	1	02	01	H1286_002_0	6	5	00000000000000000000001110000000000000000000		1	30	30	6	2		
H1286	002	0	1	02	01	H1286_002_0	6	6	00010000000000000000000000000000000000000000		2				1	75.00	75.00
H1286	002	0	1	02	01	H1286_002_0	6	7	00000000010010000010000000000000000000000000		2				1	35.00	45.00
H1286	002	0	1	02	01	H1286_002_0	6	8	00000100000000000000000000000000100000000000		2				1	20.00	20.00
H1286	002	0	1	02	01	H1286_002_0	6	2	00101001000001001101000000000001011111100010	Group 2	1	40	40	6	2		
H1286	002	0	1	02	01	H1286_002_0	6	1	00000000000000110000000000000000000000000000	Group 1	1	0	40	6	1	0.00	20.00
H1286	002	0	1	02	01	H1286_002_0	6	4	00000000000000000000000001000000000000000000		2				2		
H1286	003	0	1	02	01	H1286_003_0	4	3	01000000000000000000000000000000000000000000	Group 3	2				1	125.00	125.00
H1286	003	0	1	02	01	H1286_003_0	4	2	00101001000001001101001110000001011111100010	Group 2	1	30	30	6	2		
H1286	003	0	1	02	01	H1286_003_0	4	1	00000000000000110000000000000000000000000000	Group 1	1	0	30	6	1	0.00	20.00
H1286	003	0	1	02	01	H1286_003_0	4	4	00000000000000000000100000000000000000000000		2				1	175.00	175.00
H1286	003	0	1	02	01	H1286_003_0	4	9	00000010101100000000000000000000000000001101		2				1	25.00	25.00
H1286	003	0	1	02	01	H1286_003_0	4	8	00000100000000000000000000000000100000000000		2				1	20.00	20.00
H1286	003	0	1	02	01	H1286_003_0	4	7	00000000000000000000000001000000000000000000		2				2		
H1286	003	0	1	02	01	H1286_003_0	4	6	00000000010010000010000000000000000000000000		2				1	35.00	45.00
H1286	003	0	1	02	01	H1286_003_0	4	5	00010000000000000000000000000000000000000000		2				1	75.00	75.00
H1286	004	0	1	02	01	H1286_004_0	7	1	00000000000000110000000000000000000000000000	Group 1	1	0	40	6	1	0.00	20.00
H1286	004	0	1	02	01	H1286_004_0	7	2	00101001000001001101000000000001011111100010	Group 2	1	40	40	6	2		
H1286	004	0	1	02	01	H1286_004_0	7	3	01000000000000000000100000000000000000000000	Group 3	2				1	175.00	175.00
H1286	004	0	1	02	01	H1286_004_0	7	7	00000000000000000000001110000000000000000000		1	30	30	6	2		
H1286	004	0	1	02	01	H1286_004_0	7	9	00000010101100000000000000000000000000001101		2				1	35.00	35.00
H1286	004	0	1	02	01	H1286_004_0	7	6	00000000010010000010000000000000000000000000		2				1	35.00	45.00
H1286	004	0	1	02	01	H1286_004_0	7	5	00010000000000000000000000000000000000000000		2				1	75.00	75.00
H1286	004	0	1	02	01	H1286_004_0	7	4	00000000000000000000000001000000000000000000		2				2		
H1286	004	0	1	02	01	H1286_004_0	7	8	00000100000000000000000000000000100000000000		2				1	20.00	20.00
H1286	005	0	1	02	01	H1286_005_0	4	2	00101001000001001101001110000001011111100010	Group 2	1	30	30	6	2		
H1286	005	0	1	02	01	H1286_005_0	4	3	01000000000000000000000000000000000000000000	Group 3	2				1	125.00	125.00
H1286	005	0	1	02	01	H1286_005_0	4	4	00000000000000000000100000000000000000000000		2				1	175.00	175.00
H1286	005	0	1	02	01	H1286_005_0	4	5	00010000000000000000000000000000000000000000		2				1	75.00	75.00
H1286	005	0	1	02	01	H1286_005_0	4	6	00000000010010000010000000000000000000000000		2				1	35.00	45.00
H1286	005	0	1	02	01	H1286_005_0	4	7	00000000000000000000000001000000000000000000		2				2		
H1286	005	0	1	02	01	H1286_005_0	4	8	00000100000000000000000000000000100000000000		2				1	20.00	20.00
H1286	005	0	1	02	01	H1286_005_0	4	9	00000010101100000000000000000000000000001101		2				1	25.00	25.00
H1286	005	0	1	02	01	H1286_005_0	4	1	00000000000000110000000000000000000000000000	Group 1	1	0	30	6	1	0.00	20.00
H1286	801	0	1	02	01	H1286_801_0	7	1	00000000000000110000000000000000000000000000	Group 1	1	0	40	6	1	0.00	20.00
H1286	801	0	1	02	01	H1286_801_0	7	2	00101001000001001101000000000001011111100010	Group 2	1	40	40	6	2		
H1286	801	0	1	02	01	H1286_801_0	7	3	01000000000000000000100000000000000000000000	Group 3	2				1	175.00	175.00
H1286	801	0	1	02	01	H1286_801_0	7	4	00000110101100000000000000000000100000001101		2				1	40.00	40.00
H1286	801	0	1	02	01	H1286_801_0	7	5	00010000000000000000000000000000000000000000		2				1	75.00	75.00
H1286	801	0	1	02	01	H1286_801_0	7	8	00000000000000000000000001000000000000000000		2				2		
H1286	801	0	1	02	01	H1286_801_0	7	6	00000000010010000010000000000000000000000000		2				1	35.00	45.00
H1286	801	0	1	02	01	H1286_801_0	7	7	00000000000000000000001110000000000000000000		1	30	30	6	2		
H1961	002	0	1	02	01	H1961_002_0	4	1	01111111111111111111101111010001011111100111	Choice 3 medical benefits	1	20	20	1	2		
H1961	002	0	1	02	01	H1961_002_0	4	2	00000000000000000000000000000000000000011000	Choice 3 Non Participating Prov dental	2				1	0.00	1000.00
H2320	004	1	1	02	01	H2320_004_1	3	1	00010000010010000010000000000000000000000000	Services with  50% copayment	1	50	50	1	2		
H2320	004	1	1	02	01	H2320_004_1	3	2	11101111101101111101111111000001111111100111	Services with a 20 % Coinsurance	1	20	20	1	2		
H2320	004	2	1	02	01	H2320_004_2	3	1	00010000010010000010000000000000000000000000	Services with  50% copayment	1	50	50	1	2		
H2320	004	2	1	02	01	H2320_004_2	3	2	11101111101101111101111111000001111111100111	Services with a 20 % Coinsurance	1	20	20	1	2		
H2320	004	3	1	02	01	H2320_004_3	3	1	00010000010010000010000000000000000000000000	Services with  50% copayment	1	50	50	1	2		
H2320	004	3	1	02	01	H2320_004_3	3	2	11101111101101111101111111000001111111100111	Services with a 20 % Coinsurance	1	20	20	1	2		
H2320	005	1	1	02	01	H2320_005_1	3	1	00010000010010000010000000000000000000000000	Services with  50% copayment	1	50	50	1	2		
H2320	005	1	1	02	01	H2320_005_1	3	2	11101111101101111101111111000001111111100111	Services with a 20 % Coinsurance	1	20	20	1	2		
H2320	005	2	1	02	01	H2320_005_2	3	1	00010000010010000010000000000000000000000000	Services with  50% copayment	1	50	50	1	2		
H2320	005	2	1	02	01	H2320_005_2	3	2	11101111101101111101111111000001111111100111	Services with a 20 % Coinsurance	1	20	20	1	2		
H2320	005	3	1	02	01	H2320_005_3	3	1	00010000010010000010000000000000000000000000	Services with  50% copayment	1	50	50	1	2		
H2320	005	3	1	02	01	H2320_005_3	3	2	11101111101101111101111111000001111111100111	Services with a 20 % Coinsurance	1	20	20	1	2		
H2459	001	0	1	02	01	H2459_001_0	3	1	01111101111111111111101111000001111111100101	All Other POS Benefits	1	20	20	2	2		
H2459	002	0	1	02	01	H2459_002_0	4	1	01111101111111111111101111000001111111100101	All Other POS Benefits	1	20	20	2	2		
H2459	005	0	1	02	01	H2459_005_0	3	1	01111101111111111111101111000001111111100101	All Other POS Benefits	1	20	20	2	2		
H2459	006	0	1	02	01	H2459_006_0	6	1	01111101111111111111101111000001111111100101	All Other POS Benefits	1	20	20	2	2		
H2459	013	0	1	02	01	H2459_013_0	4	1	01111101111111111111101111000001111111100101	All Other POS Benefits	1	20	20	2	2		
H2459	014	0	1	02	01	H2459_014_0	6	1	01111101111111111111101111000001111111100101	All Other POS Benefits	1	20	20	2	2		
H2459	801	0	1	02	01	H2459_801_0	1	1	01111101111111111111101111000001111111100101	All Other POS Benefits	1	20	20	2	2		
H2459	802	0	1	02	01	H2459_802_0	1	1	01111101111111111111101111000001111111100101	All Other POS Benefits	1	20	20	2	2		
H2459	803	0	1	02	01	H2459_803_0	1	1	01111101111111111111101111000001111111100101	All Other POS Benefits	1	20	20	2	2		
H2654	013	0	1	02	01	H2654_013_0	11	1	00100001000001001101000000000000000000000000		1	35	35	6	2		
H2654	013	0	1	02	01	H2654_013_0	11	2	00000000000000110000000000000000000000000000		1	0	35	2	1	0.00	20.00
H2654	013	0	1	02	01	H2654_013_0	11	3	00000000010010000010000000000000000000000000		2				1	35.00	45.00
H2654	022	0	1	02	01	H2654_022_0	8	1	00100001000001001101000000000000000000000000		1	35	35	6	2		
H2654	022	0	1	02	01	H2654_022_0	8	2	00000000000000110000000000000000000000000000		1	0	35	6	1	0.00	20.00
H2654	022	0	1	02	01	H2654_022_0	8	3	00000000010010000010000000000000000000000000		2				1	35.00	45.00
H2803	001	0	1	02	01	H2803_001_0	9	5	00010000000000000000000000000000000000000000	Group 5	2				1	75.00	75.00
H2803	001	0	1	02	01	H2803_001_0	9	4	00000000000000110000000000000000000000000000	Group 4	1	0	25	6	1	0.00	15.00
H2803	001	0	1	02	01	H2803_001_0	9	3	00000000000000000000100000000000000000000000	Group 3	2				1	175.00	175.00
H2803	001	0	1	02	01	H2803_001_0	9	2	00101001000001001101001110000001011111100010	Group 2	1	25	25	6	2		
H2803	001	0	1	02	01	H2803_001_0	9	1	01000000000000000000000000000000000000000000	Group 1	2				1	150.00	150.00
H2803	001	0	1	02	01	H2803_001_0	9	6	00000000010010000010000000000000000000000000	Group 6	2				1	35.00	45.00
H2803	001	0	1	02	01	H2803_001_0	9	9	10000000000000000000000001000000000000000010	Group 9	2				2		
H2803	001	0	1	02	01	H2803_001_0	9	8	00000010101100000000000000000000000000001101	Group 8	2				1	30.00	30.00
H2803	001	0	1	02	01	H2803_001_0	9	7	00000100000000000000000000000000100000000000	Group 7	2				1	20.00	20.00
H2803	002	0	1	02	01	H2803_002_0	12	1	01000000000000000000000000000000000000000000	Group 1	2				1	150.00	150.00
H2803	002	0	1	02	01	H2803_002_0	12	2	00101001000001001101001110000001011111100010	Group 2	1	25	25	6	2		
H2803	002	0	1	02	01	H2803_002_0	12	3	00000000000000000000100000000000000000000000	Group 3	2				1	175.00	175.00
H2803	002	0	1	02	01	H2803_002_0	12	4	00000000000000110000000000000000000000000000	Group 4	1	0	25	6	1	0.00	15.00
H2803	002	0	1	02	01	H2803_002_0	12	9	10000000000000000000000001000000000000000010	Group 9	2				2		
H2803	002	0	1	02	01	H2803_002_0	12	8	00000010101100000000000000000000000000001101	Group 8	2				1	30.00	30.00
H2803	002	0	1	02	01	H2803_002_0	12	7	00000100000000000000000000000000100000000000	Group 7	2				1	20.00	20.00
H2803	002	0	1	02	01	H2803_002_0	12	6	00000000010010000010000000000000000000000000	Group 6	2				1	35.00	45.00
H2803	002	0	1	02	01	H2803_002_0	12	5	00010000000000000000000000000000000000000000	Group 5	2				1	75.00	75.00
H2803	005	0	1	02	01	H2803_005_0	6	5	00010000000000000000000000000000000000000000	Group 5	2				1	75.00	75.00
H2803	005	0	1	02	01	H2803_005_0	6	4	00000000000000110000000000000000000000000000	Group 4	1	0	25	6	1	0.00	15.00
H2803	005	0	1	02	01	H2803_005_0	6	3	00000000000000000000100000000000000000000000	Group 3	2				1	175.00	175.00
H2803	005	0	1	02	01	H2803_005_0	6	2	00101001000001001101000000000001011111100010	Group 2	1	25	25	6	2		
H2803	005	0	1	02	01	H2803_005_0	6	10	00000000000000000000001110000000000000000000	Group 10	1	30	30	6	2		
H2803	005	0	1	02	01	H2803_005_0	6	1	01000000000000000000000000000000000000000000	Group 1	2				1	150.00	150.00
H2803	005	0	1	02	01	H2803_005_0	6	6	00000000010010000010000000000000000000000000	Group 6	2				1	35.00	45.00
H2803	005	0	1	02	01	H2803_005_0	6	9	00000000000000000000000001000000000000000010	Group 9	2				2		
H2803	005	0	1	02	01	H2803_005_0	6	8	00000010101100000000000000000000000000001101	Group 8	2				1	30.00	30.00
H2803	005	0	1	02	01	H2803_005_0	6	7	00000100000000000000000000000000100000000000	Group 7	2				1	20.00	20.00
H2803	006	0	1	02	01	H2803_006_0	9	1	01000000000000000000000000000000000000000000	Group 1	2				1	150.00	150.00
H2803	006	0	1	02	01	H2803_006_0	9	10	00000000000000000000001110000000000000000000	Group 10	1	30	30	6	2		
H2803	006	0	1	02	01	H2803_006_0	9	2	00101001000001001101000000000001011111100010	Group 2	1	25	25	6	2		
H2803	006	0	1	02	01	H2803_006_0	9	3	00000000000000000000100000000000000000000000	Group 3	2				1	175.00	175.00
H2803	006	0	1	02	01	H2803_006_0	9	4	00000000000000110000000000000000000000000000	Group 4	1	0	25	6	1	0.00	15.00
H2803	006	0	1	02	01	H2803_006_0	9	5	00010000000000000000000000000000000000000000	Group 5	2				1	75.00	75.00
H2803	006	0	1	02	01	H2803_006_0	9	6	00000000010010000010000000000000000000000000	Group 6	2				1	35.00	45.00
H2803	006	0	1	02	01	H2803_006_0	9	9	00000000000000000000000001000000000000000010	Group 9	2				2		
H2803	006	0	1	02	01	H2803_006_0	9	8	00000010101100000000000000000000000000001101	Group 8	2				1	30.00	30.00
H2803	006	0	1	02	01	H2803_006_0	9	7	00000100000000000000000000000000100000000000	Group 7	2				1	20.00	20.00
H2803	010	0	1	02	01	H2803_010_0	4	2	10000000000000000000000000000000000000000010	Group 2	2				2		
H2803	010	0	1	02	01	H2803_010_0	4	1	01111111111111111111111111000001111111101101	Group 1	1	30	30	6	2		
H2803	011	0	1	02	01	H2803_011_0	4	1	01111111111111111111111111000001111111101101		1	30	30	6	2		
H2803	011	0	1	02	01	H2803_011_0	4	2	10000000000000000000000000000000000000000010		2				2		
H2803	012	0	1	02	01	H2803_012_0	4	1	01111111111111111111111111000001111111101101	Group 1	1	30	30	6	2		
H2803	012	0	1	02	01	H2803_012_0	4	2	10000000000000000000000000000000000000000010	Group 2	2				2		
H2803	801	0	1	02	01	H2803_801_0	5	1	01000000000000000000000000000000000000000000	Group 1	2				1	165.00	165.00
H2803	801	0	1	02	01	H2803_801_0	5	2	00101001000001001101001110000001011111100010	Group 2	1	25	25	6	2		
H2803	801	0	1	02	01	H2803_801_0	5	3	00000000000000000000100000000000000000000000	Group 3	2				1	175.00	175.00
H2803	801	0	1	02	01	H2803_801_0	5	4	00000010101100000000000000000000000000001101	Group 4	2				1	30.00	30.00
H2803	801	0	1	02	01	H2803_801_0	5	5	00000000000000110000000000000000000000000000	Group 5	1	0	25	6	1	0.00	15.00
H2803	801	0	1	02	01	H2803_801_0	5	6	00010000000000000000000000000000000000000000	Group 6	2				1	75.00	75.00
H2803	801	0	1	02	01	H2803_801_0	5	7	00000000010010000010000000000000000000000000	Group 7	2				1	35.00	45.00
H2803	801	0	1	02	01	H2803_801_0	5	9	00000000000000000000000001000000000000000000	Group 9	2				2		
H2803	801	0	1	02	01	H2803_801_0	5	8	00000100000000000000000000000000100000000000	Group 8	2				1	20.00	20.00
H2931	002	0	1	02	01	H2931_002_0	3	1	01111111111111111111101111000001111111101111	Other Than Inpatient Group	1	20	20	2	2		
H2931	006	0	1	02	01	H2931_006_0	3	1	01111111111111111111101111000001111111101111	Other Than Inpatient Group	1	20	20	2	2		
H2961	002	0	1	10	05	H2961_002_0	6	1	01111111111111111111101111000001111111101111	Other Than Inpatient Group	1	20	20	2	2		
H2961	011	0	1	10	05	H2961_011_0	5	1	01111111111111111111101111000001111111101111	Other Than Inpatient Group	1	20	20	2	2		
H3154	005	0	1	02	01	H3154_005_0	10	3	10000000000000000000000000000000000000000000	Hearing Aids	2				2		
H3154	005	0	1	02	01	H3154_005_0	10	2	00000000000000000000000000000000000000000001	Hearing Exams	2				1	50.00	50.00
H3154	005	0	1	02	01	H3154_005_0	10	1	01111111111111111111001111000011111111100110	General OON Benefits	1	35	35	2	2		
H3154	006	0	1	02	01	H3154_006_0	10	1	01111111111111111111001111000011111111100110	General OON Benefits	1	35	35	2	2		
H3154	006	0	1	02	01	H3154_006_0	10	3	10000000000000000000000000000000000000000000	Hearing Aids	2				2		
H3154	006	0	1	02	01	H3154_006_0	10	2	00000000000000000000000000000000000000000001	Hearing Exams	2				1	50.00	50.00
H3154	801	0	1	02	01	H3154_801_0	9	3	10000000000000000000000000000000000000000000	Hearing Aids	2				2		
H3154	801	0	1	02	01	H3154_801_0	9	2	00000000000000000000000000000000000000000001	Hearing Exams	2				1	50.00	50.00
H3154	801	0	1	02	01	H3154_801_0	9	1	01111111111111111111001111000011111111100110	General OON Benefits	1	30	30	2	2		
H3154	802	0	1	02	01	H3154_802_0	10	2	00000000000000000000000000000000000000000001	Hearing Exams	2				1	50.00	50.00
H3154	802	0	1	02	01	H3154_802_0	10	3	10000000000000000000000000000000000000000000	Hearing Aids	2				2		
H3154	802	0	1	02	01	H3154_802_0	10	1	01111111111111111111001111000011111111100110	General OON Benefits	1	30	30	2	2		
H3154	805	0	1	02	01	H3154_805_0	10	1	01111111111111111111001111000011111111100110	General OON Benefits	1	30	30	2	2		
H3154	805	0	1	02	01	H3154_805_0	10	2	00000000000000000000000000000000000000000001	Hearing Exams	2				1	50.00	50.00
H3154	805	0	1	02	01	H3154_805_0	10	3	10000000000000000000000000000000000000000000	Hearing Aids	2				2		
H3156	021	0	1	02	01	H3156_021_0	8	1	11111111111111111111001111000001111111101011	Group 1	1	30	30	2	2		
H3156	024	0	1	02	01	H3156_024_0	5	1	11111111111111111111001111000001111111101011	Group 1	1	30	30	2	2		
H3327	003	0	1	06	01	H3327_003_0	7	1	11111011101101111101001111000001111111100111	Out-Of-Network Coverage	1	15	15	1	2		
H3327	023	0	1	06	01	H3327_023_0	6	1	11111011101101111101001111000001111111100111	Out-Of-Network Coverage	1	20	20	1	2		
H3327	803	0	1	06	01	H3327_803_0	7	2	01000000000000000000000000000000000000000000	SNF	2				1	0.00	125.00
H3327	803	0	1	06	01	H3327_803_0	7	1	10111011101101111101001111000001111111100111	Out-Of-Network Coverage, Non-SNF	1	20	20	1	2		
H3327	804	0	1	06	01	H3327_804_0	5	1	11111011101101111101001111000001111111100111	Out-Of-Network Coverage	1	20	20	1	2		
H3327	807	0	1	06	01	H3327_807_0	7	2	01000000000000000000000000000000000000000000	SNF	2				1	0.00	125.00
H3327	807	0	1	06	01	H3327_807_0	7	1	10111011101101111101001111000001111111100111	Out-Of-Network Coverage, Non-SNF	1	20	20	1	2		
H3327	808	0	1	06	01	H3327_808_0	5	1	11111011101101111101001111000001111111100111	Out-Of-Network Coverage	1	20	20	1	2		
H3362	807	0	1	02	01	H3362_807_0	7	1	01101111111111111111001111000011011111101001	Out of Network	1	20	20	1	2		
H3362	814	0	1	02	01	H3362_814_0	6	1	01101111111111111111001111000011011111101001	Out of Network	1	20	20	1	2		
H3379	024	0	1	02	01	H3379_024_0	6	4	00000000000000110000000000000000000000000000		1	0	30	6	1	0.00	20.00
H3379	024	0	1	02	01	H3379_024_0	6	5	00010000000000000000000000000000000000000000		2				1	75.00	75.00
H3379	024	0	1	02	01	H3379_024_0	6	6	00000000010010000010000000000000000000000000		2				1	35.00	45.00
H3379	024	0	1	02	01	H3379_024_0	6	7	00000100000000000000000000000000100000000000		2				1	18.00	18.00
H3379	024	0	1	02	01	H3379_024_0	6	8	00000010101100000000000000000000000000001101		2				1	38.00	38.00
H3379	024	0	1	02	01	H3379_024_0	6	9	00000000000000000000000001000000000000000010		2				2		
H3379	024	0	1	02	01	H3379_024_0	6	1	01000000000000000000000000000000000000000000		2				1	180.00	180.00
H3379	024	0	1	02	01	H3379_024_0	6	2	00101001000001001101001110000001011111100000		1	30	30	6	2		
H3379	024	0	1	02	01	H3379_024_0	6	3	00000000000000000000100000000000000000000000		2				1	175.00	175.00
H3379	034	0	1	02	01	H3379_034_0	6	1	01000000000000000000000000000000000000000000		2				1	180.00	180.00
H3379	034	0	1	02	01	H3379_034_0	6	2	00101001000001011101001110000001011111100000		1	30	30	6	2		
H3379	034	0	1	02	01	H3379_034_0	6	3	00000000000000000000100000000000000000000000		2				1	175.00	175.00
H3379	034	0	1	02	01	H3379_034_0	6	4	00000000000000110000000000000000000000000000		1	0	30	6	1	0.00	20.00
H3379	034	0	1	02	01	H3379_034_0	6	5	00010000000000000000000000000000000000000000		2				1	75.00	75.00
H3379	034	0	1	02	01	H3379_034_0	6	6	00000000010010000010000000000000000000000000		2				1	35.00	45.00
H3379	034	0	1	02	01	H3379_034_0	6	9	00000100000000000000000000000000100000000000		2				1	18.00	18.00
H3379	034	0	1	02	01	H3379_034_0	6	7	00000000000000000000000001000000000000000000		2				2		
H3379	034	0	1	02	01	H3379_034_0	6	8	00000010101000000000000000000000000000001101		2				1	38.00	38.00
H3435	001	0	1	37	05	H3435_001_0	3	1	01111011111111111111101111000001111111101101	Group 1	1	30	30	6	2		
H3435	001	0	1	37	05	H3435_001_0	3	2	10000000000000000000000000000000000000000010	Group 2	2				2		
H3435	002	0	1	37	05	H3435_002_0	2	1	01111011111111111111101111000001111111101101	Group 1	1	30	30	6	2		
H3435	002	0	1	37	05	H3435_002_0	2	2	10000000000000000000000000000000000000000010	Group 2	2				2		
H3435	003	0	1	37	05	H3435_003_0	4	2	10000000000000000000000000000000000000000010	Group 2	2				2		
H3435	003	0	1	37	05	H3435_003_0	4	1	01111011111111111111101111000001111111101101	Group 1	1	30	30	6	2		
H3659	001	0	1	02	01	H3659_001_0	8	3	00000000000000000000100000000000000000000000		2				1	175.00	175.00
H3659	001	0	1	02	01	H3659_001_0	8	9	00000010101100000000000000000000000000001101		2				1	38.00	38.00
H3659	001	0	1	02	01	H3659_001_0	8	5	00000000000000110000000000000000000000000000		1	30	30	6	1	20.00	20.00
H3659	001	0	1	02	01	H3659_001_0	8	6	00010000000000000000000000000000000000000000		2				1	75.00	75.00
H3659	001	0	1	02	01	H3659_001_0	8	7	00000000010010000010000000000000000000000000		2				1	35.00	45.00
H3659	001	0	1	02	01	H3659_001_0	8	8	00000100000000000000000000000000100000000000		2				1	25.00	25.00
H3659	001	0	1	02	01	H3659_001_0	8	2	00101001000001001101001110000001011111100010		1	30	30	6	2		
H3659	001	0	1	02	01	H3659_001_0	8	1	01000000000000000000000000000000000000000000		2				1	170.00	170.00
H3659	001	0	1	02	01	H3659_001_0	8	4	00000000000000000000000001000000000000000000		2				2		
H3659	033	0	1	02	01	H3659_033_0	8	1	00101001000001001101001110000001011111100010		1	30	30	6	2		
H3659	033	0	1	02	01	H3659_033_0	8	2	00000000000000000000100000000000000000000000		2				1	175.00	175.00
H3659	033	0	1	02	01	H3659_033_0	8	9	01000000000000000000000000000000000000000000		2				1	150.00	150.00
H3659	033	0	1	02	01	H3659_033_0	8	8	00000000000000000000000001000000000000000000		2				2		
H3659	033	0	1	02	01	H3659_033_0	8	7	00000010101100000000000000000000000000001101		2				1	35.00	35.00
H3659	033	0	1	02	01	H3659_033_0	8	6	00000100000000000000000000000000100000000000		2				1	15.00	15.00
H3659	033	0	1	02	01	H3659_033_0	8	5	00000000010010000010000000000000000000000000		2				1	35.00	45.00
H3659	033	0	1	02	01	H3659_033_0	8	4	00010000000000000000000000000000000000000000		2				1	75.00	75.00
H3659	033	0	1	02	01	H3659_033_0	8	3	00000000000000110000000000000000000000000000		1	0	30	6	1	0.00	20.00
H3659	050	0	1	02	01	H3659_050_0	7	1	01000000000000000000000000000000000000000000		2				1	170.00	170.00
H3659	050	0	1	02	01	H3659_050_0	7	2	00101001000001001101001110000001011111100010		1	30	30	6	2		
H3659	050	0	1	02	01	H3659_050_0	7	9	00000000000000000000000001000000000000000000		2				2		
H3659	050	0	1	02	01	H3659_050_0	7	8	00000010101100000000000000000000000000001101		2				1	38.00	38.00
H3659	050	0	1	02	01	H3659_050_0	7	7	00000100000000000000000000000000100000000000		2				1	25.00	25.00
H3659	050	0	1	02	01	H3659_050_0	7	6	00000000010010000010000000000000000000000000		2				1	35.00	45.00
H3659	050	0	1	02	01	H3659_050_0	7	5	00010000000000000000000000000000000000000000		2				1	75.00	75.00
H3659	050	0	1	02	01	H3659_050_0	7	4	00000000000000110000000000000000000000000000		1	30	30	6	1	20.00	20.00
H3659	050	0	1	02	01	H3659_050_0	7	3	00000000000000000000100000000000000000000000		2				1	175.00	175.00
H3659	055	0	1	02	01	H3659_055_0	6	1	01000000000000000000000000000000000000000000		2				1	150.00	150.00
H3659	055	0	1	02	01	H3659_055_0	6	2	00101001000001001101001110000001011111100010		1	30	30	6	2		
H3659	055	0	1	02	01	H3659_055_0	6	3	00000000000000000000100000000000000000000000		2				1	175.00	175.00
H3659	055	0	1	02	01	H3659_055_0	6	4	00000000000000110000000000000000000000000000		1	30	30	6	1	20.00	20.00
H3659	055	0	1	02	01	H3659_055_0	6	9	00000000000000000000000001000000000000000000		2				2		
H3659	055	0	1	02	01	H3659_055_0	6	6	00000000010010000010000000000000000000000000		2				1	35.00	45.00
H3659	055	0	1	02	01	H3659_055_0	6	7	00000100000000000000000000000000100000000000		2				1	15.00	15.00
H3659	055	0	1	02	01	H3659_055_0	6	8	00000010101100000000000000000000000000001101		2				1	35.00	35.00
H3659	055	0	1	02	01	H3659_055_0	6	5	00010000000000000000000000000000000000000000		2				1	75.00	75.00
H3660	028	0	1	02	01	H3660_028_0	5	1	01000000000000000000100000000000000000000000	GROUP I SNF/AMBULANCE $75 COPAY	2				1	75.00	75.00
H3660	028	0	1	02	01	H3660_028_0	5	2	00001000000000111100000000000000000000000000	GROUP II HOME HEALTH CARE 20%	1	20	20	1	2		
H3660	028	0	1	02	01	H3660_028_0	5	3	00000100000000000000000000000000000000000000	GROUP III PCP $15	2				1	15.00	15.00
H3660	028	0	1	02	01	H3660_028_0	5	4	00110011111111000011000000000000000000000101	SPECIALIST $40 COPAYS	2				1	40.00	40.00
H3660	028	0	1	02	01	H3660_028_0	5	5	00000000000000000000001110000000000000000000	Group V DME Prothetics, Diabetic Sup.30%	1	30	30	1	2		
H3660	028	0	1	02	01	H3660_028_0	5	6	00000000000000000000000000000000000000100000	Group VI - Diabletic Monitoring.$0	2				2		
H3660	028	0	1	02	01	H3660_028_0	5	7	00000000000000000000000000000001111110000000	Group VII Preventive Services $15	2				1	15.00	15.00
H3660	029	0	1	02	01	H3660_029_0	5	3	00001000000000000000000000000000000000000000	Group III 20% HHS	1	20	20	1	2		
H3660	029	0	1	02	01	H3660_029_0	5	2	00000000000000000000100000000000000000000000	Group II $75 Copay Ambulanc	2				1	75.00	75.00
H3660	029	0	1	02	01	H3660_029_0	5	1	01000000000000000000000000000000000000000000	Group I SNF $100	2				1	100.00	100.00
H3660	029	0	1	02	01	H3660_029_0	5	4	00000100000000000000000000000000000000000000	GROUP IV PCP	2				1	15.00	15.00
H3660	029	0	1	02	01	H3660_029_0	5	5	00110011111111000011000000000000000000000101	GROUP V $45	2				1	45.00	45.00
H3660	029	0	1	02	01	H3660_029_0	5	6	00000000000000111100001110000000000000000000	GROUP 6 30%	1	30	30	1	2		
H3660	029	0	1	02	01	H3660_029_0	5	7	00000000000000000000000000000000000000100000	Group VII Diabetic Monitoring	2				2		
H3660	029	0	1	02	01	H3660_029_0	5	8	00000000000000000000000000000001111111000000	Group 8 - Preventive Care $15	2				1	15.00	15.00
H3660	805	0	1	02	01	H3660_805_0	2	3	00001000000000111100000000000000000000000000	Group III 20% HHS OCDT LAB	1	20	20	1	2		
H3660	805	0	1	02	01	H3660_805_0	2	2	00000000000000000000100000000000000000000000	Group II $75 Copay Ambulance	2				1	75.00	75.00
H3660	805	0	1	02	01	H3660_805_0	2	1	01000000000000000000000000000000000000000000	Group I SNF $100	2				1	100.00	100.00
H3660	805	0	1	02	01	H3660_805_0	2	4	00000100000000000000000000000000000000000000	GROUP IV PCP $35	2				1	35.00	35.00
H3660	805	0	1	02	01	H3660_805_0	2	8	00000000000000000000000000000001111111000000	OON Preventive Services	2				1	15.00	15.00
H3660	805	0	1	02	01	H3660_805_0	2	7	00000000000000000000000000000000000000100000	Group VII Diabetic Monitoring $0	2				2		
H3660	805	0	1	02	01	H3660_805_0	2	6	00000000000000000000001110000000000000000000	GROUP 6 30%	1	30	30	1	2		
H3660	805	0	1	02	01	H3660_805_0	2	5	00110011111111000011000000000000000000000101	GROUP V $55 specialist	2				1	55.00	55.00
H3660	806	0	1	02	01	H3660_806_0	3	1	01000000000000000000000000000000000000000000	Group I SNF $100	2				1	100.00	100.00
H3660	806	0	1	02	01	H3660_806_0	3	2	00000000000000000000100000000000000000000000	Group II $75 Copay Ambulance	2				1	75.00	75.00
H3660	806	0	1	02	01	H3660_806_0	3	3	00001000000000111100000000000000000000000000	Group III 20% HHS OCDT LAB	1	20	20	1	2		
H3660	806	0	1	02	01	H3660_806_0	3	7	00000000000000000000000000000000000000100000	Group VII Diabetic Monitoring	2				2		
H3660	806	0	1	02	01	H3660_806_0	3	6	00000000000000000000001110000000000000000000	GROUP 6 30%	1	30	30	1	2		
H3660	806	0	1	02	01	H3660_806_0	3	5	00110011111111000011000000000000000000000101	GROUP V $55 Specialist	2				1	55.00	55.00
H3660	806	0	1	02	01	H3660_806_0	3	4	00000100000000000000000000000000000000000000	GROUP IV PCP $35	2				1	35.00	35.00
H3660	806	0	1	02	01	H3660_806_0	3	8	00000000000000000000000000000001111111000000	OON Preventive Services	2				1	15.00	15.00
H3706	007	0	1	02	01	H3706_007_0	4	2	00000100000000000000000000000000000000000000	POS Primary Care Physician Services	2				2		
H3706	007	0	1	02	01	H3706_007_0	4	1	01111011101101111101111111000001111111101111	POS out of network services	1	20	20	2	2		
H3706	008	0	1	02	01	H3706_008_0	4	2	01111011101101111101111111000001111111101111	POS Out of Network Services	1	20	20	2	2		
H3706	008	0	1	02	01	H3706_008_0	4	1	00000100000000000000000000000000000000000000	POS Out of Network PCP Services	2				2		
H3864	007	0	1	02	01	H3864_007_0	7	1	00000100100000010000000000000000000000000000	Doctor Office Visits	1	10	10	6	2		
H3887	001	0	1	02	01	H3887_001_0	5	2	00000000000000000000000000000000000000000010	Group 2	2				2		
H3887	001	0	1	02	01	H3887_001_0	5	1	01111111111111111111111111000001111111101101	Group 1	1	30	30	6	2		
H3887	002	0	1	02	01	H3887_002_0	7	1	01111111111111111111111111000001111111101101		1	30	30	6	2		
H3887	002	0	1	02	01	H3887_002_0	7	2	10000000000000000000000000000000000000000000		2				2		
H3887	003	0	1	02	01	H3887_003_0	5	5	00000000010010000010000000000000000000000000		2				1	35.00	45.00
H3887	003	0	1	02	01	H3887_003_0	5	4	00000010101100000000000000000000000000001101		2				1	35.00	35.00
H3887	003	0	1	02	01	H3887_003_0	5	3	00000000000000000000001110000000000000000000		1	30	30	6	2		
H3887	003	0	1	02	01	H3887_003_0	5	2	00101001000001001101000000000001011111100010		1	40	40	6	2		
H3887	003	0	1	02	01	H3887_003_0	5	10	01000000000000000000000000000000000000000000		2				1	150.00	150.00
H3887	003	0	1	02	01	H3887_003_0	5	1	00000000000000000000000001000000000000000000		2				2		
H3887	003	0	1	02	01	H3887_003_0	5	6	00000000000000000000100000000000000000000000		2				1	175.00	175.00
H3887	003	0	1	02	01	H3887_003_0	5	9	00000000000000110000000000000000000000000000		1	0	40	6	1	0.00	20.00
H3887	003	0	1	02	01	H3887_003_0	5	8	00000100000000100000000000000000100000000000		2				1	20.00	20.00
H3887	003	0	1	02	01	H3887_003_0	5	7	00010000000000000000000000000000000000000000		2				1	75.00	75.00
H3887	004	0	1	02	01	H3887_004_0	3	1	00000000000000000000000001000000000000000000		2				2		
H3887	004	0	1	02	01	H3887_004_0	3	10	01000000000000000000000000000000000000000000		2				1	150.00	150.00
H3887	004	0	1	02	01	H3887_004_0	3	2	00101001000001001101000000000001011111100010		1	40	40	6	2		
H3887	004	0	1	02	01	H3887_004_0	3	3	00000000000000000000001110000000000000000000		1	30	30	6	2		
H3887	004	0	1	02	01	H3887_004_0	3	9	00000000000000110000000000000000000000000000		1	0	40	6	1	0.00	20.00
H3887	004	0	1	02	01	H3887_004_0	3	5	00000000010010000010000000000000000000000000		2				1	35.00	45.00
H3887	004	0	1	02	01	H3887_004_0	3	8	00000100000000000000000000000000100000000000		2				1	20.00	20.00
H3887	004	0	1	02	01	H3887_004_0	3	7	00010000000000000000000000000000000000000000		2				1	75.00	75.00
H3887	004	0	1	02	01	H3887_004_0	3	6	00000000000000000000100000000000000000000000		2				1	175.00	175.00
H3887	004	0	1	02	01	H3887_004_0	3	4	00000010101100000000000000000000000000001101		2				1	35.00	35.00
H3887	801	0	1	02	01	H3887_801_0	6	1	00000000000000000000000001000000000000000000		2				2		
H3887	801	0	1	02	01	H3887_801_0	6	2	00101001000001001101000000000001011111100000		1	40	40	6	2		
H3887	801	0	1	02	01	H3887_801_0	6	3	00000000000000000000001110000000000000000000		1	30	30	6	2		
H3887	801	0	1	02	01	H3887_801_0	6	4	00000010101100000000000000000000000000001101		2				1	35.00	35.00
H3887	801	0	1	02	01	H3887_801_0	6	5	00000000010010000010000000000000000000000000		2				1	35.00	45.00
H3887	801	0	1	02	01	H3887_801_0	6	6	01000000000000000000100000000000000000000000		2				1	175.00	175.00
H3887	801	0	1	02	01	H3887_801_0	6	7	00010000000000000000000000000000000000000000		2				1	75.00	75.00
H3887	801	0	1	02	01	H3887_801_0	6	8	00000000000000110000000000000000000000000000		1	0	40	6	1	0.00	20.00
H3887	801	0	1	02	01	H3887_801_0	6	9	00000100000000000000000000000000100000000000		2				1	25.00	25.00
H3887	802	0	1	02	01	H3887_802_0	3	1	00000000000000000000000001000000000000000000		2				2		
H3887	802	0	1	02	01	H3887_802_0	3	2	00101001000001001101000000000001011111100000		1	40	40	6	2		
H3887	802	0	1	02	01	H3887_802_0	3	3	00000000000000000000001110000000000000000000		1	30	30	6	2		
H3887	802	0	1	02	01	H3887_802_0	3	4	00000010101100000000000000000000000000001101		2				1	35.00	35.00
H3887	802	0	1	02	01	H3887_802_0	3	5	00000000010010000010000000000000000000000000		2				1	35.00	45.00
H3887	802	0	1	02	01	H3887_802_0	3	6	01000000000000000000100000000000000000000000		2				1	175.00	175.00
H3887	802	0	1	02	01	H3887_802_0	3	9	00000100000000000000000000000000100000000000		2				1	25.00	25.00
H3887	802	0	1	02	01	H3887_802_0	3	7	00010000000000000000000000000000000000000000		2				1	75.00	75.00
H3887	802	0	1	02	01	H3887_802_0	3	8	00000000000000110000000000000000000000000000		1	0	40	6	1	0.00	20.00
H3952	030	0	1	02	01	H3952_030_0	4	1	11111011111111111111001111000000000001101011	Group 1	1	20	20	2	2		
H3952	032	0	1	02	01	H3952_032_0	8	1	11111011111111111111001111000000000001101011	Group 1	1	20	20	2	2		
H4003	001	0	1	02	01	H4003_001_0	5	2	00000000000000000000001100000000000000000000	DME	1	20	20	1	2		
H4003	001	0	1	02	01	H4003_001_0	5	1	01111111111111111111100011100001111111100000	General	2				2		
H4208	001	0	1	02	01	H4208_001_0	4	2	00000000000000001100000000000000000000000000	Outpatient Surgery	1	0	20	1	1	0.00	50.00
H4208	001	0	1	02	01	H4208_001_0	4	10	00000000000000000000000000000000000000001000	Dental Services Due to an Accident	2				1	25.00	25.00
H4208	001	0	1	02	01	H4208_001_0	4	1	00000110101100000000000000000000000000000000	Physician Services	2				1	10.00	25.00
H4208	001	0	1	02	01	H4208_001_0	4	3	00000000000000000000100000000000000000000000	Ambulance Services	2				1	50.00	50.00
H4208	001	0	1	02	01	H4208_001_0	4	5	00000000000000000000001100000000000000000000	Durable Medical Equipment & Prosthetics	1	30	30	1	2		
H4208	001	0	1	02	01	H4208_001_0	4	4	00100001000001000001000000000000000000000000	Outpatient Rehabilitation Services	2				1	10.00	10.00
H4208	001	0	1	02	01	H4208_001_0	4	9	00000000000000000000000000000000000000000001	Hearing Services	2				1	25.00	25.00
H4208	001	0	1	02	01	H4208_001_0	4	8	00000000000000000000000000000001111111000000	Preventive Services & Screenings	2				2		
H4208	001	0	1	02	01	H4208_001_0	4	7	00000000000000110000000001000000000000000000	Diagnostic Test, X-ray, Lab Services	1	20	30	1	2		
H4208	001	0	1	02	01	H4208_001_0	4	6	00000000000000000000000010000000000000100000	Diabetes, Self-Monitoring, Training, etc	1	0	30	1	1	10.00	25.00
H4208	002	0	1	02	01	H4208_002_0	3	1	00000110101100000000000000000000000000000000	Physician Services	2				1	15.00	30.00
H4208	002	0	1	02	01	H4208_002_0	3	10	00000000000000000000000000000000000000001000	Dental Services Due to an Accident	2				1	30.00	30.00
H4208	002	0	1	02	01	H4208_002_0	3	2	00000000000000001100000000000000000000000000	Outpatient Surgery	1	20	20	1	2		
H4208	002	0	1	02	01	H4208_002_0	3	3	00000000000000000000100000000000000000000000	Ambulance Services	1	20	20	2	2		
H4208	002	0	1	02	01	H4208_002_0	3	9	00000000000000000000000000000000000000000001	Hearing Services	2				1	30.00	30.00
H4208	002	0	1	02	01	H4208_002_0	3	8	00000000000000000000000000000001111111000000	Preventive Services & Screenings	2				2		
H4208	002	0	1	02	01	H4208_002_0	3	7	00000000000000110000000001000000000000000000	Diagnostic Test, X-ray, Lab Services	1	20	50	1	2		
H4208	002	0	1	02	01	H4208_002_0	3	6	00000000000000000000000010000000000000100000	Diabetes, Self-Monitoring, Training, etc	1	0	50	1	1	15.00	30.00
H4208	002	0	1	02	01	H4208_002_0	3	5	00000000000000000000001100000000000000000000	Durable Medical Equipment & Prosthetics	1	50	50	1	2		
H4208	002	0	1	02	01	H4208_002_0	3	4	00100001000001000001000000000000000000000000	Outpatient Rehabilitation Services	2				1	30.00	30.00
H4208	008	0	1	02	01	H4208_008_0	4	7	00000000000000110000000001000000000000000000	Diagnostic Test, X-ray, Lab Services	1	20	30	1	2		
H4208	008	0	1	02	01	H4208_008_0	4	6	00000000000000000000000010000000000000100000	Diabetes, Self-Monitoring, Training, etc	1	0	30	1	1	10.00	25.00
H4208	008	0	1	02	01	H4208_008_0	4	5	00000000000000000000001100000000000000000000	Durable Medical Equipment & Prosthetics	1	30	30	1	2		
H4208	008	0	1	02	01	H4208_008_0	4	4	00100001000001000001000000000000000000000000	Outpatient Rehabilitation Services	2				1	10.00	10.00
H4208	008	0	1	02	01	H4208_008_0	4	3	00000000000000000000100000000000000000000000	Ambulance Services	2				1	50.00	50.00
H4208	008	0	1	02	01	H4208_008_0	4	2	00000000000000001100000000000000000000000000	Outpatient Surgery	1	0	20	1	1	0.00	50.00
H4208	008	0	1	02	01	H4208_008_0	4	10	00000000000000000000000000000000000000001000	Dental Services Due to an Accident	2				1	25.00	25.00
H4208	008	0	1	02	01	H4208_008_0	4	1	00000110101100000000000000000000000000000000	Physician Services	2				1	10.00	25.00
H4208	008	0	1	02	01	H4208_008_0	4	8	00000000000000000000000000000001111111000000	Preventive Services & Screenings	2				2		
H4208	008	0	1	02	01	H4208_008_0	4	9	00000000000000000000000000000000000000000001	Hearing Services	2				1	25.00	25.00
H4208	009	0	1	02	01	H4208_009_0	3	3	00000000000000000000100000000000000000000000	Ambulance Services	1	20	20	2	2		
H4208	009	0	1	02	01	H4208_009_0	3	2	00000000000000001100000000000000000000000000	Outpatient Surgery	1	20	20	1	2		
H4208	009	0	1	02	01	H4208_009_0	3	10	00000000000000000000000000000000000000001000	Dental Services Due to an Accident	2				1	30.00	30.00
H4208	009	0	1	02	01	H4208_009_0	3	1	00000110101100000000000000000000000000000000	Physician Services	2				1	15.00	30.00
H4208	009	0	1	02	01	H4208_009_0	3	9	00000000000000000000000000000000000000000001	Hearing Services	2				1	30.00	30.00
H4208	009	0	1	02	01	H4208_009_0	3	5	00000000000000000000001100000000000000000000	Durable Medical Equipment & Prosthetics	1	50	50	1	2		
H4208	009	0	1	02	01	H4208_009_0	3	6	00000000000000000000000010000000000000100000	Diabetes, Self-Monitoring, Training, etc	1	0	50	1	1	15.00	30.00
H4208	009	0	1	02	01	H4208_009_0	3	7	00000000000000110000000001000000000000000000	Diagnostic Test, X-ray, Lab Services	1	20	50	1	2		
H4208	009	0	1	02	01	H4208_009_0	3	8	00000000000000000000000000000001111111000000	Preventive Services & Screenings	2				2		
H4208	009	0	1	02	01	H4208_009_0	3	4	00100001000001000001000000000000000000000000	Outpatient Rehabilitation Services	2				1	30.00	30.00
H4208	801	0	1	02	01	H4208_801_0	2	3	00000000000000000000100000000000000000000000	Ambulance Services	1	20	20	2	2		
H4208	801	0	1	02	01	H4208_801_0	2	2	00000000000000001100000000000000000000000000	Outpatient Surgery	1	20	20	1	2		
H4208	801	0	1	02	01	H4208_801_0	2	10	00000000000000000000000000000000000000001000	Dental Services Due to an Accident	2				1	30.00	30.00
H4208	801	0	1	02	01	H4208_801_0	2	1	00000110101100000000000000000000000000000000	Physician Services	2				1	15.00	30.00
H4208	801	0	1	02	01	H4208_801_0	2	4	00100001000001000001000000000000000000000000	Outpatient Rehabilitation Services	2				1	20.00	20.00
H4208	801	0	1	02	01	H4208_801_0	2	9	00000000000000000000000000000000000000000001	Hearing Services	2				1	30.00	30.00
H4208	801	0	1	02	01	H4208_801_0	2	8	00000000000000000000000000000001111111000000	Preventive Services & Screenings	2				2		
H4208	801	0	1	02	01	H4208_801_0	2	7	00000000000000110000000001000000000000000000	Diagnostic Test, X-ray, Lab Services	1	20	50	1	2		
H4208	801	0	1	02	01	H4208_801_0	2	6	00000000000000000000000010000000000000100000	Diabetes, Self-Monitoring, Training, etc	1	0	50	1	1	15.00	30.00
H4208	801	0	1	02	01	H4208_801_0	2	5	00000000000000000000001100000000000000000000	Durable Medical Equipment & Prosthetics	1	50	50	1	2		
H4208	802	0	1	02	01	H4208_802_0	2	1	00000110101100000000000000000000000000000000	Physician Services	2				1	15.00	30.00
H4208	802	0	1	02	01	H4208_802_0	2	10	00000000000000000000000000000000000000001000	Dental Services Due to an Accident	2				1	30.00	30.00
H4208	802	0	1	02	01	H4208_802_0	2	2	00000000000000001100000000000000000000000000	Outpatient Surgery	1	20	20	1	2		
H4208	802	0	1	02	01	H4208_802_0	2	3	00000000000000000000100000000000000000000000	Ambulance Services	1	20	20	2	2		
H4208	802	0	1	02	01	H4208_802_0	2	9	00000000000000000000000000000000000000000001	Hearing Services	2				1	30.00	30.00
H4208	802	0	1	02	01	H4208_802_0	2	7	00000000000000110000000001000000000000000000	Diagnostic Test, X-ray, Lab Services	1	20	50	1	2		
H4208	802	0	1	02	01	H4208_802_0	2	6	00000000000000000000000010000000000000100000	Diabetes, Self-Monitoring, Training, etc	1	0	50	1	1	15.00	30.00
H4208	802	0	1	02	01	H4208_802_0	2	5	00000000000000000000001100000000000000000000	Durable Medical Equipment & Prosthetics	1	50	50	1	2		
H4208	802	0	1	02	01	H4208_802_0	2	4	00100001000001000001000000000000000000000000	Outpatient Rehabilitation Services	2				1	20.00	20.00
H4208	802	0	1	02	01	H4208_802_0	2	8	00000000000000000000000000000001111111000000	Preventive Services & Screenings	2				2		
H4208	803	0	1	02	01	H4208_803_0	2	4	00100001000001000001000000000000000000000000	Outpatient Rehabilitation Services	2				1	20.00	20.00
H4208	803	0	1	02	01	H4208_803_0	2	5	00000000000000000000001100000000000000000000	Durable Medical Equipment & Prosthetics	1	50	50	1	2		
H4208	803	0	1	02	01	H4208_803_0	2	6	00000000000000000000000010000000000000100000	Diabetes, Self-Monitoring, Training, etc	1	0	50	1	1	15.00	30.00
H4208	803	0	1	02	01	H4208_803_0	2	7	00000000000000110000000001000000000000000000	Diagnostic Test, X-ray, Lab Services	1	20	50	1	2		
H4208	803	0	1	02	01	H4208_803_0	2	8	00000000000000000000000000000001111111000000	Preventive Services & Screenings	2				2		
H4208	803	0	1	02	01	H4208_803_0	2	9	00000000000000000000000000000000000000000001	Hearing Services	2				1	30.00	30.00
H4208	803	0	1	02	01	H4208_803_0	2	1	00000110101100000000000000000000000000000000	Physician Services	2				1	15.00	30.00
H4208	803	0	1	02	01	H4208_803_0	2	10	00000000000000000000000000000000000000001000	Dental Services Due to an Accident	2				1	30.00	30.00
H4208	803	0	1	02	01	H4208_803_0	2	2	00000000000000001100000000000000000000000000	Outpatient Surgery	1	20	20	1	2		
H4208	803	0	1	02	01	H4208_803_0	2	3	00000000000000000000100000000000000000000000	Ambulance Services	1	20	20	2	2		
H4406	001	0	1	02	01	H4406_001_0	7	7	00000010101100000000000000000000000000001101		2				1	40.00	40.00
H4406	001	0	1	02	01	H4406_001_0	7	6	00000100000000000000000000000000100000000000		2				1	20.00	20.00
H4406	001	0	1	02	01	H4406_001_0	7	2	00000000000000000000100000000000000000000000		2				1	175.00	175.00
H4406	001	0	1	02	01	H4406_001_0	7	1	00101001000001001101001110000001011111100010		1	30	30	6	2		
H4406	001	0	1	02	01	H4406_001_0	7	3	00000000000000110000000000000000000000000000		1	0	30	6	1	0.00	20.00
H4406	001	0	1	02	01	H4406_001_0	7	4	00010000000000000000000000000000000000000000		2				1	75.00	75.00
H4406	001	0	1	02	01	H4406_001_0	7	5	00000000010010000010000000000000000000000000		2				1	35.00	45.00
H4406	001	0	1	02	01	H4406_001_0	7	8	00000000000000000000000001000000000000000000		2				2		
H4406	003	0	1	02	01	H4406_003_0	6	6	00000100000000000000000000000000100000000000		2				1	20.00	20.00
H4406	003	0	1	02	01	H4406_003_0	6	7	00000010101100000000000000000000000000001101		2				1	40.00	40.00
H4406	003	0	1	02	01	H4406_003_0	6	1	00101001000001001101001110000001011111100010		1	30	30	6	2		
H4406	003	0	1	02	01	H4406_003_0	6	4	00010000000000000000000000000000000000000000		2				1	75.00	75.00
H4406	003	0	1	02	01	H4406_003_0	6	3	00000000000000110000000000000000000000000000		1	0	30	6	1	0.00	20.00
H4406	003	0	1	02	01	H4406_003_0	6	2	00000000000000000000100000000000000000000000		2				1	175.00	175.00
H4406	003	0	1	02	01	H4406_003_0	6	5	00000000010010000010000000000000000000000000		2				1	35.00	45.00
H4406	003	0	1	02	01	H4406_003_0	6	8	00000000000000000000000001000000000000000000		2				2		
H4604	003	0	1	02	01	H4604_003_0	7	2	01000000000000000000100000000000000000000000		2				1	175.00	175.00
H4604	003	0	1	02	01	H4604_003_0	7	1	00000010101100000000000000000000000000001101		2				1	35.00	35.00
H4604	003	0	1	02	01	H4604_003_0	7	7	00000000000000000000000001000000000000000000		2				2		
H4604	003	0	1	02	01	H4604_003_0	7	5	00000000010010000010000000000000000000000000		2				1	35.00	45.00
H4604	003	0	1	02	01	H4604_003_0	7	4	00010000000000000000000000000000000000000000		2				1	75.00	75.00
H4604	003	0	1	02	01	H4604_003_0	7	3	00101001000001111101001110000001011111100010		1	30	30	6	2		
H4604	003	0	1	02	01	H4604_003_0	7	6	00000100000000000000000000000000100000000000		2				1	20.00	20.00
H4604	005	0	1	02	01	H4604_005_0	5	9	00000100000000000000000000000000000000000000		2				1	15.00	15.00
H4604	005	0	1	02	01	H4604_005_0	5	7	01000000000000000000000000000000000000000000		2				1	150.00	150.00
H4604	005	0	1	02	01	H4604_005_0	5	6	00101001000001111101000000000001011111100010		1	20	20	6	2		
H4604	005	0	1	02	01	H4604_005_0	5	5	00000000010010000010000000000000000000000000		2				1	35.00	45.00
H4604	005	0	1	02	01	H4604_005_0	5	4	00010000000000000000000000000000000000000000		2				1	75.00	75.00
H4604	005	0	1	02	01	H4604_005_0	5	3	00000000000000000000001110000000000000000000		1	30	30	6	2		
H4604	005	0	1	02	01	H4604_005_0	5	2	00000000000000000000100000000000000000000000		2				1	175.00	175.00
H4604	005	0	1	02	01	H4604_005_0	5	1	00000010101100000000000000000000000000001101		2				1	30.00	30.00
H4604	005	0	1	02	01	H4604_005_0	5	8	00000000000000000000000001000000000000000000		2				2		
H4604	006	0	1	02	01	H4604_006_0	5	2	10000000000000000000000000000000000000000010	Group 2	2				2		
H4604	006	0	1	02	01	H4604_006_0	5	1	01111111111111111111111111000001111111101101	Group 1	1	30	30	6	2		
H4604	007	0	1	02	01	H4604_007_0	5	1	01111111111111111111111111000001111111101101	Group 1	1	30	30	6	2		
H4604	007	0	1	02	01	H4604_007_0	5	2	10000000000000000000000000000000000000000010	Group 2	2				2		
H4779	001	0	1	37	05	H4779_001_0	3	1	01111011111111111111101111000001111111101101	Group 1	1	30	30	6	2		
H4779	001	0	1	37	05	H4779_001_0	3	2	10000000000000000000000000000000000000000010	Group 2	2				2		
H4779	002	0	1	37	05	H4779_002_0	2	2	10000000000000000000000000000000000000000010	Group 2	2				2		
H4779	002	0	1	37	05	H4779_002_0	2	1	01111011111111111111101111000001111111101101	Group 1	1	30	30	6	2		
H4779	003	0	1	37	05	H4779_003_0	4	2	10000000000000000000000000000000000000000010	Group 2	2				2		
H4779	003	0	1	37	05	H4779_003_0	4	1	01111011111111111111101111000001111111101101	Group 1	1	30	30	6	2		
H5253	004	0	1	02	01	H5253_004_0	10	4	01000000000000000000000000000000000000000000		2				1	150.00	150.00
H5253	004	0	1	02	01	H5253_004_0	10	5	00010000000000000000000000000000000000000000		2				1	75.00	75.00
H5253	004	0	1	02	01	H5253_004_0	10	6	00000010101100000000000000000000000000001101		2				1	35.00	35.00
H5253	004	0	1	02	01	H5253_004_0	10	7	00000100000000000000000000000000100000000000		2				1	20.00	20.00
H5253	004	0	1	02	01	H5253_004_0	10	8	00000000000000000000000001000000000000000000		2				2		
H5253	004	0	1	02	01	H5253_004_0	10	9	00000000000000110000000000000000000000000000		1	0	30	6	1	0.00	20.00
H5253	004	0	1	02	01	H5253_004_0	10	1	00101001000001001101001110000001011111100010		1	30	30	6	2		
H5253	004	0	1	02	01	H5253_004_0	10	2	00000000010010000010000000000000000000000000		2				1	35.00	45.00
H5253	004	0	1	02	01	H5253_004_0	10	3	00000000000000000000100000000000000000000000		2				1	175.00	175.00
H5253	011	0	1	02	01	H5253_011_0	11	4	00000000000000110000000000000000000000000000		1	0	30	6	1	0.00	20.00
H5253	011	0	1	02	01	H5253_011_0	11	3	00010000000000000000000000000000000000000000		2				1	75.00	75.00
H5253	011	0	1	02	01	H5253_011_0	11	2	01000000000000000000000000000000000000000000		2				1	150.00	150.00
H5253	011	0	1	02	01	H5253_011_0	11	1	00101001000001001101001110000001011111100010		1	30	30	6	2		
H5253	011	0	1	02	01	H5253_011_0	11	9	00000000000000000000100000000000000000000000		2				1	175.00	175.00
H5253	011	0	1	02	01	H5253_011_0	11	6	00000100000000000000000000000000100000000000		2				1	15.00	15.00
H5253	011	0	1	02	01	H5253_011_0	11	7	00000010101100000000000000000000000000001101		2				1	30.00	30.00
H5253	011	0	1	02	01	H5253_011_0	11	8	00000000000000000000000001000000000000000000		2				2		
H5253	011	0	1	02	01	H5253_011_0	11	5	00000000010010000010000000000000000000000000		2				1	35.00	45.00
H5253	021	0	1	02	01	H5253_021_0	8	4	00000000000000110000000000000000000000000000		1	0	30	6	1	0.00	20.00
H5253	021	0	1	02	01	H5253_021_0	8	3	00000000000000000000100000000000000000000000		2				1	175.00	175.00
H5253	021	0	1	02	01	H5253_021_0	8	2	01000000000000000000000000000000000000000000		2				1	150.00	150.00
H5253	021	0	1	02	01	H5253_021_0	8	1	00101001000001001101001110000001011111100010		1	30	30	6	2		
H5253	021	0	1	02	01	H5253_021_0	8	5	00000000010010000010000000000000000000000000		2				1	35.00	45.00
H5253	021	0	1	02	01	H5253_021_0	8	9	00000100000000000000000000000000100000000000		2				1	20.00	20.00
H5253	021	0	1	02	01	H5253_021_0	8	8	00000000000000000000000001000000000000000000		2				2		
H5253	021	0	1	02	01	H5253_021_0	8	7	00000010101100000000000000000000000000001101		2				1	35.00	35.00
H5253	021	0	1	02	01	H5253_021_0	8	6	00010000000000000000000000000000000000000000		2				1	75.00	75.00
H5253	022	0	1	02	01	H5253_022_0	4	1	00101001000001001101001110000001011111100010		1	30	30	2	2		
H5253	022	0	1	02	01	H5253_022_0	4	2	01000000000000000000000000000000000000000000		2				1	150.00	150.00
H5253	022	0	1	02	01	H5253_022_0	4	3	00000000000000000000100000000000000000000000		2				1	175.00	175.00
H5253	022	0	1	02	01	H5253_022_0	4	4	00000000000000110000000000000000000000000000		1	0	30	6	1	0.00	20.00
H5253	022	0	1	02	01	H5253_022_0	4	9	00000000000000000000000001000000000000000000		2				2		
H5253	022	0	1	02	01	H5253_022_0	4	7	00000100000000000000000000000000100000000000		2				1	15.00	15.00
H5253	022	0	1	02	01	H5253_022_0	4	6	00000000010010000010000000000000000000000000		2				1	35.00	45.00
H5253	022	0	1	02	01	H5253_022_0	4	5	00010000000000000000000000000000000000000000		2				1	75.00	75.00
H5253	022	0	1	02	01	H5253_022_0	4	8	00000010101100000000000000000000000000001101		2				1	30.00	30.00
H5302	003	0	1	02	01	H5302_003_0	3	1	01100001100101011100100001000000000000000000		1	30	30	2	2		
H5302	004	0	1	02	01	H5302_004_0	7	1	01100001100101011100100001000000000000000000		1	30	30	2	2		
H5302	805	0	1	02	01	H5302_805_0	3	1	01100001100101011100100001000000000000000000		1	20	20	2	2		
H5302	806	0	1	02	01	H5302_806_0	3	1	01100001100101011100100001000000000000000000		1	20	20	2	2		
H5302	807	0	1	02	01	H5302_807_0	2	1	01100001100101011100100001000000000000000000		1	20	20	2	2		
H5302	808	0	1	02	01	H5302_808_0	2	1	01100001100101011100100001000000000000000000		1	20	20	2	2		
H5404	086	0	1	02	01	H5404_086_0	7	2	00100000000000001101000000000000000000000000	POS Group 2	1	0	20	2	2		
H5404	086	0	1	02	01	H5404_086_0	7	1	01011111111111110010101111000011111111111000	POS Group 2	2				1	0.00	150.00
H5404	087	0	1	02	01	H5404_087_0	8	1	01011111111111110010101111000011111111111000	POS Group 2	2				1	0.00	150.00
H5404	087	0	1	02	01	H5404_087_0	8	2	00100000000000001101000000000000000000000000	POS Group 2	1	0	20	2	2		
H5426	007	0	1	02	01	H5426_007_0	18	2	00000100000000000000000000000000000000000000	PCP Office Visit	2				1	50.00	50.00
H5426	007	0	1	02	01	H5426_007_0	18	1	01000000000000000000000000000000000000000000	Skilled Nursing Facility	2				1	0.00	150.00
H5426	007	0	1	02	01	H5426_007_0	18	3	00000000100000000000000000000000000000000000	Specialist Office Visit	2				1	100.00	100.00
H5426	008	0	1	02	01	H5426_008_0	18	1	01000000000000000000000000000000000000000000	Skilled Nursing Facility	2				1	0.00	150.00
H5426	008	0	1	02	01	H5426_008_0	18	2	00000100000000000000000000000000000000000000	PCP Office Visit	2				1	50.00	50.00
H5426	008	0	1	02	01	H5426_008_0	18	3	00000000100000000000000000000000000000000000	Specialist Office Visit	2				1	100.00	100.00
H5426	009	0	1	02	01	H5426_009_0	17	1	01000000000000000000000000000000000000000000	Skilled Nursing Facility	2				1	0.00	150.00
H5426	009	0	1	02	01	H5426_009_0	17	2	00000100000000000000000000000000000000000000	PCP Office Visit	2				1	50.00	50.00
H5426	009	0	1	02	01	H5426_009_0	17	3	00000000100000000000000000000000000000000000	Specialist Office Visit	2				1	100.00	100.00
H5598	001	0	1	39	05	H5598_001_0	6	1	00000000000000110000000000000000000000000000	Group 1	1	20	20	6	2		
H5598	001	0	1	39	05	H5598_001_0	6	3	00000000000000000000000000000000000000000010	Group 3	2				2		
H5598	001	0	1	39	05	H5598_001_0	6	2	01111111111111001111101111000001111111101101	Group 2	1	30	30	6	2		
H5604	003	0	1	02	01	H5604_003_0	3	1	11111111111111111111111111111111111111111111	All other Medicare covered services	1	20	20	6	2		
H5652	001	0	1	37	05	H5652_001_0	3	1	01111011111111111111101111000001111111101101	Group 1	1	30	30	6	2		
H5652	001	0	1	37	05	H5652_001_0	3	2	10000000000000000000000000000000000000000010	Group 2	2				2		
H5652	002	0	1	37	05	H5652_002_0	3	1	01111011111111111111101111000001111111101101	Group 1	1	30	30	6	2		
H5652	002	0	1	37	05	H5652_002_0	3	2	10000000000000000000000000000000000000000010	Group 2	2				2		
H5652	003	0	1	37	05	H5652_003_0	5	1	01111011111111111111101111000001111111101101	Group 1	1	30	30	6	2		
H5652	003	0	1	37	05	H5652_003_0	5	2	10000000000000000000000000000000000000000010	Group 2	2				2		
H5652	004	0	1	37	05	H5652_004_0	4	1	01111011111111111111101111000001111111101101	Group 1	1	30	30	6	2		
H5652	004	0	1	37	05	H5652_004_0	4	2	10000000000000000000000000000000000000000010	Group 2	2				2		
H5678	001	0	1	37	05	H5678_001_0	3	1	01111011111111111111101111000001111111101101	Group 1	1	30	30	6	2		
H5678	001	0	1	37	05	H5678_001_0	3	2	10000000000000000000000000000000000000000010	Group 2	2				2		
H5678	002	0	1	37	05	H5678_002_0	2	1	01111011111111111111101111000001111111101101	Group 1	1	30	30	6	2		
H5678	002	0	1	37	05	H5678_002_0	2	2	10000000000000000000000000000000000000000010	Group 2	2				2		
H5678	003	0	1	37	05	H5678_003_0	4	1	01111011111111111111101111000001111111101101	Group 1	1	30	30	6	2		
H5678	003	0	1	37	05	H5678_003_0	4	2	10000000000000000000000000000000000000000010	Group 2	2				2		
H5678	004	0	1	37	05	H5678_004_0	4	1	01111011111111111111101111000001111111101101	Group 1	1	30	30	6	2		
H5678	004	0	1	37	05	H5678_004_0	4	2	10000000000000000000000000000000000000000010	Group 2	2				2		
H5697	001	0	1	37	05	H5697_001_0	3	1	01111011111111111111101111000001111111101101	Group 1	1	30	30	6	2		
H5697	001	0	1	37	05	H5697_001_0	3	2	10000000000000000000000000000000000000000010	Group 2	2				2		
H5697	002	0	1	37	05	H5697_002_0	2	1	01111011111111111111101111000001111111101101	Group 1	1	30	30	6	2		
H5697	002	0	1	37	05	H5697_002_0	2	2	10000000000000000000000000000000000000000010	Group 2	2				2		
H5697	003	0	1	37	05	H5697_003_0	4	1	01111011111111111111101111000001111111101101	Group 1	1	30	30	6	2		
H5697	003	0	1	37	05	H5697_003_0	4	2	10000000000000000000000000000000000000000010	Group 2	2				2		
H5754	001	0	1	37	05	H5754_001_0	3	2	10000000000000000000000000000000000000000010	Group 2	2				2		
H5754	001	0	1	37	05	H5754_001_0	3	1	01111011111111111111101111000001111111101101	Group 1	1	30	30	6	2		
H5754	002	0	1	37	05	H5754_002_0	2	1	01111011111111111111101111000001111111101101	Group 1	1	30	30	6	2		
H5754	002	0	1	37	05	H5754_002_0	2	2	10000000000000000000000000000000000000000010	Group 2	2				2		
H5754	003	0	1	37	05	H5754_003_0	5	1	01111011111111111111101111000001111111101101	Group 1	1	30	30	6	2		
H5754	003	0	1	37	05	H5754_003_0	5	2	10000000000000000000000000000000000000000010	Group 2	2				2		
H5754	004	0	1	37	05	H5754_004_0	4	1	01111011111111111111101111000001111111101101	Group 1	1	30	30	6	2		
H5754	004	0	1	37	05	H5754_004_0	4	2	10000000000000000000000000000000000000000010	Group 2	2				2		
H5760	002	0	1	02	01	H5760_002_0	10	1	01111111111111111111001111000011111111100000		1	20	20	2	2		
H5760	003	0	1	02	01	H5760_003_0	10	1	01111111111111111111001111000011111111100000		1	20	20	2	2		
H5760	004	0	1	02	01	H5760_004_0	8	1	01111111111111111111001111000011111111100000		1	20	20	2	2		
H5760	005	0	1	02	01	H5760_005_0	10	1	01111111111111111111001111000011111111100000		1	20	20	2	2		
H5918	001	0	1	37	05	H5918_001_0	3	1	01111011111111111111101111000001111111101101	Group 1	1	30	30	6	2		
H5918	001	0	1	37	05	H5918_001_0	3	2	10000000000000000000000000000000000000000010	Group 2	2				2		
H5918	002	0	1	37	05	H5918_002_0	3	1	01111011111111111111101111000001111111101101	Group 1	1	30	30	6	2		
H5918	002	0	1	37	05	H5918_002_0	3	2	10000000000000000000000000000000000000000010	Group 2	2				2		
H5918	003	0	1	37	05	H5918_003_0	4	1	01111011111111111111101111000001111111101101	Group 1	1	30	30	6	2		
H5918	003	0	1	37	05	H5918_003_0	4	2	10000000000000000000000000000000000000000010	Group 2	2				2		
H5918	004	0	1	37	05	H5918_004_0	4	1	01111011111111111111101111000001111111101101	Group 1	1	30	30	6	2		
H5918	004	0	1	37	05	H5918_004_0	4	2	10000000000000000000000000000000000000000010	Group 2	2				2		
H6717	001	0	1	02	01	H6717_001_0	3	2	00000000000000000000000000000000000000000010	Group 2	2				2		
H6717	001	0	1	02	01	H6717_001_0	3	1	01111111111111111111111111000001111111101101	Group 1	1	30	30	6	2		
H7187	001	0	1	02	01	H7187_001_0	4	2	10000000000000000000000000000000000000000010	Group 2	2				2		
H7187	001	0	1	02	01	H7187_001_0	4	1	01111111111111111111111111000001111111101101	Group 1	1	30	30	6	2		
H7187	002	0	1	02	01	H7187_002_0	4	2	10000000000000000000000000000000000000000010	Group 2	2				2		
H7187	002	0	1	02	01	H7187_002_0	4	1	01111111111111111111111111000001111111101101	Group 1	1	30	30	6	2		
H7187	003	0	1	02	01	H7187_003_0	7	4	00010000000000000000000000000000000000000000		2				1	75.00	75.00
H7187	003	0	1	02	01	H7187_003_0	7	1	00101001000001001101001110000001011111100010		1	30	30	6	2		
H7187	003	0	1	02	01	H7187_003_0	7	2	01000000000000000000100000000000000000000000		2				1	175.00	175.00
H7187	003	0	1	02	01	H7187_003_0	7	5	00000000010010000010000000000000000000000000		2				1	35.00	45.00
H7187	003	0	1	02	01	H7187_003_0	7	6	00000100000000000000000000000000100000000000		2				1	20.00	20.00
H7187	003	0	1	02	01	H7187_003_0	7	7	00000010101100000000000000000000000000001101		2				1	35.00	35.00
H7187	003	0	1	02	01	H7187_003_0	7	8	00000000000000000000000001000000000000000000		2				2		
H7187	003	0	1	02	01	H7187_003_0	7	3	00000000000000110000000000000000000000000000		1	0	30	6	1	0.00	20.00
H7187	004	0	1	02	01	H7187_004_0	3	7	00000010101100000000000000000000000000001101		2				1	35.00	35.00
H7187	004	0	1	02	01	H7187_004_0	3	8	00000000000000000000000001000000000000000000		2				2		
H7187	004	0	1	02	01	H7187_004_0	3	6	00000100000000000000000000000000100000000000		2				1	20.00	20.00
H7187	004	0	1	02	01	H7187_004_0	3	5	00000000010010000010000000000000000000000000		2				1	35.00	45.00
H7187	004	0	1	02	01	H7187_004_0	3	4	00010000000000000000000000000000000000000000		2				1	75.00	75.00
H7187	004	0	1	02	01	H7187_004_0	3	3	00000000000000110000000000000000000000000000		1	30	30	6	1	20.00	20.00
H7187	004	0	1	02	01	H7187_004_0	3	2	01000000000000000000100000000000000000000000		2				1	175.00	175.00
H7187	004	0	1	02	01	H7187_004_0	3	1	00101001000001001101001110000001011111100010		1	30	30	6	2		
H7254	001	0	1	02	01	H7254_001_0	4	1	01111111111111111111111111000001111111101101	Group 1	1	30	30	6	2		
H7254	001	0	1	02	01	H7254_001_0	4	2	10000000000000000000000000000000000000000010	Group 2	2				2		
H7254	002	0	1	02	01	H7254_002_0	4	1	01111111111111111111111111000001111111101101	Group 1	1	30	30	6	2		
H7254	002	0	1	02	01	H7254_002_0	4	2	10000000000000000000000000000000000000000010	Group 2	2				2		
H7274	001	0	1	39	05	H7274_001_0	8	1	00000000000000110000000000000000000000000000	Group 1	1	20	20	6	2		
H7274	001	0	1	39	05	H7274_001_0	8	2	01111111111111001111101111000001111111101101	Group 2	1	30	30	6	2		
H7274	001	0	1	39	05	H7274_001_0	8	3	00000000000000000000000000000000000000000010	Group 3	2				2		
H8000	001	0	1	39	05	H8000_001_0	7	1	00000000000000110000000000000000000000000000	Group 1	1	20	20	6	2		
H8000	001	0	1	39	05	H8000_001_0	7	3	00000000000000000000000000000000000000000010	Group 3	2				2		
H8000	001	0	1	39	05	H8000_001_0	7	2	01111111111111001111101111000001111111101101	Group 2	1	30	30	6	2		
H9047	024	0	1	02	01	H9047_024_0	9	1	01111111111111111111101111010011111111101111	POS	1	20	20	6	2		
H9047	035	0	1	02	01	H9047_035_0	6	1	01111111111111111111101111010011111111101111	POS	1	20	20	6	2		
H9313	002	0	1	02	01	H9313_002_0	2	1	11111111111111111111111111111111111111111111		1	20	20	2	2		
H9313	003	0	1	02	01	H9313_003_0	2	1	11111111111111111111111111111111111111111111		1	20	20	2	2		
H9313	801	0	1	02	01	H9313_801_0	1	1	11111111111111111111111111111111111111111111		1	40	40	2	2		
H9313	802	0	1	02	01	H9313_802_0	1	1	11111111111111111111111111111111111111111111		1	40	40	2	2		
H9418	001	0	1	02	01	H9418_001_0	4	2	00000000000000000000000000000000000000000010		2				2		
H9418	001	0	1	02	01	H9418_001_0	4	1	01111111111111111111111111000001111111101101		1	30	30	6	2		
H9418	002	0	1	02	01	H9418_002_0	6	2	10000000000000000000000000000000000000011010	Group 2	2				2		
H9418	002	0	1	02	01	H9418_002_0	6	1	01111111111111111111111111000001111111101101	Group 1	1	30	30	6	2		
